Authors (including presenting author) :
Tang OS(1), Wong CS(1), Kwok KW(1), Wong YH(1)
Affiliation :
1Operating Room, United Christian Hospital, Hong Kong
Introduction :
All instrument trays would be sent to Central Sterile Services Department (CSSD) for sterilisation processing after every operation. However, 7 incidences of postoperative sharps retention when transferring to CSSD had been reported cases in 2018. The total number of incidents were 19 cases from 2018 to 2021. It might pose an increased risk of sharps injury whenever a needle or other sharp device is exposed. It was reported an average of 5 cases per year since 2019 despite the use of yellow kidney dish which is used to receive and gather all disposable sharps for disposal after the procedure. Thus, sufficient preventive measure must be in place to reduce the risk of occupational exposure to infections from sharps injury.
Objectives :
(1) To reduce the incidence rate of postoperative retained disposable sharps transferring to Central Sterile Services Department (CSSD) by at least 50%; (2) To implement the standardised workflow for sharps disposal; (3) To improve self management on sharps disposal; and (4) to enhance staff’s awareness and promote safety culture by changing work practice.
Methodology :
(1) A workgroup was formed in Aug 2020 to identify risk factors for implementation of strategies. (2) “3D on Sharps Disposal” (“Drop off sharps in yellow kidney dish”, “Dispose of all sharps” and “Double check all open containers”) strategies were launched to integrate safer habit into daily practice . (3) Training workshop on changing behaviour practice of sharps disposal had been held to arouse the staff’s awareness on safety culture. (4) Promotional activities including video broadcasting in scrubbing areas, poster displaying near dirty corridor and catchy slogans enhancing sharps disposal were conducted. (5) The reminder chop was printed on the voucher of each case. Circulating nurse will put a confirmation tick on the voucher after checking all open containers are cleared. (6) Behavioural reinforcement: specialty team leaders were participated to monitor the compliance. Regular audits were essential to evaluate the workflow and compliance. Spot checks for improvement was conducted. (7) Reviewed working process in Nov 2021: identified the difficulties encountered, collected feedback, then revised to 2nd edition and enforced the practice.
Result & Outcome :
Following 3 easy steps, the retained sharps transferring to CSSD after operation was significantly decreased by 60% in 2022 compared with 2018. The overall compliance rate had reached over 95%. Further to the remarkable decrease of retained sharps cases, most of the frontline staff had a positive response to departmental commitment and communication to build a safety culture. Regular monitoring staff behaviors on sharps disposal and usage of yellow kidney dish would be substained.
