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Improving Safety
the QC Way
The Quality Circle Team, Eminent, with the portable sharps tray they invented to cut down needlestick injuries. L-R: Ms Goh Siew Mui, Ms Janet Choo, Ms Loh Siw Eng, Ms Avril Elizabeth Chew and Ms Ratha U Singh. (Absent with apologies: Dr Helen Oh)
The infection control nurses of CGH completed a quality projcet on reducing the number of needlestick injuries by 60% from 54 needle stick injuries from April to Sept 2003 to 27 during the same period of this year.
CGH’s very own Needle Safety Badge.
and unused items in the kidney dish before disposal. The team sourced around and modified a $2 tool box into a portable blood-taking tray using pharmaceutical boxes as dividers that can hold items required for blood-taking. The sharps container also fits easily into the portable tray allowing staff to bring along the tray when they need to draw blood allowing them to dispose sharps into the sharps container.

The team also encouraged the staff to use vacutainers. A vacutainer system is a safety device whereby blood gets collected directly into the specimen tube without the use of syringe and needle and transferring blood into the specimen tube.

Road-shows and Video Screening on “Needle-stick Awareness were held to raise greater awareness and train the staff in the prevention of needle stick injuries. Needle-stick Free departments, a Rap song and “Design A Badge” competitions were also held on CGH’s annual Needlestick Awareness Day on 8 Oct 04.

 

The Eminent Team won the Star Award at the NQCC (National Quality Circle Convention) 2004 on 8 Dec 2004 held at CGH Auditorium. Invited assessors were Mr Harnek Singh, Vice President/Director, ST Engineering and Mr Ivan Ho, Senior Manager, ST Electronics to judge the projects.

According to Ministry of Health, there were 503 needlestick injuries in hospitals in 2003. This works out to be an average of 42 needlestick injuries a month island wide. A needlestick injury is a prick or cut sustained by staff from contaminated needles during blood taking, giving injection or during operation. Staff who sustain needle-stick injury face physical trauma and psychological trauma from the risk of blood borne infections eg. Hepatitis B or HIV viruses.

The team, comprising mainly nurses from Infection Control and their advisor Dr Helen Oh, Senior Consultant, Department of Medicine, found out that 30% of needlestick injuries were caused by improper disposal and another 20% were caused by the use of syringes and needles during blood-taking.

Immediate disposal of sharps is very important because staff often sustain needlestick injuries when sorting out used
Drawing blood through vacutainers helps to eliminate the step of transferring blood into the specimen tube thus preventing needlestick injuries.

 

 
The second team that won the Star category was the Eureka team from both MICU and SICU (medical and surgical intensive care units). An intra-arterial (IA) line is the insertion of a cannula directly in the artery. It serves as an access for blood sampling of the patient and allows continuous monitoring of blood pressure.

Eureka discovered that when an open IA line caused higher risk of needlestick injury for staff and wastage of patient’s blood when different sizes of syringes were used.

The team came up with the creative idea of using a closed IA system to reduce the incidence of needle stick injury, eliminate different methods of blood sampling and minimise blood loss during sampling. They worked with Becton Dickenson to design the closed IA system and conducted training for staff to use the new system. Not only did they eliminate the problems of the open IA system, there was savings of $12,438 from time savings and cost savings from syringes.

 
Eureka QC team with the closed intra-arterial (IA) system. (L-R: Mr Tony Chow from Becton Dickenson, Mr Melvyn Chiang, Ms Connie Yeoh, Ms Mardianah I, Ms Susan Hiew, Ms Aishah Sim) (Absent with apologies: Ms Suraya A).