11 Work practice controls minimize the risk of exposure to blood and other potentially infectious materials by changing the method of performing a task.11, 21 and 22 Administrative

controls include developing policies and procedures and providing education and training on prevention of bloodborne pathogen exposure. Health care facilities must have a bloodborne pathogens exposure control plan, as required by OSHA.11 The exposure control plan is a component of administrative controls, which are important Selleckchem C59 wnt to the success of a sharps safety program. The plan must include an exposure determination for employees who have the potential to be exposed to blood and body fluids; a plan to reduce sharps injuries, including prioritized risk-reduction strategies; and a process to monitor sharps injury data. The plan must be reviewed and updated at least annually and any time new practices are implemented. Ensuring compliance with the exposure control plan and related policies is important

to show commitment to prevention of sharps injuries. Administrators and managers, in collaboration with occupational health and infection prevention practitioners, can develop the exposure control plan. Frontline personnel, including perioperative RNs and surgeons, should be involved in identifying control methods to prevent sharps injuries by using the hierarchy of controls to prioritize prevention interventions (Figure 1).23 At the top of the hierarchy (ie, the most effective strategy) is eliminating the hazard by completely removing it from use. Eliminating Fluorouracil purchase the hazard (eg, a sharp item or instrument) involves identifying alternative ways to perform the necessary task without using sharps, such as by Adenosine using a tissue adhesive and adhesive strips

or a skin stapler to close a skin incision. A systematic review of 14 randomized controlled trials that evaluated surgical wound healing when tissue adhesives were used for skin closure showed there was no significant difference in infection rates, patient and user satisfaction, or cost between use of sutures and use of adhesives.24 Therefore, when clinically indicated, it could be appropriate to use adhesives in place of suture to help prevent needlestick injuries. The highest priority should be eliminating the device that has the potential to cause the most injuries.5 If eliminating use of the device is not feasible, controls at lower levels of the hierarchy should be considered, such as using engineering controls, work practice controls, administrative controls, and PPE.23 When elimination of sharps is not feasible, perioperative team members must use sharps with safety-engineered devices that “isolate or remove the risk of bloodborne pathogen exposure.