Occupational Medicine TeamOccupational Medicine Team

Dr.Fiona Donnelly,MFOM,MRCGP.Ms.Elaine Dunne,CNM2Ms.Mgt Kelleher,CNM2Ms.Ann Wall, RgnMs.Emma Scannell,Grade 3 clerical.

Analysis of Data: what was of Analysis of Data: what was of use in Connolly Hospital?use in Connolly Hospital?

Investigation of Safer Needle Investigation of Safer Needle systems for Connolly Hospital.systems for Connolly Hospital.

Occupational Health Dept Connolly Hospital.

Staff Population covered :6,300.Throughout HSE north of Liffey excluding

Mater Misericordiae, Beaumont Hospital.All public Healthcare facilities: Dental,

Care of Elderly, Psychiatry Hospital and Community residential facilities.

Population breakdownPopulation breakdownStaff employed:Tot.Headcount Staff employed:Tot.Headcount

6,3356,335..

Connolly Hospital : 1,300 St.Ita’ acute Psychiatry and Intellectual Disability: 1,026 St.Brendan’s: 400 Community Welfare: 420. Drug Addiction services: 230. Care of Elderly:

– St. Mary’s Hosp.: 400 Community Care 6,7, and 8 : 1,544

– (Includes Residential Childcare Units) Dental: 115 5,617.97 WTE

Rate of Needlestick/Blood and Rate of Needlestick/Blood and Body Fluid exposure incidentsBody Fluid exposure incidents

in NAHBin NAHB

2001:2002:2003:2004: 69 cases reported.2005: 60

101

Foundation of IHOPS groupFoundation of IHOPS group

Represents all Occupational Medicine Specialists covering HCW in Ireland.

Population covered approx 10,000. Need for register of NSI’s /Body fluid exposures

for Ireland– Why? To identify frequency of occurrences – Estimate outcomes: How many 3° Referrals ?– Propose improved preventative measures including

saferneedle systems.

USAUSA

In 1998 President Bill Clinton introduced into Federal law the requirement for all healthcare facilities to ADOPT saferneedle systems in the workplace(www.CDC.gov.---NIOSH)

Why has it taken Ireland and UK so long to address this risk?

Case law in UNISON V Scotland Executive, March 2003 European Law (Provision and Use of Work Equipment Regulations) won compensation for 2 HCW’s exposed to risk of infection on grounds of breach of care by employer.

www.osha.gov. Health Procurement Agency( Central Purchasing NHS ) Lancets off listings.

IHOPS approached HSE-HPSCIHOPS approached HSE-HPSC

Project proposal was constructed Aims and objectives : evidence base nationally of injury

frequency and engineering controls on a basis of medical education

2 pilot sites chosen Prospective descriptive analysis over 3 month of all

NSI’s/Body Fluid exposures in hospital site reported. SVUH, Dr. Paul Gueret , Occupational Medicine

Specialist and Occupational Nurse Advisors. Connolly Hospital, Dr. Fiona Donnelly & Occupational

Nursing. team Period October.2004-December 2004.

EPINetEPINetMS Access database

Paper and database forms to record details of: - Blood and body fluid exposure incidents- Needlestick and sharp object incidents- Post-exposure follow up form (test results and

treatment)

Standardised method for recording and tracking percutaneous injuries and blood and body fluid contacts

Can compare data to other health facilities who are using this programme

- Over 1,500 hospitals in the US- Hospitals in Canada, Italy, Spain, Japan and the UK

Available free of charge with free technical support from the University of Virginia

User-friendlyUser-friendlyPaper form completed by exposed worker with the help of occupational health department

Data entered into similar database form

Once follow-up is complete, a post exposure follow-up form is completed

Standard graphs, summary reports and single incident reports available from drop-down menus

Can create your own reports

Can add your own questions and drop-down menu options

Password security provided

Anonymised or full data can be exported to Excel and Access using drop-down menus

Entering dataEntering data

Follow-up form

Initial form

ReportingReporting

Graphs

Reports

True cost of injuries to Dept. of True cost of injuries to Dept. of Health Ireland.Health Ireland.

Cost to roll out reporting to HPSCCost to roll out reporting to HPSC

Salary of 0.5 Disease Surveillance Scientist0.5 Surveillance Scientist AssistantFunding by private companies, existing

DOH Staff recruitment embargo precludes direct funding at present.

Many thanks for your kind attention.