OVERVIEW

Scalpel Injuries are a major source of bloodborne pathogen exposure in the OR

It has been estimated by the Centers of Disease Control that approximately 385,000 sharps injuries occur each year to hospital employees. More than half of these sharps injuries are not reported. There are a variety of factors leading to these sharps injuries including: Fatigue, rushing, inaccurately anticipating a surgeon’s movement or an unintended mishap passing instruments back and forth are the most common causes for many sharps injuries. Many of these injuries are due to scalpel injuries that afflict surgeons, nurses and other OR personnel. These injuries can expose healthcare workers to bloodborne pathogens.

There are many costs associated with these exposures. These costs can include the time spent reporting, treating, and following up on these injuries. In addition, there is the cost of salaries and benefits of injured staff. There is also the cost of laboratory testing of exposure sources and exposed personnel and appropriate postexposure prophylaxis. How can we decrease the incidence of injury in the operating room? Many clinicians believe that the following activities provide the most beneficial results:

• The use of standard precautions
• Training and awareness for those at risk
• The mandatory use of safety-engineered devices that help decrease the incidence of injury
• Neutral passing zones

OSHA continues to site facilities for neglecting sharps safety initiatives. These lapses in compliance may lead to fines of up to $7000. However, willful neglect of the Blood-Borne Pathogen Standard can result in penalties of $70,000 and may include criminal charges. In addition to these cost the potential treatment and care of the healthcare worker damaged by scalpel injury can be extensive because of the cost of damage to nerves, arteries or tendons, actions from blood-borne pathogens etc.