Report Title:
Health Care Workers; Needlestick Injury Prevention
Description:
Requires director of health, in conjunction with a special advisory committee, to propose rules to minimize the risk of needlestick injuries to health care workers.
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THE SENATE |
S.B. NO. |
61 |
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TWENTY-FIRST LEGISLATURE, 2001 |
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STATE OF HAWAII |
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A BILL FOR AN ACT
RELATING TO NEEDLESTICK 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 or even fatal diseases as a result of being stuck by needles or cut by other contaminated sharp instruments. It has been estimated by the centers for disease control and prevention that between six hundred thousand and one million needlestick injuries occur each year in health care settings. A variety of health care workers are at risk, but studies show that nurses sustain a 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 with it will eventually develop AIDS. In addition to the health effects that can result from needlesticks and other injuries, there are also psychological and other adverse consequences.
The Centers for Disease Control estimate that between sixty-two and eighty-eight per cent of sharps injuries can potentially be prevented by the use of safer medical devices. Needlestick and other sharps-related injuries, which can cause occupational bloodborne pathogens exposure, remain an important public health concern.
Although the United States Congress recently passed the Needlestick Safety and Prevention Act amending the 1991 standard set by the occupational safety and health administration, there is a need for the State to implement legislation to fully protect nurses and other health care workers from needlestick injuries.
The purposes of this Act are to: (1) develop a written sharps exposure control plan that is regularly updated; (2) require the evaluation and use of safer medical devices (engineering controls); (3) ensure front-line health care worker participation in the evaluation and selection of safer medical devices; and (4) record all exposure incidents in a sharps injury log.
SECTION 2. Chapter 321, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and to read as follows:
"PART . NEEDLESTICK INJURY PREVENTION
§321- Definitions. As used in this part:
"Director" means the director of health.
"Engineering controls" means sharps prevention technology, including systems not using needles and needles with engineered sharps injury protection.
"Exposure incident" means a specific eye, mouth, other mucous membrane, nonintact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of an employee's duties.
"Facility" means every hospital, nursing home, and 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 utilize needles for the withdrawal of bodily fluids after initial venous or arterial access is established, for the administration of medication or fluids, or for 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 needles, lancets, scalpels and contaminated broken glass.
"Sharps" means any object that can penetrate the skin, including needles, scalpels, broken glass, broken capillary tubes, and exposed ends of dental wires.
§321- Needlestick injury prevention rules. (a) The director, with the advice and cooperation of the advisory committee established in section 321- , shall propose rules under chapter 91 to minimize the risk of needlestick injuries to health care workers no later than six months from the effective date of this Act.
(b) The rules shall be at least as prescriptive as the most recent standards adopted by the federal Occupational Safety and Health Administration and shall include at least the following:
(1) A requirement that facilities utilize needleless systems or other engineering controls designed to prevent needlestick or sharps 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 circumstances where the technology is not medically contraindicated or 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 at the facility and reported annually to the director. Information kept in the log shall include, 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 object had engineered sharps injury protection, whether the protective mechanism was activated, and whether the incident occurred 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 and needles and sharps injuries 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 in accordance 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 Prevention.
(4) Provisions to ensure that all front-line health care workers are trained in the use of all engineering controls before they are introduced into a clinical setting.
§321- Needlestick injury prevention advisory committee. (a) There is established a needlestick injury prevention advisory committee to advise the director regarding the development of rules required under this part.
(b) The 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, as follows:
(1) Five nurses who work primarily providing direct patient care in a hospital or nursing home, at least two of whom 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 at a hospital within the State;
(5) A phlebotomist employed in a hospital in the State; and
(6) A faculty member from a university nursing program in the State.
(c) Members of the committee shall serve without compensation; provided that each member shall be reimbursed for actual and necessary expenses incurred for each day or portion thereof engaged in the discharge of official duties.
(d) A majority of all members constitutes a quorum for the transaction of business.
(e) Members shall serve two-year terms and may not serve more than two consecutive terms."
SECTION 3. This Act shall take effect upon its approval.
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INTRODUCED BY: |
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