Sharps Safety Guidelines

December is International Sharps Injury Prevention Awareness Month.

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December is International Sharps Injury Prevention Awareness Month. The International Sharps Injury Prevention Society (ISIPS) started International Sharps Injury Prevention Month in 2013. The month reminds healthcare workers, waste management workers, laboratory staff, and others to practice sharp safety and follow safety protocols.

According to Occupational Safety and Health Administration (OSHA), it is estimated that 600,000 to 800,000 needlestick injuries and other percutaneous injuries occur annually among health care workers. Punctures and cuts can introduce bloodborne pathogens into the body, such as hepatitis B virus (HPV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV).

Most sharps-related injuries can be prevented and occur during or immediately after use. It is important to understand safe sharps waste disposal and that your organization effectively manages this type of waste.

Health care workers should first understand which items can account for sharps injuries; it can include more than needles. Other sharps include syringes, lancets, auto-injectors, connection and infusion sets, wires, and scalpels. All sharps are biohazardous waste generated during care, treatment, or services. All these items should go in sharps containers which should be rigid, puncture-resistant, and leak-resistant. All sharps containers should have a tight-fitting puncture-proof lid, a clear label, and a sturdy upright design. Containers should also be marked with a line to indicate when the container is three-fourths full. Once the container reaches that point, do not place any more sharps in the container—this line is to prevent injuries. One of the leading causes of sharps injuries is overfilled containers. Never force items into the sharps container. If you have difficulties inserting a sharp into a receptacle, it may be too full; therefore, find another nearby container. Once three-fourths full, seal the sharps container and dispose of it per your biomedical waste regulations.

During this year’s International Sharps Injury Prevention Awareness Month, reflect on your organization’s sharp safety program. A comprehensive program can promote safe work practices and reduce the risk of injury. Infection Control Today^® (ICT^®) spoke to Jackie Noble, RN, BSN, an oncology nurse at Holmes Regional Medical Center in Melbourne, Florida, regarding sharp safety. She stated, “Sharp safety is important to me because it is a large safety risk for infection for my patients and myself. I have seen coworkers accidentally stick themselves after sticking a patient. In one instance, the patient was HIV-positive. This led to many blood tests and medications for the employee to help prevent the HIV infection in their bloodstream. If we aren’t practicing sharp safety properly, a quick incident like this can have lifelong effects for the employee. These safety measures are not only for the safety of infection prevention for the patient but important to prevent infection for us as healthcare providers.”

Noble also told ICT^®, “I rarely ever feel at risk for getting a needle stick injury because I always ensure that I follow all the precautions. Caps on needles are essential to keep on prior to inserting a needle. All needles now have a safety measure that can be activated after the needle has been used to prevent unwarranted sticks. Using precautions will provide reassurance that needle sticks are preventable. Always ask for help if you feel uneasy about a shot for a patient who may not be able to hold still! We have annual sharp safety modules that remind employees of the importance of sharp safety and ways we can prevent unwarranted sticks. We are taught not to recap needles, uncap the needle only right before we use it, utilize the safety measure immediately after use, and then throw the sharp into the sharps container as soon as possible. If there is any fear that a patient may not hold still, we always have multiple people help keep a patient distracted and still for the shot.”

Other Rules of Sharps and Sharps Container Use

1. Never reach inside these containers to retrieve items.
2. Sharps containers should only be reserved for items that could puncture the skin, do not place other medical items and devices such as medications, batteries, tape, gauze, and gloves into these containers. Containers with Federal Drug Administration (FDA)-marked clearance are recommended.
3. Follow manufacturers’ instructions for use (IFUs), and use engineering controls. Many sharps now contain safety features engineered into them. Be sure to know how to use these features to prevent sharps injuries. Some of these features include retractable needles, needless systems, and sheaths/shields for needles. An essential part of an organization’s bloodborne pathogen protection program or sharps safety program can be selecting appropriate devices with safety features.
4. Other recommendations for using sharps include never bending, breaking, or recapping needles or blades.
5. Always maintain visual contact with sharps during use.
6. Immediately placing needles and other sharps into a sharps disposable container is instrumental when using sharps. Be aware of staff nearby to protect them from any sharps you are handling or disposing of.
7. The location of a sharps container should be deliberate, especially in procedure rooms. Sharps receptacles should be nearby and not be blocked by other furniture or equipment. The flow of a procedure, such as a central line insertion, should incorporate the location of the receptacle, and staff should be able to access it easily. Ensure that adequate sharps containers are located in your organization and that staff knows whom to contact if they need another container due to fullness or issues with the receptacle.
8. Report any injuries with sharps. If a sharps injury has occurred, it is essential to report it to your employer and file an injury report. Reporting is critical to receiving immediate post-exposure care and preventing future accidents. By reporting, you may be helping another employee from the same injury. Lastly, report to your supervisor if you find a needle or sharp left at the bedside or in the regular garbage.