Welcome to the ISIPS Newsletter April 27, 2018
Needlestick & Sharps Injuries
Pfizer Selects Needle-Trap Labels for Biosimilar
Innovative Guard Helps Prevent Needlestick Injuries
Medisystems Announces US Release of MasterGuard® Plus
Kamloops father being stonewalled by Interior Health after son pricked by needle
Working Safely with Sharps
TIPS FOR AVOIDING NEEDLE STICK INJURIES The Occupational Safety and Health Administration (OSHA ) standard for bloodborne pathogens requires that any employee exposed to blood, or other potentially infectious materials (OPIM), follow proper safety precautions when working with needles and other possible contaminated sharps as part of their job duty. A needle stick or cut from a contaminated sharp is one of the easiest ways health care workers expose themselves to potentially dangerous bloodborne illness, like hepatitis or HIV. Fortunately, most sharps accidents are preventable with the use of proper engineering controls, safe work practices, and personal protective clothing and equipment. HANDLING, STORAGE AND DISPOSAL 
Minimising the risk of needlestick injuries in vaccination
A few tips to help minimise the risk of needlestick injuries, we have written these for Pharmacists who do not vaccinate regularly or who maybe have become complacent – it’s all too easy to sustain a needlestick injury so we hope these help
Sharps Injury Prevention
The advent of these specialty devices provided protection against unintended needle sticks, one of EMS providers' greatest risks
When AIDS, hepatitis and other bloodborne pathogens emerged in the 80s as invisible killers, dirty needles were widely considered one of EMS providers' greatest risks.
 
Through the mid-‘90s, disease prevention consisted mainly of personal protective equipment and annual classes on how not to get infected. The curriculum justifiably portrayed uncapped needles as accidents waiting to happen; students were urged to deposit used sharps in suitable containers.
Protecting Patients with VanishPoint Retractable Syringes
Needlesticks are not just the fear of 4-year-olds receiving their vaccinations; they are also the source of blood-borne infections afflicting millions of healthcare practitioners. When a conventional needle is left exposed after use on a patient, it can accidentally stick another person, such as a healthcare worker. The accidental needlestick can infect that person if the patient had any blood-borne diseases. Recent estimates place the number of needlestick injuries in the United States at more than 300,000 per year, with infection by HIV or Hepatitis as possible consequences. The spring-retractable syringe, VanishPoint, was created to prevent needlestick injuries and ameliorate other unsafe injection practices.
VanishPoint Blood Collection Set
The VanishPoint Blood Collection Set, from Retractable Technologies, Inc., features automated in-vein retraction that effectively reduces the risk of needlestick injuries and blood exposure.  The safety mechanism is activated by depressing a retraction trigger that is located near the finger-grip area.  This allows for easy one-handed activation, without changes in hand position, while reducing the risk of inadvertent activation.  The needle is retracted directly from the patient, virtually eliminating exposure to the contaminated needle.
Needlestick Injury Caught on Camera
How fast life can change. Training in a safe simulated environment can prevent these injuries
HIV
HIV/AIDS cases nearly doubled in Ventura County
Huntington Station Named A 'Hot Spot' Area For HIV
Lives on the Line: The Human Impact of Proposed Cuts to Global HIV Funding
Hospital warns an unknown number of people may be at risk of HIV after a ‘significant’ sterilization breach
The Colorado Department of Public Health and Environment is working with Porter Adventist Hospital, which is notifying people who had orthopedic or spine surgery there between July 21, 2016 and Feb. 20, 2018. The notification is about an infection control breach that may have put some orthopedic or spine surgery patients at risk for surgical site infections or for hepatitis B, hepatitis C or HIV. The process for cleaning surgical instruments following orthopedic and spine surgeries was found to be inadequate, which may have compromised the sterilization of the instruments.
San Antonio sets high goal for people to get HIV test in April
City officials and health groups call attention to the problem of people with AIDS who are not diagnosed.
CVS Sued for Exposing HIV Status of 6,000 Patients in Mailing
A federal lawsuit has been filed against CVS Health for exposing the HIV status of at least 6,000 patients through the transparent window on envelopes that were sent in the mail. The privacy breach took place in Ohio.
125 people in Milwaukee have tested positive for HIV and syphilis
At least 125 people in Milwaukee, Wisconsin, have tested positive for HIV, syphilis or both in one of the largest sexually transmitted infection 'clusters
Nurse Jailed Over Blood Tainted Cannula Speaks Out
Rosemary Namubiru, a nurse who was accused of injecting a two-year-old baby with HIV-tainted cannula in 2014 at Victoria Medical Center, yesterday narrated her experience to a conference of lawyers and journalists in Johannesburg, South Africa. With a shaky voice, Namubiru narrated that when she turned 60, she retired from her position as a pediatric nurse from a hospital in Kenya, and was given a warm sendoff back home to Uganda. Five months down the road, in 2014, Namubiru said she missed her profession. She took a job at a private clinic, a decision that led her to jail four years later. 
Man with HIV arrested for spitting on first responder
A Louisville man infected with HIV was arrested after spitting bloody mucus in an emergency responder's face and eyes. Roy Harraway, 28, was arrested Saturday on charges of wanton endangerment and assault.
Woman Found Guilty of Biting Gates Police Officer
The investigator said Robinson became physically combative when he tried to arrest her. After she was placed in a holding cell, officers tried to handcuff her to a section inside the cell to calm her down. That's when Robinson bit the officers. Robinson then yelled she was infected with HIV and hoped the investigator would get infected.
Importance of Sharps Safety
The dangers and hazards of needle stick injuries. 
Why should Sharps Safety be a priority for any medical institute or clinical personnel. 
Innovative Guard Helps Prevent Needlestick Injuries
The NxStage Medical (Lawrence, MA, USA) MasterGuard Plus needles are designed with a patented FingerShield anchor that provides a barrier between the pressure-holding fingers and the sharp tip of the needle. During needle retraction, flexible wings with interlocking grips are drawn backwards into the jaw; the small jaw and rigid base of the MasterGuard plus align the needle into the center of the guard. Once the needle is fully retracted, an audible click is heard, signifying that the needle is locked in a steep rear angle that prevents accessibility.
HEPATITIS
Ohio Health Dept. reports 840 percent increase in Hepatitis A cases
Arby’s employee ID’d with hepatitis A in Sellersburg, Ind.
5th Hepatitis Case Confirmed In Montgomery Co.
Two Deaths Reported From Hepatitis A, But Officials Say Epidemic May Be Waning
Officials with the Salt Lake County Health Department announced two deaths from hepatitis A this week. They mark the first two fatalities in a months-long outbreak of the disease, but experts say the epidemic is starting to recede.
 
