Once a risk assessment has been completed, the methods chosen to adequately control the identified risks should, as far as possible, follow the hierarchical approach set out in the Management of Health and Safety at Work Regulations 1999 and COSHH, namely:
For general guidance on risk control and management, including example risk assessments, see: Risk management.
Consider if the hazardous procedure can be replaced completely and the associated risk eliminated.
Systems of work are usually implemented by standard operating procedures or local codes of practice. Because they rely on individuals adhering to them, usually they are only used to supplement other control measures. Examples of such systems relating to infection prevention and control are:
A summary of requirements designed to protect health care workers in England from BBV exposure is provided in The Health Act 2006: Code of practice for the prevention and control of healthcare associated infections, (known as The Hygiene Code). Although the Act is enforceable in England alone, the associated Code of Practice contains information that is relevant for anyone providing occupational health support for healthcare workers, and for prevention and management of occupational exposure to BBV. Additional guidance for the Scottish healthcare sector is available from the Scottish Infection Manual.
Failure to observe 'The Hygiene Code' in England may either result in an Improvement Notice being issued to the NHS body by the Healthcare Commission, or in it being reported for significant failings and placed on 'special measures'.
Needles and many other medical sharps are covered by The Medical Devices Regulations 2002 and regulated within the UK by The Medicines and Healthcare Products Regulatory Agency (MHRA). As such, they should be designed and manufactured in such a way that, when used under the conditions and for the purposes intended, they will not compromise the clinical condition or the safety of patients, or the safety and health of users, or where applicable, other persons, provided that any risks which may be associated with their use constitute acceptable risks when weighed against the benefits to the patient and are compatible with a high level of health and safety. Enforcement actions relating to these regulations may differ slightly depending on where in the UK they are applied.
In particular, with regard to needles , other medical sharps and blood-borne viruses, the essential requirements state that devices must be designed in such a way as to eliminate, or reduce as far as possible, the risk of infection to the patient, user and third parties. The design must also allow easy handling and, where necessary, minimise contamination of the device by the patient or vice versa during use. It may be appropriate to consider the use of newer technology such as retractable needles, where the health and safety benefits may justify any additional cost.
A summary of the MHRA's regulatory responsibilities can be found on the MHRA web site at: Medical device appeals.