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Sharps injuries - What you need to do

As an employer, you will need to take action to manage the risks if your workers;

If you are a healthcare employer you will also need to look at the Health Services  Information Sheet  produced to help you comply with the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

Complete a risk assessment

You must assess the risks. This process will help you identify the hazards; consider the nature of the work; evaluate the risks; and implement, monitor and review control measures to reduce the risk.

What is a suitable and sufficient risk assessment?

The assessment needs to be appropriate for the nature of the work. The more hazardous the work, the more in-depth the assessment should be. For example, procedures that have a higher risk of injury include intra-vascular cannulation, venepuncture and injections and involve the use of devices such as IV cannulae, winged steel-butterfly-needles, needles and syringes and phlebotomy needles. These procedures should have detailed assessments. 

Who completes your assessment, and who it applies to, will depend on the nature of the work and the complexity of the organisation. For example:

You should consider risks to all those who may use the sharps including, where relevant, those who dismantle, sterilise or dispose of the medical sharps. 

Implementing control measures

The risk control measures identified by the risk assessment should follow the hierarchical approach in the Control of Substances Hazardous to Health Regulations (COSHH) 2002:

Preventing the risk of exposure

Your primary duty is to prevent exposure to the risk of a sharps injury. 

Controlling the risk of exposure

If the risk cannot be prevented, then the risk of an injury must be adequately controlled. There is a general hierarchy of controls that needs to be considered as follows:  

The hierarchy reflects the fact that eliminating and controlling risk by using physical engineering controls and safeguards is more dependable than relying solely on systems of work.

Studies have shown that in the health and social care sector, a combination of training, safer working practices and the use of safer sharp products can prevent the majority of sharps injuries.

Providing safer sharps devices

Factors to consider when selecting appropriate safer sharps:

  • the device must not compromise patient care;
  • the reliability of the device;
  • the care-giver should be able to maintain appropriate control over the procedure;
  • other safety hazards or sources of blood exposure that may arise from use of the device;
  • ease of use (taking into account the existing clinical practices commonly in use by the relevant health professionals – but not assuming custom and practice is safest):
  • the design of the safety mechanism is suitable for the application, taking account of the following issues:
    • if activation of the safety mechanism is straightforward, it is more likely to be used;
    • if the safety mechanism is integral to the device (ie not a separate accessory) it cannot be lost or misplaced;
    • for many uses, a single-handed or automatic activation will be preferable;
    • an audible, tactile or visual signal that the safety mechanism has correctly activated is helpful to the user;  and
    • the safety mechanism is not effective if it is easily reversible.

Involving the relevant staff in the selection of safer sharps will help ensure that they use the new equipment safely, and that any reduction in the number of sharps injuries is maintained for longer.

Information, instruction and training on safe use of sharps

Training should be a key part of your approach to managing the risk of sharps injuries. You have a responsibility to provide suitable and sufficient information, instruction and training. As a minimum, the training should cover:

The training provision should also take into account:

Ensure that suitable clinical waste disposal procedures, including use of sharps containers, are followed

Ensure standard precautions for infection control are in place

The majority of incidents where the transmission of blood-borne viruses occur are caused by failure to adhere to standard precautions.

The guidelines on standard precautions (Guidance for Clinical Health Care Workers: Protection against infection with blood-borne viruses) were published by the Department of Health in 1998. They are aimed at preventing the transmission of blood-borne viruses by considering that blood and certain body fluids are potentially infectious and adopting specific procedures where contact is anticipated.

Following standard precautions alone will not help you prevent sharps injuries, but following them alongside other control measures, ie  using safer sharps devices, safe disposal and training etc. will help reduce the risk.

Have clear procedures for response to sharps injury, including speedy access to appropriate prophylaxis treatments

As mentioned previously, you have a responsibility to provide suitable and sufficient information, instruction and training and as a minimum, this must cover what procedures to follow in the event of an emergency. For example, measures to be taken in the event of a sharps injury, how to report incidents and what response should be expected from the organisation.

When preparing response procedures you should consider what prophylaxis treatments are available and how they will be provided.

Reporting work-related sharps injuries

Sharps injuries must be reported to HSE under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 (RIDDOR) if:

If the sharp is not contaminated with a BBV, or the source of the sharps injury cannot be traced, it is not reportable to HSE, unless the injury itself causes an over-seven-day injury. If the employee develops a disease attributable to the injury, then it must be reported.

Updated 2015-09-09