Overview of the insulin needle QI project

In June 2018, Intermountain Healthcare's nursing team, led by the first author, and BD, a global medical technology company, initiated a sharps safety assessment program with the goal of creating a comprehensive educational plan to reduce injuries from sharps across all Intermountain Healthcare facilities. BD supported Intermountain Healthcare's goals by performing an external evaluation of injury trends and providing a clinical safety assessment team to (1) observe variations in internal practices, processes, and products; (2) compare findings with available national evidence-based practice guidelines; and (3) provide logistical support for recommendations that we chose to implement. A review of sharps injury data by Intermountain Healthcare's nursing and BD teams recognized a trend of increased subcutaneous insulin needlestick injuries. Direct observation of practice and products by the BD team in 4 hospitals and 3 clinics identified opportunities to improve injection administration and disposal practices.

Results of the safety assessment guided the next steps taken by Intermountain Healthcare's nursing team in engaging our internal supply chain partners and product standardization committee to review and standardize insulin syringes and needles. After further independent review of national trends and literature by nursing leaders, we elected to standardize to a safety-engineered insulin syringe with a 6-mm needle. In addition, we collaborated with BD on practice change education and Intermountain Healthcare created a strategy to monitor compliance with insulin injection and needle disposal practices.