GUIDELINES FOR THE USE OF
SAFETY FEATURE EVALUATION SHEETS
Note:
OSHA has permission to
reprint this form in both traditional and electronic publishing formats. Since
the form is copyrighted, however, extensive use of the form by others may
require additional permission from the copyright holders. Other evaluation forms
for different devices also are available from Training for Development of
Innovative Control Technology Project (TDICT), Trauma Foundation, San Francisco,
CA 94110. |
Coordinators:
Determine which products are to be evaluated and provide at least four or more test
samples for each individual evaluating the product. (Each evaluator should have enough
samples to disassemble and examine the design thoroughly.)
Set up a testing station for each type of device which allows testers to evaluate products in a
simulated patient procedure. Provide training dummies (injection pads, oranges, etc.) as necessary.
Provide visual instructions and demonstrate proper use of each device.
Review the instructions and rating system with each evaluator.
Encourage each evaluator to comment on the sheets and prioritize the questions at the end of the
evaluation. This will provide a useful decision making tool and will help alert you to specific areas of
concern which may not have been covered by the questionnaire.
Evaluators:
Re-enact all steps of intended or possible procedures performed
with the device being
tested.
Attempt to misuse the device and circumvent or disable the safety feature.
Answer each question, including the short answer section at the end. If you do not understand a
question, please write comments directly on the sheets.
NOTE: Certain assumptions have been made in the development of these forms based on
information about currently available products. We recognize the likelihood that the ideal product
may not exist.
SAFETY FEATURE EVALUATION
FORM
SAFETY SYRINGES
Number of times used:
Please circle the most appropriate answer for each question. Not applicable (N/A) may be used if
the question does not apply to this particular product.
During Use:
|
agree
..... disagree |
1. The safety feature can be activated using a one-handed technique
2. The safety feature
does not obstruct vision of the tip of the sharp
3. Use of this product requires you to use the safety feature
4. This product does not require more time to use than a non-safety device
5. The safety feature works well with a wide variety of hand sizes
6. The device is easy to handle while wearing gloves
7. This device does not interfere with uses that do not require a needle
8. This device offers a good view of any aspirated fluid
9. This device will work with all required syringe and needle sizes
10. This device provides a better alternative to traditional recapping |
1 2 3 4 5 N/A
1 2 3 4 5 N/A
1 2 3 4 5 N/A
1 2 3 4 5 N/A
1 2 3 4 5 N/A
1 2 3 4 5 N/A
1 2 3 4 5 N/A
1 2 3 4 5 N/A
1 2 3 4 5 N/A
1 2 3 4 5 N/A |
After Use:
|
11. There is a clear and unmistakeable change (audible or visible) that occurs when the safety feature is activated
12. The safety feature operates reliably
13. The exposed sharp is permanently blunted or covered after use and prior to disposal
14. This device is no more difficult to process after use than non-safety
devices |
1 2 3 4 5 N/A
1 2 3 4 5 N/A
1 2 3 4 5 N/A
1 2 3 4 5 N/A |
Training:
|
15. The user
does not need extensive training for correct operation
16. The design of the device suggests proper use
17. It is not easy to skip a crucial step in proper use of the device |
1 2 3 4 5 N/A
1 2 3 4 5 N/A
1 2 3 4 5 N/A |
Of the above questions, which three are the most important to
your safety when using this product?
Are there other questions which you feel should be asked regarding the safety/product?
©
June 1993 Training for Development of Innovative Control Technology
Project
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