Miss Deborah Rhodes1, Ms Kerryn Woolley2, Mr Albert Zorzanello2, Ms Elizabeth Perry2,3, Mr Andrew Holland2, Ms Pauline Bass1, Ms Rosaleen Kehoe1, Ms Susan McLellan1, Professor Allen C Cheng1,4, Associate Professor Leon J Worth1,5
1Infection Prevention and Healthcare Epidemiology Unit – Alfred Health, Melbourne, Australia
2Caulfield Community Health Services – Alfred Health, Melbourne, Australia
3Podiatry Department – Alfred Health, Melbourne, Australia
4Monash University, Melbourne, Australia
5Victorian Healthcare Associated Infection Surveillance System (VICNISS) Coordinating Centre, Melbourne, Australia
Automated scalpel blade removers (SBRs) provide an engineered control to reduce the risk of healthcare worker injury and potential transmission of infection. They are designed for use at the end of procedures to detach scalpel blades from handles prior to reprocessing. We report the outcome following review of SBR use in a podiatry service at a large tertiary hospital.
In 2017, an annual infection prevention audit of the podiatry service was conducted using standardised criteria aligned with the Safety and Quality Improvement Guide Standard 3: Preventing and Controlling Healthcare Associated Infections.
Investigation into the utilisation of SBRs revealed re-use of scalpel handles during procedures, with reports that blades were removed mid-procedure to fit new blades to the same handle. Simulation, using UV light and fluorescent solution, illustrated the potential for SBRs to contribute to cross-contamination. A local safety alert was subsequently issued, and SBRs were withdrawn from use as disposable instruments were available. This was discussed at a state-wide forum of senior podiatry stakeholders and referred to the Australian Health Practitioner Regulation Agency. As a result, the infection prevention self-audit tool issued by the Podiatry Board of Australia was amended. Risks associated with SBRs were also reported to the Therapeutic Goods Administration.
Our findings identified a knowledge gap and enabled targeted intervention and education of staff to reduce risk. Valid, periodic auditing of systems and practices in specialised clinical units, together with engagement of clinicians is of benefit, and can contribute to embedding the national strategy.
An enthusiastic advocate for the safety of patients and staff in healthcare with over three decades of nursing experience, Deb has spent the last twelve years with Alfred Health, firstly coordinating the staff health services at The Alfred hospital before joining the Infection Prevention team in 2009. In this role, Deb has implemented two organisation-wide quality improvement projects aimed at reducing device-associated infections and received the Elaine Graham-Robertson award in 2013. Deb is also a grateful past recipient of the Cardinal Health (then Covidien) and ACIPC conference scholarships and currently works part-time at Caulfield Hospital as a Credentialled Infection Control Professional, recently graduating from Monash University with a Master of Public Health.