Playing It Safe With Sharps
One nurse's perspective on some of the most impactful ways to avoid sharps injuries and
improve safety in the operating room.
Surgical Products talked with Bryan Webb, RN, about sharps injuries, their consequences, and what can be done to limit incidents and
improve staff and patient safety. process.
SP: Generally speaking, how
prevalent are sharps injuries in
the OR today? Is this an issue
you believe is on the rise or on
Webb: First of all, it happens a lot. Available
information is being gathered, but when we
talk about reporting needle sticks and sharps
injuries, many aren't reported. It’s happening on
a daily basis in every facility, in a lot of different
departments, and the OR is being impacted a lot
more because we’re around so many sharp pieces of equipment and patients.
It’s jumping up a lot. You have to realize as the population gets larger and
more people need surgery, the more opportunity there is for exposure. But on
a daily basis, it is happening all the time.
Before I was double-gloving, oftentimes I’d take my gloves off and see blood
on my hands. I would not know if I stuck myself and didn’t feel it or there was a
micro-hole in my glove. However, I’d see blood on my hands after a surgical case.
So I know it’s happening from personal experience, and certainly it’s increasing.
Bryan Webb, RN
SP: What are some of the misconceptions out there
that are putting hospital personnel at risk?
Webb: There are a lot of things that can contribute to it. Single-gloving versus double-gloving is one of the most important factors. Even for me, I wasn’t
strongly aware about double-gloving until truly a few years ago. I think there
are so many people that are so resistant to doing that and making that change,
that they are missing out on the vital piece of safety equipment. There are also
other factors that come into play, especially with the cost of staff and having to
use employees for more than eight hours. Fatigue has to be considered The less
attentive you are to minute details, the more you get tired. When you start talking about handling needles and knife blades when you are tired, the chances do
SP: What are some of the obvious and not-so-obvi-
ous consequences of these injuries?
Webb: There’s a lot of talk about HIV and hepatitis because that’s a serious
issue with a lot of patients. I think people presume if they have a hepatitis C vaccination they’ve been vaccinated for it. Well, the problem with that is it doesn’t
always take in some people, and there is a definite need for occasional boosters.
So people think they have immunity, but they don’t.
Also, people make assumptions about patients just by looking at them. They
think nothing is wrong just because it looks like nothing is wrong. That person
could potentially have something.
As healthcare workers, we rely on the data we receive about a patient.
However, that doesn’t necessarily mean it is true. Unfortunately, some people
aren’t honest and they don’t tell us they are infected, or they don’t know they are
infected. They look healthy, act healthy, and don’t think anything’s going wrong.
We presume they are fine, but something is underlying and we just don’t know.
SP: You mentioned double-gloving as one way to
prevent or limit the chances of these types of injuries.
What are some other good measures to keep in mind?
Webb: What I’ve found to be very helpful is to create a neutral zone. A hospital I used to work at provided us disposable towels that were white instead
of blue. Anything that was loaded and sharp, they had to stay on the white
portion. so there was always constant awareness of exactly where the sharps
were. That way we didn’t make those types of mistakes.
I’ve also seen places that use a small emesis basin, and the knife or suture is
set in there. It’s then handed over to the surgeon, who reaches in and takes it
out himself or herself.
There are great ideas out there, and regardless of whatever ones you are
choosing, doing something to make people be more aware of what they are
doing, is extremely helpful.
SP: What’s holding some facilities and staff back
from embracing more effective methods?
Webb: I think a lot of different things can come into play here. There’s staff
education, and there’s also enforcement.
I think one of the most impactful ways to get the staff is to tell or show
them how easy it is to contract something if you are
exposed, and why it’s so
important to take measures
to avoid it. Education is
huge, as is having staff members onboard and willing to
enforce the rules. That can
When we talk about
double-gloving, that’s an
Unfortunately, we don’t see
a lot of facilities enforce that
as a rule in the operating
room. Part of this is the old adage, “This is the way I’ve always done it.” But
when we talk to people who have been around for awhile who are used to
wearing one pair of gloves, they don’t want to make a change. They may not
like the way it feels, or it’s too thick, or they suddenly can’t sense anything
with their fingertips. They come up with reasons why it isn’t effective for
them, even if those reasons can be disproven.
It’s just about resistance. And I think people resist because they don’t want
it to affect what they do.