Report Title:

Medical Safety

 

Description:

Protects nurses and other health care workers from needlestick and other sharps-related injuries.

 

HOUSE OF REPRESENTATIVES

H.B. NO.

790

TWENTY-FIRST LEGISLATURE, 2001

  

STATE OF HAWAII

  

 

A BILL FOR AN ACT

 

relating to health care worker injury prevention.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that health care workers are in danger of contracting serious and even fatal diseases as a result of being stuck by needles or getting cut from other contaminated sharp instruments. It has been estimated by the Centers for Disease Control (CDC) that six hundred thousand to one million needlesticks occur each year in health care facilities. Studies indicate that nurses sustain the majority of these injuries.

There are at least twenty bloodborne pathogens that can be transmitted by needlesticks, including HIV, hepatitis B, and hepatitis C. Despite improvements in the treatment of HIV, most health care workers who become infected eventually develop AIDS. In addition to the health effects from needlesticks and other injuries, there are psychological and other adverse consequences.

The CDC estimates that between sixty-two to eighty-eight per cent of needlestick injuries can potentially be prevented by the use of safer medical devices. Needlestick and other sharps-related injuries that can cause occupational bloodborne pathogens exposure remain an important public health concern.

The purpose of this Act is to protect nurses and other health care workers from needlestick and other sharps-related injuries, notwithstanding the enactment of the Needlestick Safety and Prevention Act that amended the Occupational Safety and Health Administration's 1991 blood-borne pathogens standard. This Act will require the State to:

(1) Develop a written exposure control plan that is updated regularly;

(2) Require the evaluation and use of safer medical devices (engineering controls);

(3) Ensure that front-line health care workers participate in the evaluation and selection of safer medical devices, and

(4) Require that all exposure incidents be recorded in a sharps injury log.

SECTION 2. Chapter 325, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and to read as follows:

"PART . NEEDLESTICK INJURY PREVENTION

§325- Definitions. As used in this part, unless the context otherwise requires:

"Advisory committee" means the needlestick injury prevention advisory committee established in section 325- .

"Director" means the director of health.

"Engineering controls" means sharps prevention technology including but not limited to systems not using needles and needles with engineered sharp injury protection.

"Facility" means every hospital, nursing home, home health agencies licensed by the State, including all hospitals operated by the State or any agency of the State.

"Health care worker" means any person working in a facility.

"Needleless system" means a device that does not use needles for:

(1) The withdrawal of body fluids after initial venous or arterial access is established;

(2) The administration of medication or fluids; or

(3) Any other procedure involving the potential for an exposure incident.

"Needlestick injury" means the parenteral introduction into the body of a health care worker of blood or other potentially infectious material by a hollow-bore needle or sharp instrument, including but not limited to needles, lancets, scalpels, and contaminated broken glass.

§325- Needlestick injury prevention rules. The department of health shall require the use of devices that minimize the risk of needlestick injuries to health care workers. The director shall, with the advice and cooperation of the advisory committee, adopt rules in accordance with chapter 91 to minimize the risk of needlestick injuries to health care workers.

(b) At a minimum, the rules shall be as prescriptive as the most recent standards adopted by the federal Occupational Safety and Health Administration and shall include the following:

(1) A requirement that facilities use needleless systems or other engineering controls designed to prevent needlestick injuries, except in cases where the facility can demonstrate circumstances in which the technology does not promote employee or patient safety or interferes with a medical procedure. Those circumstances shall be specified by the facility and shall include but not be limited to circumstances where the technology is:

(A) Not medically contraindicated; or

(B) Not more effective than alternative measures used by the facility to prevent exposure incidents;

(2) A requirement that information concerning exposure incidents be recorded in a sharps injury log, to be kept within the facility and reported annually to the director. Information recorded in the log shall contain, at a minimum:

(A) The date and time of the exposure incident;

(B) The type and brand of sharp object involved in the exposure incident; and

(C) A description of the exposure incident that includes:

(i) The job classification of the exposed worker;

(ii) The department or work area where the exposure incident occurred;

(iii) The procedure that the exposed worker was performing at the time of the incident;

(iv) How the incident occurred;

(v) The body part involved in the exposure incident;

(vi) If the sharp had engineered sharps injury protection, whether the protective mechanism was activated, during activation of the mechanism or after activation of the mechanism, if applicable, and

(vii) Any suggestions by the injured employee as to whether or how protective mechanisms or work practice control could be used to prevent such injuries;

(3) A provision for maintaining a list of existing needleless systems, needles and sharps injury protections. The director shall make the list available to assist employers in complying with the requirements of the needleless systems and sharp object protections rules adopted with this section. This list may be developed from existing sources of information, including, the federal Occupational Safety and Health Administration, the National Institute of Occupational Safety and Health, and the federal Centers for Disease Control; and

(4) Ensuring that all front-line health care workers are trained on the use of all engineering controls before they are introduced into the clinical setting.

§325- Needlestick injury prevention advisory committee; establishment. (a) There is established the needlestick injury prevention advisory committee to advise the director in the development of rules required under this part.

(b) The advisory committee shall meet at least four times a year for the initial two years after the effective date of this Act and on the call of the director thereafter. The director shall serve as the chair and shall appoint eleven members, one representing each of the following groups:

(1) Five nurses who work primarily providing direct patient care in a hospital or nursing home, at least two of which are employed in a state operated facility;

(2) A licensed physician practicing in the State;

(3) Two administrators of different hospitals operating within the state;

(4) A director of nursing employed in a hospital within the State;

(5) A phlebotomist employed in a hospital in the State;

(6) A faculty member from a university nursing program in the State.

(c) Members of the committee shall serve without compensation, but shall be reimbursed for actual and necessary expenses incurred in the discharge of their official duties.

(d) A majority of all members shall constitute a quorum for the transaction of all business.

(e) Each member shall serve a two-year term and may not serve more than two consecutive terms."

SECTION 3. The director of health shall adopt rules to minimize the risk of needlestick injuries to health care workers no later than six months from the effective date of this Act.

SECTION 4. This Act shall take effect upon its approval.

INTRODUCED BY:

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