Puncture brings needlestick safety to the public eye

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Puncture brings needlestick safety to the public eye

A new movie offers a mainstream medium for needlestick safety, highlighting the legal battle against medical manufacturers

After reading this article, you will be able to:

  • Explain how Puncture brings needlestick awareness to the general public
  • Analyze the importance of the U.S. Needlestick ­Safety and Prevention Act of 2000
  • Identify areas of healthcare where gaps still remain in safety needle awareness and compliance

Healthcare workers have seen it all when it comes to safety training videos. A throaty narrator exposes statistics that endanger workers if they fail to use safety needles: An estimated 800,000 needlestick injuries occur each year. Workers can be exposed to HBV, HCV, and HIV.

Although these training films routinely make their premiere in hospitals, rarely does a motion picture make its way to the big screen, highlighting the issue of needlesticks in the mainstream media.

Puncture, which opened in select cities September 23, does just that, shining a public spotlight on an issue that is generally reserved solely for the eyes of nurses, doctors, and surgeons. The legal thriller is loosely based on the true story of two lawyers, Michael Weiss (played by Chris Evans) and Paul Danziger (Mark Kassen), who battle medical manufacturing companies when an ER nurse contracts HIV after an accidental needlestick, in an effort to determine why safety needles are not being used in hospitals.

"The arc of the story is representing this event where there is the safety needle, but you can't distribute it in the majority of the hospitals," says Danziger, an executive producer of the movie, author of the screenplay, and a partner at Danziger & De Llano in Houston. "And the lawyers discover that the reason for that is there are these large group purchasing organizations [GPO] and they control significant portions-up to $100 billion-of what is purchased each year in U.S. hospitals, and they have certain deals with certain manufactures in order to get kickbacks."

Danziger says he wrote the movie for two reasons: to honor a friend, Weiss, who passed away, and to expose these issues that seem to fly under radar in the mainstream media arena.

"I just wanted to get those issues out so that people can discuss it and talk about it and understand it," Danziger says.


General public awareness

When it comes to needlesticks and needlestick safety, healthcare workers are routinely educated on dangers and subsequent safety precautions. The general public, however, is largely clueless regarding these issues.

"Most people don't understand how the purchasing system in U.S. hospitals is done," Danziger says. "They don't understand it, they don't see, they don't know, and the GPOs have done an amazing job of keeping ­below the radar and keeping this issue out of the ­public eye."

Although some newspapers, such as The San Francisco Examiner and The New York Times, have covered this issue, Puncture is really the first mainstream movie to address needlestick safety, says Ron Stoker, executive director of the International Sharps Injury Prevention Society in South Jordan, UT.

The reason Puncture may bring more awareness to the general public is not only because of its exposure, but also the compelling story that adds an authentic and personal touch to this issue. This is often the best way to capture the attention of both the general public and the healthcare community.

"I think that personal stories add a lot to the discussion of safety for healthcare workers and the public," Stoker says. "I am a great advocate of being transparent with information so that all people are aware of the dangers and concerns of medical devices."

The movie Puncture offers this personal account of a story that is based on real events, capturing the true horror that needlesticks can wreak on an individual. ­Danziger hopes this will help generate additional ­awareness within the public forum as more patients begin to realize the dangers healthcare workers face on a daily basis.

"You have to always be hopeful that the movie will bring it to people's attention," he says. "There is a certain movement amongst people to try and rein in healthcare costs that are unnecessary, so I think eventually it will change, but it's not going to change without coming to people's attention, and people looking at it, and people talking about it."


Exposing group purchasing organizations

One of the major themes in the movie is the battle with GPOs to sell safer medical equipment to hospitals. Many GPOs get kickbacks from device manufacturers, Danziger says, so there is often a reluctance to sell a device that isn't going to elicit the most profit. This serves as one of the primary controversies in the film, setting up a "David vs. Goliath" theme.

As a result, inventors and entrepreneurs that have developed a safer needle or device are shut out from healthcare facilities, and healthcare workers are put at risk.

"There are safe needle products that aren't being purchased by the hospitals through the GPOs because they are a couple of cents more and they don't have sweetheart deals with these independent manufacturers of safety needles, so nurses' safety is put at risk for a couple pennies per syringe," Danziger says.

In 1998 Stoker was working for a medical device manufacturer, training healthcare workers on the manufacturer's product. He lost 25% of his market share in one day after California passed a law requiring the use of safety needles, and he didn't have a single safety product in any of his offerings. Many states followed suit soon after, and in November 2000 the U.S. Needlestick Safety and Prevention Act was signed into law and OSHA quickly responded with corresponding amendments to its Bloodborne Pathogens standard.

"We are much safer now than we were then, but are we where we need to be? No," Stoker says. "I think we have much more work that still needs to be done."


Gaps in the healthcare environment

Although Puncture brings more awareness of needlestick safety to the general public, gaps still remain in the healthcare environment concerning the use of safe needles.

Stoker recently conducted a survey with Outpatient Surgery Magazine assessing compliance with the Bloodborne Pathogens standard in surgical suites. Although the results have not yet been published, the survey highlighted the fact that even though healthcare workers are aware of the requirements of the Bloodborne Pathogens standard, a vast majority still fail to comply.

"It is appalling to recognize how many operating rooms continue to use non-safety products," Stoker says. "For example, safety scalpels have been available for a few years. In fact, they have hit a second, or third, or fourth generation safety scalpel, and yet surgeons are unwilling to use them."

Furthermore, many hospitals are not using the safest needles on the market, Stoker says. For example, many clinicians are still using first-generation syringes, including active safety needles that require healthcare workers to activate the device themselves. Passive safety devices, which have been on the market for years, activate as soon as the needle touches the patient's skin. If the patient kicks, moves, or thrashes, the healthcare worker is protected by a device that has already activated.

"I believe that there's still much work to convert conventional sharps devices into passive safety products and to upgrade active safety products into passive safety products," Stoker says.