Developing a sharps safety program
Healthcare workers are at risk of occupational exposure to blood borne viruses (BBV) (including hepatitis B virus, hepatitis C virus and human immunodeficiency virus (HIV)) through exposure to blood, other body fluids or body tissues from an infected patient. Injuries from needles and other sharp devices carry the greatest risk of BBV transmission. The majority of occupational exposures can be prevented through an effective sharps safety program and hollow-bore needle safety program.
An effective sharps safety program includes three core elements which should be implemented simultaneously:
- engineering controls, such as:
- providing medical devices incorporating safety engineered protection mechanisms (e.g. retractable syringes or blunt-tip sutures)
- use of sharps disposal systems that conform to Australian Standards (AS4031 or AS/NZS 4261)
- sharps removal systems (e.g. scalpel blade removers)
- work practice controls, such as:
- care in handling sharp devices
- recapping avoidance
- neutral sharps safety zones
- contaminated sharps are organised in a standardised way, until they are disposed
- ensuring sharps are not passed by hand
- clear communication, especially when passing a sharp
- availability of point of use sharps containers
- use of personal protective equipment
- personal consideration to double glove application during surgical procedures (for example, reducing the risk of glove perforation)
- establishing a responsibility practise – the person who generates the sharp is responsible for the safe disposal of the sharp
- training, including:
- on induction and annual education as it should not be assumed that new staff are familiar with specific devices used or policies and procedures related to sharps safety
- the correct use of medical devices incorporating sharps protection mechanisms including demonstrated competent use of the device
- preventative measures such as those outlined in the work practice controls section
- the reporting, response and monitoring procedures for occupational exposures
- introduction of a new device
- if a member of staff sustains a sharps injury.
Additional components of an effective sharps safety program include:
- following local product complaint processes for sharps safety devices which fail to function as required (e.g. safety device fails to operate when activated)
- regularly reviewing the devices used and establish if there are any safer alternatives available
- investigating each incident conducting a thorough, systematic root cause analysis
- involving the unit manager and direct-care staff in investigations, especially when a trend or problematic process is identified
- partnering with senior staff, such as a senior surgeon, to become advocates for any change as well as safety in general
- local occupational exposure data analysis and assessment of risks
- a process of reporting any occupational exposure to key stakeholders.
Sharps safety programs should include a reporting process for any occupational exposure occurrences so that the effectiveness of the program can be monitored and evaluated. Data gathered should be used to shape any further initiatives to reduce sharps injuries.
Reports should routinely go to key stakeholders and be reported through established committees. These processes help create a blame free environment and encourage exposure/incident reporting, and a strong safety culture.
Healthcare facilities are required to develop, implement, maintain and monitor a sharps safety program as per Standard 3.1.1 of the National Safety and Quality Health Service Standards (NSQHS). Local occupational exposure data should be analysed and risk assessments undertaken where an existing sharps safety program is in place.
Australian College of Operating Room Nurses Ltd. ACORN Standards for Perioperative Nursing.
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