What Is the Needlestick Safety and Prevention Act? Overview and FAQ
Employee safety isn’t just a priority for healthcare organizations, it’s a regulatory mandate. The Needlestick Safety and Prevention Act (NSPA) sets the federal standard for the prevention of accidental needlesticks, a common healthcare hazard that affects an estimated 385,000 workers annually.
So, what does the needlestick safety and prevention act require and who does it affect? In this article, we’ll give a brief overview of these regulations and answer some key questions to help ensure you’re prepared with the information you need to maintain compliance.
What Is the Needlestick Safety and Prevention Act?
The NSPA is a regulatory measure meant to reduce the risk of occupational bloodborne pathogen exposure for frontline workers (like nurses and phlebotomists) who handle needles. Preventative requirements for employers of facilities such as hospitals and ambulatory surgical centers aim to address the risk of needlestick injuries primarily by enforcing the use of safer medical devices and necessitating program reform that incorporates employee feedback.
The three main requirements under the NSPA are summarized below:
| Review and adopt new technologies | The Needlestick Safety and Prevention Act requires facilities to research safer device options and demonstrate either the adoption or consideration of changing technologies. |
| Solicit and document feedback | Non-managerial employee input on sharps safety and programs needs to be documented and implemented within the exposure control plan (ECP). |
| Maintain a confidential sharps injury log | Accidental needlesticks must be documented to assist with identifying risk areas and evaluating device safety. While maintaining employee confidentiality, the needlestick log must note:
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The ECP is a requirement of Occupational Safety and Health Administration (OSHA) regulations, but its fulfillment criteria was modified by the NSPA. The modifications include a mandatory annual update to the ECP with documentation of all technology considerations and non-managerial input.
The History of the Needlestick Safety Act: An Overview
Sharps-related injuries became a major discussion in healthcare after the 1981 publication of a years-long study which concluded that needlesticks accounted for one-third of all work-related accidental injuries. The study also demonstrated that nurses suffered one of the highest incidences of needlesticks. The first occurrence of an occupational exposure with resulting Human Immunodeficiency Virus (HIV) contraction was reported just two years after that study was published.
Follow-up measures from OSHA failed to make a significant impact on the increasing rates of needlestick injuries in healthcare. Frontline workers — including nurses who had contracted HIV and hepatitis C from contaminated needlesticks — petitioned for reform alongside the American Nurses Association and their Safe Needles Save Lives campaign. Their efforts resulted in the NSPA: a regulatory shift in focus from response measures to prevention.
The Needlestick Safety and Prevention Act: FAQ
Whether your facility is looking to review for compliance or promote a safer work environment, learning the ins and outs of the needlestick safety act is a great starting place. Here, we’ll review some of the key questions related to the NSPA.
Who does the needlestick act apply to?
The NSPA is essentially a modification of the existing Bloodborne Pathogen Exposure Standard from OSHA and applies to all organizations that are required to follow those OSHA guidelines. Example facilities include hospitals, urgent care clinics, and even schools where a school nurse may give medication by injection.
What must be reported per the act regulations?
There is no external reporting mandated by the NSPA which focuses its requirements on internal record-keeping. Per the law’s requirements, facilities must keep an annual sharps-related injury log and documentation with annual revisions to the ECP that includes new technology considerations for safer medical devices and the feedback of employees on needlestick safety.
Who maintains the sharps injury log and what time period does it cover?
A well-organized sharps injury log is an annual document that notes the details of needlestick incidents within a calendar year while maintaining employee confidentiality. It’s up to the employer to ensure the injury log is updated after each incident occurrence and to verify that it’s filed appropriately and kept on-site for five years following the end of its associated year.
Is the OSHA 300 log the same as the injury log?
No, they’re separate documentation requirements. Unlike the sharps injury log, the OSHA 300 log covers all workplace injuries (not just needlesticks) and isn’t confidential. However, like the sharps injury log, it must be filed and available on site for five years following the date of the incident and is used for data tracking purposes.
What counts as a safer medical device?
A major component of the NSPA is the push for facilities to adopt safer medical devices to prevent needlestick injuries. These safer medical devices are essentially engineered control measures that help isolate or remove bloodborne pathogen hazards. Examples include self-sheathing needles and needleless systems.
How can an organization prove solicitation of employee input?
An employer can provide proof of solicitation within their ECP by including a reference to their standardized orientation material that requests feedback alongside methods of contact. A good time to ask for verbal feedback may be during safety huddles and staff meetings. If feedback is given, input should be notated in the ECP with time stamps, details about the suggestion, and follow-up actions (a supply request, for example). Other opportunities for documentation compliance include:
- Routine employee surveys with questions dedicated to sharps safety.
- A comments and take-aways section included on education sign-in rosters or competency check-off sheets.
Are there any penalties for noncompliance?
Although there are no penalties provisioned within the NSPA directly, any violations of its mandates could be considered a violation of the OSHA bloodborne pathogen standard and could incur a penalty fee of as much as $15,625. If the violation is deemed willful or repeated, that fee could go as high as $156,259.
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Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current, as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.