Hands-Free Transfer White Paper

SHARPS SAFETY and NEUTRAL ZONE IMPLEMENTATION in the OR ENVIRONMENT
by Dr. Stephen B. Lober, MD

1. Background
The majority of surgical “sharps” injuries occur during the act of passing instruments such as scalpels, skin hook retractors, and hypodermic needles from one operative personnel to another. It is estimated that 384,000 needle/sharp sticks occur annually. Statistically, the operating surgeon and first assistants are at highest risk for such injuries, which puts them at risk for transmission of HIV, HBV, HCV and other pathogens. 

 

2. Discussion 

To help reduce the incidence of such injuries, it has become common practice to incorporate the hands free transfer (HFT) of such instruments utilizing a designated area referred to as the “neutral zone.” This is intended to help avoid the inadvertent sharps injuries that can occur when passing sharp instruments by way of hand-to-hand.

Numerous embodiments of the neutral zone have been devised in an attempt promote HFT’s. A common method is to arbitrarily designate an area to be the neutral zone. This somewhat ‘imaginary’ neutral zone is often poorly delineated, and subject to variation throughout a single case due to changes in scrub tech personnel. Trays (such as emesis basins) have been used as neutral zones that can be used as mobile platforms for passing sharp instruments back and forth, but such devices are often perceived by the operating surgeon as being both cumbersome and bothersome, and do not completely circumvent the potential dangers of what is still a form of a hand-to-hand transfer.

The Instrument Platform has been designed to clearly designate a true neutral zone  to facilitate HFT’s and maximize acceptance by all operating personnel, including the operating surgeon. 

 

3. Outcomes
The Instrument Platform 

• Clearly delineates a true neutral zone for sharps placement and HFT’s. 

• Reduces risk of injury by eliminating instrument passing with the patented, FDA approved ElasTak adhering surface. 

• Reduced risk of complications from injury and need for worker compensation claims. 

• The platform adhere’s safely in place on the surgical field for ease of instrument reach.

• Provides high visibility of sharps instrumentation via low profile design.

• Minimizes instrument drops, reducing cost and time lost with replacement instruments/equipment.

 

Furthermore, the Platform has been designed to be unobtrusive to the operating surgeon, providing for a high rate of acceptance and actual utilization.

Resources:
Statement on Sharps Safety, American College of Surgeons, online October 1, 2007.
OSHA-AORN Sharps Injury Prevention Program. May 2009.
Sharps Safety Tool Kit. AORN. www.aorn.org.
Practical strategies to prevent surgical sharps injuries. Guglielmi, Ogg. American Nurse Today. Sept 2012, Vol. 7, No. 9.