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| The Surgical Technologist | SEPTEMBER 2015 406 SUMMA RY The risk premium per blade is the real cost of using conven- tional scalpels that must be added to the purchase price of the blade. These costs warrant the following observations concerning the costs of using conventional scalpels. • Operating room scalpel injuries indirectly increase the cost of purchased blades by at least $2 per blade. • Health economics argues that safety products that have the potential to reduce injuries garner a premium over the cost of conventional blades. One may assess a device’s ability to reduce the risk premium by consider- ing how a device might reduce risk in each stage of use (before use – how blade attachment is eliminated; dur- ing use – when cutting tissue and other materials; when passing – the likelihood of the blade being unexposed between steps; and after use – the likelihood of finish- ing the procedure with the blade unexposed). • The purchasing cost of a conventional scalpel blade should NOT be considered the actual cost of the blade. • Risk managers and purchasing agents should re-exam- ine how they assess the costs of using safety scalpels. When evaluating a potential safety-engineered device, it is important to consider the percentage of risk premium (added cost) that it will eliminate. The use of an appropriate safety scalpel that reduces blade exposures (and therefore risk of injury) can bring the cost of using safety scalpels below the cost of using conventional scalpel blades. A BOU T T HE AU T HORS Ron Stoker, MS, is the founder and execu- tive director of ISIPS, the International Sharps Injury Prevention Society and is the co-author of the Compendium of Infection Control Technologies and numerous medi- cal journal articles. Mark Davis, MD, is a gynecologic sur- geon, OR safety consultant and author of the sharps injury prevention manual Advanced Precautions for Today’s OR, Third Edition. R E F ER ENC E S 1. Are Safety Scalpels Making the Cut with Surgeons and Nurses? Ron Stok- er. http://www.outpatientsurgery.net/surgical-facility-administration/ personal-safety/are-safety-scalpels-making-the-cut-with-surgeons-and- nurses--patient-safety-11 2. Eisenstein, HC; and DA Smith. (1992). “Epidemiology of reported sharps injuries in a tertiary care hospital.” J Hosp Infect 20(4): 271-80. 3. Centers for Disease Control (CDC); National Institute for Occupational Health and Safety (NIOSH) Preventing Needlestick and Sharps Injuries; General Information, Safer Needle Devices, Management and Treatment Guidelines. 4. AORN Position Statement onWorkplace Safety. 5. Jagger, J; Bentley, M; and Tereskerz, P. 1998. A study of patterns and pre- vention of blood exposures in OR personnel. AORN J. 67:979-4, 986. 6. Increase in Sharps Injuries in Surgical Settings Versus Nonsurgical Settings after Passage of National Needlestick Legislation Janine Jagger, MPH, Ph et all, J Am Coll Surg . Vol. 210, No. 4, April 2010. 7. Hatcher, IB. Reducing Sharps Injuries Among Health Care Workers: A Sharps Container Quality Improvement Project. Jt Comm J Qual Improv. 2002;28(7):410-414. 8. Tan L, Hawk JC, Sterling ML. Report of the Council Scientific Affairs: Pre- venting Needlestick Injuries in Health Care Settings. Arch Intern Med. 2001;161(7):929-936. 9. National Health Service for Scotland (NHS Scotland). Needlestick Inju- ries: Sharpen Your Awareness. Report of the Short Life Working Group on Needlestick Injuries in the NHS Scotland. Edinburgh: National Health Services for Scotland:2001. 10. United States General Accounting Office. Occupational safety: selected cost and benefit implications of needlestick prevention devices for hospi- tals. GAO-01-60R; November 17, 2000. 11. O’Malley, et al. Costs of Management of Occupational Exposures to Blood and Body Fluids. Infect Control and Hosp Epidemiol. 2007;28(7). 12. Sharps Injuries among Hospital Workers in Massachusetts, 2010. 13. https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_ id=24385&p_table=INTERPRETATIONS 14. OSHA – Standard Interpretations, 1910.1030, 9/1/2004 Debbie Eckard letter from Richard Fairfax, Director, Directorate of Enforcement Pro- grams; https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_ table=INTERPRETATIONS&p_id=25090 15. Are Safety Scalpels Making the Cut with Surgeons and Nurses, Outpatient Surgery Magazine, http://www.outpatientsurgery.net/surgical-facility- administration/personal-safety/are-safety-scalpels-making-the-cut-with- surgeons-and-nurses--patient-safety-11 16. Cutting to the Truth about Safety Scalpels, Mark McGraw, Outpatient Surgery Magazine, http://www.outpatientsurgery.net/surgical-facility- administration/personal-safety/cutting-to-the-truth-about-safety-scal- pels--02-12&pg=3 17. Stoker, R. Scalpel safety: Protecting patients and clinicians. Managing Infect Control. May 2008. 18. https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_ id=24385&p_table=INTERPRETATIONS