How a Healthcare Facility Achieved Zero Needlesticks with Retractable Technologies
A regional healthcare facility in Pennsylvania successfully implemented VanishPoint retractable safety syringes to address the persistent problem of needlestick injuries (NSIs) among healthcare workers. Through a methodical evaluation process that involved frontline users, the hospital achieved zero needlestick injuries with the new technology within one year of implementation. This case study documents their journey from identifying the problem to selecting and implementing a solution that effectively eliminated a significant workplace hazard while ensuring compliance with federal safety regulations.
Memorial Medical Center is a 566-bed community and regional referral hospital in Western Pennsylvania. As a member of the Conemaugh Health System, MMC is recognized for clinical excellence and patient satisfaction, having earned designation as a top 100 Hospital in the U.S. in both orthopedics and open-heart surgery. The hospital provides specialized services including regional trauma care, intensive care for newborns, high-risk obstetrical care, and centers for heart care, vascular disease, neuroscience, and minimally invasive surgery.
Beyond patient care, MMC has been educating healthcare professionals for over a century through physician residency programs and accredited education programs for various healthcare careers including nursing, radiology, surgical technology, and emergency medical services.
In 1999, MMC discovered that 64% of their needlestick injuries were associated with hollow-bore needles, mirroring national statistics. Despite some safety measures being in place, these weren’t consistently implemented across the hospital:
- A recessed needle for intermittent IV administration had been implemented in the early 1990s
- The laboratory used safety butterflies and safety ABG collection devices
- The psychiatric unit had safety syringes with needle shields available, but they weren’t being used consistently.
- The hospital was still using the same sharps containers they had used since 1987
The hospital faced additional pressure when President Clinton signed the Needlestick Safety and Prevention Act in November 2000, which required OSHA to revise its Bloodborne Pathogen Standard. The revised standard mandated that hospitals update their Exposure Control Plans annually, implement new technology to reduce employee exposure, involve frontline users in device selection, and maintain detailed logs of exposure incidents.
"We decided it was time to take an across-the-board look at the dangers and possible solutions..."
MMC formed a multidisciplinary “SafetyNet Committee” as a subcommittee of their Infection Control Committee. This team was tasked with reviewing and updating engineering controls and fulfilling OSHA’s Bloodborne Pathogen Standard requirements.
Their approach included several key elements:
- Targeting high-risk procedures first: The committee prioritized procedures involving hollow-bore needles, which carried the highest risk of injury and subsequent infection.
- Involving frontline users: Staff who would actually use the devices were central to the evaluation process, providing valuable insights based on real-world usage and technique.
- Including Materials Management early: The supply chain team helped source products, verify availability, and later provided input on pricing considerations.
- Comprehensive evaluation: Three safety syringes were selected for trial based on past experiences with the manufacturers and recommendations from ECRI’s Health Devices Needlestick-Prevention Selection Guide
The trials were conducted in spring 2001 in both a psychiatric unit and a cardiac med/surg unit, chosen to represent different clinical scenarios including potentially uncooperative patients. Clinicians used a standardized evaluation form from the American Hospital Association’s Sharps Injury Prevention Program to assess each device.
After thorough evaluation, the VanishPoint syringe emerged as the clear preference among frontline users. Key factors in this decision included:
- Passive safety mechanism: Unlike “active” devices that require an extra step to activate safety features, the VanishPoint automatically retracts when the plunger is fully depressed-a normal part of injection procedure.
- Protection during critical moments: The CDC has noted that most needlesticks occur within seconds of withdrawing the needle from the patient. The VanishPoint® protects clinicians during this high-risk period.
- One-handed technique: The safety mechanism can be activated using a one-handed technique, with the worker’s hands remaining behind the needle at all times.
- Downstream protection: The device protects not only clinicians but also housekeeping staff and others who might encounter discarded syringes.
Implementation involved several steps:
- Securing approval: Results were presented to Nursing Management and the SafetyNet Committee for final endorsement.
- Inventory management: Materials Management ensured sufficient product availability in all locations where conventional syringes had been stocked.
- Comprehensive training: The sales representative provided educational programs and training materials. Additionally, the departments of Education and Nursing incorporated VanishPoint® training into their nine-month weekly course on Clinical Basic Skills.
- Creating a device catalog: A catalog with pictures and descriptions of all safety devices was created for new clinicians and in-service training.
- Clear exception policy: A procedure was established for situations where clinicians needed to use another device, with exceptions managed through separate inventory systems.
Results: One year after implementation, there were zero needlestick injuries involving the VanishPoint syringe, compared to six NSIs in the three quarters prior to implementation. During this period, the hospital delivered nearly 173,000 injections using the VanishPoint syringe.
Materials Management was involved in the SafetyNet Committee from the beginning, understanding that different safety syringes had different pricing structures. However, they supported the evaluation approach that prioritized frontline user preference for the device offering the best protection without hindering patient care.
As Lisa Hoegg noted: “In my experience the most expensive product is not always the best and the least expensive is not always the worst-the bigger picture is that costs to the institution will be decreased if sharps injuries are decreased and the ’emotional cost’ to employees reduced.”
While specific cost figures weren’t provided, the hospital recognized that the financial analysis needed to consider not just unit costs but overall institutional savings from:
- Reduced injury incidents
- Decreased costs for medical evaluation following exposures
- Reduced lost work time
- Minimized emotional impact on employees
Lisa Hoegg, BSN, CIC, Infection Control/Value Analysis Specialist at MMC had this to say about VanishPoint syringes:
"The VanishPoint syringe is a high quality product with advanced technology that is moving us one step closer to minimizing the exposure potential for our employees!"
Several factors contributed to the successful implementation:
- Frontline user involvement: Clinicians who actually use the devices had the primary voice in selection.
- Passive safety design: The automatic safety mechanism ensured compliance without requiring extra steps.
- Comprehensive training: Extensive education ensured staff were comfortable with the new technology.
- Clear policy on exceptions: A clearly defined policy for using alternative devices ensured consistent safety standards while still allowing flexibility for specific clinical needs.
- Materials Management partnership: Early involvement of the supply chain team facilitated smooth implementation.
- Continuous monitoring: Ongoing assessment of needlestick injuries and user feedback allowed for adjustments as needed.
The implementation of VanishPoint syringes has had several lasting impacts:
- Sustained elimination of NSIs: The hospital achieved and maintained zero needlestick injuries related to hypodermic injections.
- Enhanced safety culture: The project reinforced the importance of engineering controls in workplace safety.
- Regulatory compliance: The hospital successfully met OSHA’s revised Bloodborne Pathogen Standard requirements.
- Continuous improvement mindset: The success established a framework for ongoing reassessment of safety devices and practices.
Memorial Medical Center’s experience demonstrates that a comprehensive, multidisciplinary approach to needlestick prevention can effectively eliminate injuries from hypodermic injections. By prioritizing staff safety, involving users in device selection, and implementing passive safety technology, the hospital created a safer environment for both clinicians and patients.
The project highlights that while education and safe work practices are essential, devices with automated retraction like the VanishPoint syringe play a crucial role in minimizing exposure risk.
- Hoegg, L. (2002). Needlestick Prevention: An Ongoing Journey. Memorial Medical Center, Johnstown, Pennsylvania.