Sharps safety
Healthcare workers are at risk of occupational exposure to blood borne viruses (BBV). This includes hepatitis B virus, hepatitis C virus and human immunodeficiency virus (HIV). This can occur through exposure to blood, other body fluids or body tissues from an infected patient. Sharp implements or objects can also cause injury to the user or to other people that are in or use the environment.
Injuries from used needles and other used sharp devices carry the greatest risk of occupational BBV transmission. The majority of percutaneous occupational exposures can be prevented through an effective sharps safety program and hollow-bore needle safety program.
Legislative requirements
The Work Health and Safety Act 2011 (Queensland) requires that a risk to safety is removed where this is practicable. Where it is not practicable, the risk must be minimized as far as is practicable.
Healthcare facilities are required to develop, implement, maintain and monitor a sharps safety program as per the National Safety and Quality Health Service Standards (NSQHS).
Chapter 4 of the Public Health Act 2005 (Queensland) requires operators of facilities that offer health services to identify and manage risks associated with procedures that are performed at their facility. An Infection Control Management Plan (ICMP) is required to be available to all workers to help mitigate these risks.
A sharps safety program should be part of a wider work health, safety, and wellbeing program. It is important to engage with your local work health, safety, and wellbeing representatives. For further information please refer to the Queensland Health work health safety and wellbeing website.
Perioperative sharps safety
Perioperative areas should use the Australian College of Perioperative Nurses (ACORN) Standard for Safe and Quality Care in the Perioperative Environment to develop a sharps safety program. Particularly the Sharps and preventing sharps-related injury Standard.
Local occupational exposure data should be analysed and risk assessments undertaken where an existing sharps safety program is in place.
Prevention
Please refer to Prevention of needlestick injuries for more information about aspects of prevention, including further information about the hierarchy of controls.
Reporting and surveillance
In addition to the normal workplace incident/injury reporting requirements, sharps safety programs should include the process of reporting any occupational exposure occurrences. An occupational exposure is a workplace exposure to blood or body fluids via a percutaneous route, via a sharp instrument or via a hollow bore needle. Occupational exposures can also occur via blood or body fluid contact with broken skin or mucous membrane. Where you have had an exposure to blood or body fluids, please seek medical attention for your injury and for an assessment of your risk. Please refer to Riskman to report you exposure and to your local procedure for any additional local requirements.
Information about occupational exposures and sharps injuries may be used by key stakeholders to monitor and evaluate the effectiveness of the program.
To report incidence rates and adequately measure effectiveness of interventions:
- facilities should collect accurate numerator (e.g. occupational exposures to blood and body fluids) and denominator data (e.g. the number of full-time-equivalent staff)
- data on sharps injuries should be analysed and interpreted to inform prevention planning
- timelines of introduction of safety devices and other interventions should be recorded on the surveillance plan to measure the effectiveness of the interventions
- occupational exposures should be analysed and reported regularly to the appropriate committee.
Surveillance of occupational exposures is different to other types of healthcare-associated infection surveillance. It is a passive process that requires a staff member to voluntarily report an exposure incident. Periodic reviews should be used to measure reporting compliance and healthcare worker knowledge of procedures for reporting needle stick injuries e.g. standardised, anonymous questionnaire survey to determine reporting rate of needle stick injuries.
It is important to note that an increase in numbers may reflect increased reporting rather than increased incidents of needle stick injuries.
More resources
- Australian College of Operating Room Nurses Ltd. ACORN Standards for Perioperative Nursing
- RACGP practice standards – Safe sharps handling practices
- Worksafe Queensland – Skin penetrating injuries
- Centers for Disease Control and Prevention. Workbook for Designing, Implementing and Evaluating a Sharps Injury Prevention Program. 2008
- European Bio-safety Network Resources
- National Health and Medical Research Council. Australian Guidelines for the Prevention and Control of Infection in Healthcare. 2019
- Queensland Health. Health, safety and wellbeing risk management standard QH-IMP-401-3:2020
- Association of occupational health professionals in healthcare. Proven Strategies to Prevent Bloodborne Pathogen Exposure in EXPO-S.T.O.P Hospitals. 2017.
For more information on post exposure management of an occupational exposure, please refer to the Queensland Health Management of exposures to blood and body fluids guideline.