VA Health Care:

Purchases of Safer Devices Should Be Based on Risk of Injury

HEHS-95-12: Published: Nov 17, 1994. Publicly Released: Nov 21, 1994.

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Pursuant to a congressional request, GAO reviewed the effect of safer medical devices on the working environment of Department of Veterans Affairs (VA) health care workers, focusing on the: (1) incidence of needle and sharps injuries; (2) extent to which VA health care workers have tested positive for hepatitis B or human immunodeficiency virus (HIV) after a needle or sharps injury; (3) safety procedures and devices used to minimize these injuries; (4) extent to which VA is adopting new, safer technologies to prevent needle and sharps injuries; and (5) cost of screening and treating personnel who have received needle and sharps injuries.

GAO found that: (1) medical equipment injuries may be understated because they are not being reported by VA health care workers; (2) as of September 1994, no VA health care worker had been reported as having acquired HIV or Acquired Immunodeficiency Syndrome because of a percutaneous injury; (3) VA does not know the number of workers who may have acquired hepatitis B through work-related percutaneous injuries because it does not routinely collect those data; (4) VA has implemented safety procedures and standards designed to protect health care workers from percutaneous injuries; (5) VA medical centers' acquisition of safer devices varies widely; (6) VA needs to improve the dissemination of information among VA medical centers about the efficacy of safer devices; and (7) VA does not gather data on the costs associated with screening and treating its health care workers injured by needle or sharp devices.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: VA arranged for all medical centers to participate free of charge in a data collection system that will collect information on all percutaneous injuries and permit analysis of such injuries, thus enabling VAMCs to base purchase of safer devices on the risk of injury.

    Recommendation: The Secretary of Veterans Affairs should require the Under Secretary of Health to test ways to improve the reporting of percutaneous injuries and develop a systemwide strategy to implement successful approaches.

    Agency Affected: Department of Veterans Affairs

  2. Status: Closed - Not Implemented

    Comments: VA does not intend to select pilot facilities for more in-depth evaluation of device usage. VA believes that the publication of performance details for devices that are in use at VAMCs throughout the country will sufficiently address this recommendation.

    Recommendation: The Secretary of Veterans Affairs should require the Under Secretary of Health to fund pilot projects in which acute care medical centers acquire and test safer needle and sharp devices, and determine their impact on the incidence of injuries over a period of time.

    Agency Affected: Department of Veterans Affairs

  3. Status: Closed - Implemented

    Comments: VA conducted workshops, participated in national conferences, provided poster sessions at the Association for Professionals in Infection Control and Epidemiology 1995 conference, and has addressed the need for each facility to assess its individual risk levels and to take appropriate action through internal hotlines and the Under Secretary's newsletter. However, this recommendation is linked to the pilot testing of safer devices and, since VA does not intend to take action on that recommendation this recommendation can only be partially implemented.

    Recommendation: The Secretary of Veterans Affairs should require the Under Secretary of Health to establish a communications network to disseminate information on the results of tests and studies involving safer devices to all medical centers and to others when requested.

    Agency Affected: Department of Veterans Affairs

 

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