Both individuals who died were residents of Salt Lake County, in what health officials considered ‘high-risk groups’ — homeless individuals, people using intravenous drugs and those who were recently incarcerated. According to Salt Lake County Medical Director Dagmar Vitek, this population is especially vulnerable because they frequently have other health issues that can cause the disease to be fatal.
Hepatitis C - Why every kidney patient should be tested
There is a connection between hepatitis C and kidney disease. hepatitis C can cause kidney disease, and sometimes kidney patients can get hepatitis C ...
 
Mobile unit testing people for HIV, Hep C in southern Indiana
Southern Indiana health officials are trying to stop the spread of HIV and Hepatitis C. 
100,000th Veteran treated by VA for Hepatitis C
Through innovative systems redesign, dedicated providers and engaged Veterans, VA recently began treatment for its 100,000th Veteran with hepatitis C (HCV). New highly effective medications are easy to take and cure hepatitis C in 95 percent of Veterans who take them – a huge improvement from past treatments.
 
On the ground, teams of providers and staff have worked to develop ways to get the word out over the past three years; new HCV treatments work, and most Veterans in VA care have answered “yes.”
WEST NILE
Let’s work on being less attractive (to blood-thirsty mosquitos)
What is hantavirus?
Could there be a human vaccine for the West Nile virus?
West Nile virus reemerged and spread to new areas in Greece in 2017, researchers show
ZIKA VIRUS
Purified Zika virus tested in mice obliterates 2 types of brain tumors
What is the Zika virus? What you need to know
Employing Zika as a Cancer Killing Tool
Another mosquito species may carry Zika
Are Zika and toxoplasmosis related?
Zika virus eliminates advanced human tumor in central nervous system of rodents
In test with mice, Zika virus eliminates human brain tumor common in children
Zika virus wipes out two types of brain tumors in mice
'Breakthrough' in mosquito-packed drones to combat Zika in Brazil
Novel therapy stops Zika in pregnant monkeys but not their fetuses, UM scientists say
IN THE NEWS
ADDRESSING THE STICKING POINT OF NEEDLE & SHARPS INJURIES

