Sharps Safety

Sharps Selling

The Needlestick Safety and Prevention Act became law five years ago. This act required that all facilities using sharps provide their employees with safety-engineered sharps products. Acute care facilities have broadly converted to safety-engineered devices; it is estimated that more than 80 percent have converted. The results have been impressive. The EPINet? computerized surveillance program shows that between 1999 and 2003 (the most recent year data is available), the injury rate fell 45 percent in non-teaching hospitals and 33 percent in teaching hospitals. Physicians? offices have been much slower to adopt safety-engineered products, yet the needlestick safety law and the accompanying benefits apply just as much to them. Converting more of the physician market to safety products represents continued opportunity for you to bring value to your customers and increased revenues to your territory.

Selling tips:

Lead with Education

There are a variety of sources for information on the needlestick safety law, what it takes to be in compliance, and the benefits of safety. Your manufacturing partners can provide you with this information. Correct any misconceptions your customers may have on the safety law and position yourself as a consultative resource. Even if your customer is not interested in converting to safety devices right now, by positioning yourself as the ?safer medical devices expert?, they are more likely to come to you when they are ready to evaluate and convert to safety devices.

Help your customers with a friendly ?compliance audit? before the OSHA inspectors do. Some manufacturers have materials to help you in this regard, and would support you in this effort, but basically, all you would need to do is list all of the sharps used at the location, see where safety alternatives are not being used, or where some opportunities for upgrades might exist, and present them to the decision maker.

Offer choice

Several different safety technology choices are available. Different customers have different preferences. Change in technique is one reason physician offices have been slow to adopt safety devices. Offering choices will help them find the right product for their practice.

Pediatric practices are good targets. Interest in safety is higher among pediatric practices, as more than half are using safety injection devices. Pediatric offices have an interest in protecting their staff and the families of their small patients. They tend to prefer safety products that offer single-handed activation, quick and easy activation, and unobtrusive safety features, which some clinicians feel is important in reducing patient anxiety over injections.

Help customers with the transition to safety devices. Successful conversion requires that management (or person responsible for safety compliance) do the following (with your help):

• Provide training materials on how to use the new safety devices.
• Work with those manufacturers with product training programs.

Walk around the facility to ensure that the new safety products are actively in use for all procedures with a potential for an occupational exposure, and that the safety features are being properly activated.

Remove all old ?non-safety? stock to avoid continued use.

Allow sufficient time for the staff to get past the learning curve after introduction of new safer medical devices. Clinicians are bound to complain at first, since any change is often viewed negatively. Make sure any complaints are separated into those related to lack of training or experience with the new product, vs. the real performance issues. Safety devices are being used by thousands of healthcare workers around the country, so most complaints tend to be short lived once they get used to the product.

Common sales objections:

Objection: ?Safety devices are more expensive.?

Yes, they are, just like wearing gloves is more expensive than not wearing gloves. In some categories, safety devices can be three to four times more. As significant as this sounds, when you figure that, for example, the difference between a standard injection needle and a safety injection needle might be 20 cents, and a doctor might use 5,000 of them a year, the actual additional expenditure is really a tiny fraction of the typical operating budget. What does the doctor get for that extra $1,000? In handling the objection, consider adapting the following talking points:

?Doctor, you can?t put a price on patient or employee loyalty. If you lost just one patient because they perceived you weren?t taking their health seriously, or lost just one employee because they left because they felt you didn?t care if they were being put at greater risk of catching AIDS or Hepatitis C, what would that cost you? And people talk. What does your nurse think when she hears that her friend over at Dr. Jones? office is being trained on safer medical devices? Don?t you think she wonders why she doesn?t deserve the same level of concern??

If you are discussing blood collection equipment, you might also want to point out that, statistically, blood collection needles, because they tend to have the most contact with blood, tend to be the most dangerous in terms of disease transmission. If you are discussing injections, you might want to point out that, statistically; injection needles are responsible for more sticks that any other device.

?What if, God forbid, someone did get stuck? Do you realize that the cost of simple testing and follow-up can easily add up to $2,000 or $3,000? And, if someone got a disease from it, lifetime healthcare costs could run into hundreds of thousands. Now, not all of that would be out of pocket, most likely, but what do you think your insurer would do?

?Then, of course, there?s also the possibility of you getting sued. It hasn?t happened yet, but many in the industry feel that not following the law could constitute gross negligence and open the door for an employee lawsuit overriding any Workers Compensation protections. Do you want to be that test case doctor? ?And the biggest and most likely cost ? OSHA fines. Blatant violations can run you $70,000. Individual citations are for $7,000, and a single incident of not using a safety device can lead to multiple citations, like failure to use the product, failure to document use of the product, failure to include employees in evaluating the product and so on.

