You received a report from the Occupational Health office that Melinda, a phlebotomist, reported a needle stick exposure. Four days later, you receive a second report about another phlebotomist at a different location. When you visit Melinda to get further details, you learn that she carries a sharps container on her tray with no lid for the disposal of her needles. She informs you that there is not enough room in the small container for her used needles and needle holders, and she typically overfills the container until she returns to the lab to dump it. She received the exposure while placing a needle into the overfilled container on her tray. As you investigate the second incident, you discover the cause was the same, and with further questioning, you learn that most phlebotomists follow the practice of using uncovered sharps containers. This is a safety problem that appears widespread and could cause harm to several people.

Now is the time to implement a safety stand-down. Following the steps discussed last month, immediate education should be created and distributed to all phlebotomy staff. Any product or process changes should be discussed in that stand-down, and participation should be mandatory and documented. Follow-up by checking that all phlebotomists are using the correct supplies and see that they are using them properly.

On Tuesday you receive a complaint from an employee about odors in the histology lab where there has been recent significant staff turnover. The next day you receive the formaldehyde vapor badge results from the monitoring performed over the last two weeks, and all results are elevated with some exceeding the STEL and PEL. When you enter the laboratory, you notice the specimen storage cabinets are full of specimens and the doors are open, and the smell of formaldehyde is strong. When you interview some of the staff, you learn that storage space has become limited, and staff desired to save space. Employees decided to pour off the formalin from small tissue specimens and stack the mostly empty containers inside of each other with no lids on them.

This situation also calls for a safety stand-down. Multiple staff members are affected and the situation is endangers their health. The stand-down here should include education on proper specimen storage and a solution to increase storage space.

Knowing when to conduct a safety stand-down in the laboratory is important. There are several other possible scenarios for which a stand-down may need to be conducted, and again, swift action should always occur. There may be instances for which all work in the lab must stop until the stand-down is complete. These may be situations in which staff or patients have been harmed or there is imminent danger such that work must the halted until the safety issue is resolved. If you are a lab safety professional, and you think a safety stand-down is necessary, make it happen. It’s better to err on the side of caution to keep your employees or patients safe.