OR Neutral Zone prevents sharps injuries
Injuries related to the handling of sharps, such as needles and scalpels, have been rising at Saint Joseph for the past couple of years. At this point in 2024, the hospital has documented as many sharps injuries as it did for the entire year in 2023.
While the risk of transmission of communicable disease is low with a hospital sharps injury, it is not zero. Every incident requires extra lab testing for the patient and the clinician, at substantial cost and anxiety for all involved.
Most of the hospital’s sharps injuries occur in either the OR or SPD. In response, the Saint Joseph Operating Room has instituted a “Neutral Zone” when transferring sharps from the tech to the surgeon and back.
Research has shown that one of the most common times for sharps injuries to occur is in the transfer of sharps from one person to another. A Neutral Zone is a location on or near the operating table where sharps can be placed for pickup and retrieval without two people touching at the same time. There will be exemptions for specific surgical situations, such as when loupes or microscopes are in use.
A policy has been approved regarding the use of a Neutral Zone. The policy and key points are outlined below.
Neutral Zone policy, key points
Purpose: A Neutral Zone method for managing sharps at the surgical field will be utilized by the sterile team members in a conscious effort to reduce and/or eliminate the potential for sharps injuries that can occur during a surgical procedure.
Scope: This policy applies to specific roles/functions including the surgical team at the sterile field.
Definition of Neutral Zone: A Safe Work Practice control technique used to ensure that the surgeon and the scrubbed person do not touch the same sharp instrument at the same time. This technique is accomplished by establishing a designated Neutral Zone on the sterile field and placing sharp items within the zone for transfer of the item between scrubbed personnel.
Policy:
Use of protective devices will be well communicated and agreed upon by the sterile team members including the primary surgeon, assistant, surgical scrub/technologist and any other persons who gown and glove for the surgical procedure during the pre-incision time-out process.
Exceptions: Certain procedures, such as microscope-in-use, vascular and other procedures that do not permit the surgeon to look away from the field might not be applicable for implementing a no-touch or Neutral Zone process. In these situations, the passing of sharps cannot be avoided and special care must be taken by all team members when passing and returning sharps.