?The bottom line is that the days of clinicians not using safety devices are going away as sure as the days of clinicians not washing their hands or not using gloves. It?s the right thing to do, and the liability can be huge.? Objections: ?We tried them and we don?t like them ?. We don?t think they are safe ... We think they?re dangerous ? We think they?re clinically detrimental.?

The law allows providers to not use safety devices if they try them, have clinical justifications that override the safety benefits for not using them, and formally document these experiences. Not surprisingly, few have done so. By now, safety devices are being used successfully in every type of application in every type of specialty in every type of practice, so the odds are that this argument will not pass muster with OSHA. The objection is more likely a smokescreen (Probe, if you like, ?doctor, I haven?t heard of anyone having such a serious problem with that ? can I see your documentation??) or the result of one bad experience with one bad product years ago. Probe to find out the problems they had ... and demonstrate a product that overcomes these problems.

Objection: ?I?m a little guy, so OSHA won?t inspect me.?

Since the law was passed, OSHA officials have inspected all types of healthcare facilities, including physician practices, surgery centers, nursing homes and hospitals. OSHA does inspect all types of facilities. Doctors should also be aware that many inspections are initiated because of staff or patient complaints ? and OSHA is obligated to follow up within 24 hours. For example, at one family practice, a patient called OSHA to complain that a nurse was not following proper safety procedures. An investigation ensued, resulting in thousands of dollars in fines ? in areas additional to the original complaint.

Objection: ?It?s too hard for my people to learn a new device.?

Many devices do require a slight change in technique, but the learning curve is small, especially with the expert in-service training you will provide. Thousands of other healthcare professionals just like ?Nurse Nancy? have learned to use them ? she will too. Here?s a way you could respond to this objection: ?I know what you mean doctor. Needles are the utility tool of our profession. They?re everywhere; you could use them in your sleep. They?re to us like ... pens. Can you imagine if someone suddenly came along and redesigned your pen? But you know, pens used to be dipped in ink. Now they have the ink built in. People probably didn?t like that at first. ?The ink?s built in? How does that work? Doesn?t it run out? How can you tell?? But they learned to use the new design because it was better. Same thing here.?

Objection: ?We have a box on the shelf we use in high risk situations.?

?Well, that?s a step in the right direction, but the law says you must use them every time. And that?s smart. No one comes in with a sign saying ?I have Hepatitis C.? As a matter of fact, most people who have it don?t even know it themselves, so how could you??

Objection: ?We don?t need to use safety needles because we put them in the sharps container or pulverize the needles right away.?

?Proper disposal is vital to safety, but you are missing an important link. The period of time between use and disposal is among the most dangerous periods ? more than one-third of all injuries occur in those few seconds. That?s why safety devices form an important link in your overall safety chain.?

Objection:?We?ve never had a needlestick, so we don?t need safety devices.?

Unfortunately, you will still encounter this objection from otherwise intelligent professionals. First, you should realize that studies show that more than half of needlesticks are not reported, some offices have a culture that discourages needlestick reporting, and that, in a hospital setting, reported needlesticks occur at a rate of 30 for every 100 beds. Here?s the bottom line ? any healthcare professional who uses needles, has patients and has been in operation more than a couple of years has had a needlestick. It?s just part of the business. You may want to keep this fact to yourself at this point, but know that their assertion is probably wishful thinking ? at best. You?ll probably want to counter the objection with language like ... ?Doctor, can you imagine buying the smoke alarm after the fire starts, or the airbag after the accident?? And if logic doesn?t work, go back to argument one: ?It?s the law ...? and proceed to educate them on their responsibilities under the Bloodborne Pathogens Standard. After effectively handling the general objections, you will likely get a deep sigh and a reluctant ?OK, I?ll try them? from the noncomplier. Congratulations ? another win for safety! Experienced reps point out that the step you take next is vital to the customer staying in compliance and not immediately falling back into old ways, and keeping you in the customers? good graces and on his supplier list. They say that, when closing on safety devices, it is vital that, no matter what the location, or whether the customer is buying their first safety devices or a new type, that you never simply hand the devices over. You must provide in-service training or at least a careful demonstration to as many end users as possible. These devices are not difficult to use, but they are often different to use, and if people try them without guidance, using the old familiar techniques, they are likely to find them unsatisfactory, leading to complaints, lack of compliance and failed sales.