Despite it being nearly 20 years since the signing of the Needlestick Safety and Prevention Act (NSPA) into law, about 385,000 sharps-related injuries occur annually among healthcare workers in hospitals, according to the Centers for Disease Control and Prevention. Accidental needlesticks can expose clinicians to various diseases, such as HIV, hepatitis, diphtheria, herpes, malaria and tuberculosis. Nurses who handle dirty linens and waste containers are at particular risk of these injuries and are encouraged to advocate for the institution of safety measures in workplaces where there is occupational exposure to blood or other potentially infectious materials, as expressed by the NSPA. Even when safety measures are instituted, nurses can never be too careful about taking precautions on a daily basis, say nurses who recently spoke with ADVANCE.

Cindy Rothenberger, DNP, RN, ACNS-BC, an assistant professor of nursing at Alvernia University in Reading, PA, warns nurses in particular about the potential to become lackadaisical about needle handling and disposal to the point that poor habits develop.

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SYRINGE SAFETY
Used syringes can pose a health hazard to the community. Council provides a range of services to assist you with the safe disposal of used syringes. 
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ADVANCES IN INTERNAL BONE FIXATION - SHARPS SAFETY FOR ORTHOPEDIC SURGEONS II
The demand for hip revision procedures is projected to double by the year 2026.(2) As patients live longer and as the number of hip replacement and revision arthroplasty procedures increases, so does the prevalence of periprosthetic fractures. The difficulty in treating periprosthetic fractures following total hip arthroplasty is evidenced by the numerous treatment modalities and techniques available. There is no ideal treatment that is appropriate for all hip fractures.
 
During hip replacement and treatment of associated peri-prosthetic fractures, it is often necessary to hold the bone or fragments of bone together to create a stable environment for healing to occur. This is typically done with metal wires or cables using a technique called cerclage (ser-klahzh). A cerclage wire or cable is wound around a bone or bony fragments to hold them together to allow them to heal. Wire cerclage is one of the oldest forms of internal fixation. Cerclage has numerous applications in orthopedics as a primary method of fracture fixation and as a supplement to other forms of fixation. During hip replacement and hip revision surgeries and other times when the bone is resected or fractured, the bone fragments often require additional support. During situations like these, cerclage wires provide an opportunity for the bony pieces to unite again. For example, in a patella fracture, normal knee forces tend to pull the bony fragments apart unless they are held together by cerclage techniques.
 
Although wire cerclage has had numerous applications in orthopedics as a primary method of fracture fixation, it also has several disadvantages. Monofilament wires are prone to breakage.(3) Multi-filament cables are subject to fatigue and fraying, releasing metallic particulate debris into the body.(4,5,6) Problems associated with metal cerclage wires and cables include:
  • broken metal wires or cables;
  • interruption of the blood supply to the bone;
  • fraying and fretting.
Sometimes a broken fragment of a cerclage wire or cable can separate unintentionally and cause iatrogenic injury to the patient. Patients may not even be aware that this has occurred. The Center for Devices and Radiological Health (CDRH) at FDA receives nearly 1,000 adverse event reports each year related to unretrieved device fragments within the human body.
 
One of the problems with metal debris migration near a hip replacement is that the metallic debris can intrude into the bearing surface of the hip replacement. Exposure of metallic debris to the bearing surface can cause accelerated wear of the bearing surface and lead to premature failure of the hip replacement.
 
In addition, the medical literature contains several “horror-stories” that detail complications caused by broken metal cerclage wires. One notable case deals with a fragment of a broken metal cerclage wire that was found in the right ventricle of a patient who was treated 13 years previously for a patella fracture using cerclage wire. Imaging confirmed that part of the cerclage wire had broken off and had migrated into his heart.
 
