Since the AIDS epidemic became widespread in the 1980s, sharps handling procedures have taken on a much greater significance for healthcare practitioners.
Along the way other bloodborne pathogens, such as hepatitis B and C and at least 20 other less common pathogens, have only heightened the importance of needle safety. As a result, robust protocols have been established for many common needle uses in a healthcare setting over the years.
However, for those who provide intraoperative neuromonitoring (IONM), needlestick injury is a unique risk, as they place multiple subdermal needle electrodes during a single procedure. These needles can easily be misplaced among the surgical waste. Best practices have not always been evident, and research on the topic is limited.
A 2014 study found that neurodiagnostic technologists who provide IONM, as well as other operating room personnel, were at risk for needlesticks from these needles. The study concluded that steps to minimize needlesticks as a result of IONM should be taken.
A recent retrospective analysis reviewed efforts to do just that and suggests one improvement that may result in fewer needlesticks for personnel conducting IONM. In the review of various adhesive solutions and their impact on needlestick injuries, researchers analyzed 2,002 surgical procedures that took place from 2006 to 2018. These dates were broken down into the two periods where different adhesive solutions were employed – 2006 to 2012 and 2013 to 2018.
Grace Padilla-Kastenberg, MPH, presented the results of the study at the 2019 ASET Annual Conference. She explained that, in the earlier time period, 17,250 subdermal needles were placed using standard surgical tape to secure them. During the later time period, 20,125 subdermal needles were placed using tape that was specially marked to alert healthcare workers to the presence of needles.
Researchers discovered a 90 percent reduction in needlesticks when the switch was made to specially marked tape, from 32 needlesticks prior to its introduction, to only three after – a substantial reduction in needlesticks for those at risk.
Prospective research is needed to confirm the benefit of the specially marked tape. Some things to consider are whether the benefit is brand specific or can be generalized to other specially marked tape, and what type of markings are most effective.
In the meantime, those neurodiagnostic technologists who perform IONM should engage with their institutions regarding the risks that are unique to ORs with IONM. Taking leadership on issues like this can help solidify the role of neurodiagnostic technologists during a time of uncertainty in the field, while also driving safety and effectiveness in the surgical suite.