In another case, a 37-year-old man was evaluated for acute onset of sharp chest pain.  His medical history indicated that he had experienced a joint dislocation of the right shoulder from a football injury that had been treated operatively with metal cerclage wire. Imaging confirmed a broken metal cerclage wire around the distal clavicle and a 1 cm segment of the broken wire in the myocardium of the right ventricle.
 
more next week
 
VANISHPOINT® BLOOD COLLECTION TUBE HOLDER
  • Automated retraction is activated by securely closing end cap while needle is still in patient's vein

  • Once activated, needle is automatically retracted from patient, virtually eliminating exposure

  • Single use holder protects users from both ends of contaminated blood collection needles

  • Utilizes conventional multiple sample blood collection needles and prevents cross contamination

  • Capable of multi-tube blood draws

  • Small diameter tube adapter available for use with small diameter tubes

 

OUCH! MANAGING SHARPS INJURIES TO AVOID INFECTION
Dermatology providers should be aware of how to manage sharps and/or needlestick injuries
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SCALPELS
A permanent lock position has been added to the retracted position. This requires a conscious amount of force to engage the slider into the permanent lock position
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TUNGSTEN SYRINGE SHIELD FOR TECHNETIUM-99M
Tungsten syringe shield designed for Technetium-99m use. This syringe shield has 2 mm tungsten shielding to provide 99.9% attenuation of Tc-99m to assure hand and finger dose protection. The tungsten syringe shield has a lead glass viewing window with a lead equivalency of 2 mm for accuracy and assurance. This tungsten syring shield design has an easy-to-operate syringe holding clip to keep the syringe in place while injecting the patient and while withdrawing the Tc-99m from the elution vial shield. The design of this syringe shield has an ergonomic grip to minimize the potential of spillage and optimize handling time. 
 
This tungsten syringe shield has been designed for the new legislation which requires the use of safe syringes with safety covers to prevent needlestick injuries. These safety cover needles have different.
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CLICKZIP SAFETY SRYINGE
Clickzip
The ClickZip™ Needle Retractable Safety Syringe is a new and globally patented Swiss technology active, high-quality needle with a retraction mechanism, thus preventing needlestick injury and syringe reuse.The ClickZip™ Needle Retractable Safety Syringe is simple to operate, which is why the technology is so valuable. Minimal or no extra training is required to use this product. Please view below the simple four step process of DRAW, INJECT, ZIP, SNAP.
 
The ClickZip™ Needle Retractable Safety Syringe is simple to operate which is why the technology is so valuable. Minimal or no extra training is required to use this product.
 
Using the ClickZip syringe is easy - a simple four step process of DRAW, INJECT, ZIP, SNAP.
 
Step 1: Shown is the ClickZip™ as it is packaged. Make sure the needle is fixed tight and then use the standard aseptic technique to DRAW out the medication and fill the syringe.

 
Step 2: INJECT the medication by fully depressing the plunger to the end of the syringe barrel to engage the locking mechanism. The user should be able to feel and hear a ‘CLICK’.

 
Step 3: ZIP the plunger back to retract the needle safely back into the barrel. The needle will tilt to one side and prevent the needle being able to be pushed out again, preventing reuse or needlestick injury.

 
Step 4: SNAP off the plunger at the breaking point. ClickZip™ is now disabled and cannot be reused. Discard the complete unit as per regulations require.

With less waste, a safer mechanism, and no need for special sharps disposal units, and the potential for needle reuse or needlestick injury greatly reduced, long term and other immediate costs are significantly lowered, and safety and health benefits for health workers, patients and the community as a whole are significantly increased.

 
PROPER SHARPS MANAGEMENT IN SENIOR LIVING HELPS REDUCE RISK FOR NEEDLE STICK INJURIES
Many residents come into a senior living facility without a proper understanding of sharps management, increasing the risk for staff injury.
 
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Built-in safety mechanism is activated by fully depressing plunger while needle is still in patient 
 
Once activated, needle is automatically retracted from patient, virtually eliminating exposure
 
One-handed activation 
 
Requires minimal training
 
Non-reusable
 
Safe, efficient disposal
 
Color coded for gauge size
 
1cc, 3cc, 5cc, and 10cc syringe sizes available, in a variety of needle gauges and lengths.
DOCUMENT ANNUAL SAFER SHARPS EVALUATION
OSHA’s Bloodborne Pathogen Standard, 29 CFR 1910.1030, applies to all occupational exposure to blood or other potentially infections material as defined in the standard. Employers that have covered employees are required to develop and implement an Exposure Control Plan to minimize employee exposure. One of the elements that must be included in the Exposure Control Plan is to document annual consideration and implementation of safer medical devices. If you have employees working with human source material and sharps, be sure to solicit input from the end users on a regular basis to determine if they are aware of any safer sharps options that would reduce their potential for an incident resulting in exposure. 
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OUR CORPORATE MEMBERS
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