Avoiding sharps injuries
The use of sharps cannot be avoided in some industries, eg:
- tattooing and body piercing;
Handling and disposal of sharps
In the past, many inoculation accidents have occurred as a result of re-sheathing used hypodermic needles, but in most cases, modern blood-taking devices negate the need for traditional syringes and make blood taking safer. When a sharp has been used, if sharps disposal bins are not available, or if the working environment makes their immediate use impractical, then smaller needle securing systems exist. These systems enclose sharps from syringe-needles and render them safe for handling after use. If used, these systems must be disposed of by incineration. Guidance on infection prevention for healthcare workers is available, and includes the process of risk assessment related to the safe handling of sharps.
Needles and syringes collected in public places have also been proven to contain blood-borne virus (BBV) contamination, such materials should never be handled if found, but should be reported to the local authority responsible for the site. Those working in the refuse collection and recycling industry should be aware of the risks from discarded drug-litter. Guidance on handling needles gives examples of good practice within the industry.
Obtaining blood samples in the community setting can present challenges beyond those experienced within the more controlled healthcare environment. Patients may have poorly accessible veins, eg those with a history of prolonged intravenous drug use, who are therefore at a higher risk of suffering from a BBV infection. In these cases, some NHS Trusts implement policies that allow patients to obtain their own blood sample, supervised by the community healthcare worker (HCW). When this is a practice approved by the Trust, training and a written procedure are required for staff to make sure the safe acquisition and handling of samples. This should include a risk assessment that considers the health and safety needs of the patient and the HCW. In particular, sample bottles should be given to the patient by the HCW and filled by the patient to avoid the need for unnecessary sample and needle handling. The needle and syringe must be deposited immediately into a sharps bin by the patient after use. If a patient self sample-taking policy exists, and these principles are followed, the risk of contaminated sharps injury to the HCW will be minimised.
Needlestick injuries (NSIs)
Needlestick injuries (NSIs) are still reported in the UK. The Health Protection Agency's Eye of the needle report suggests that dutyholders could do more to reduce the incidence of these injuries by following safe working practices. The increased use of suitable equipment, for example safer needle technology, may also help to reduce instances of NSIs. An increasing number of devices and systems are available, which include:
- blood lancets;
- syringes and needles;
- blood collection systems;
- needle-free devices; and
- safety cannulae.
These devices are available through the NHS Supply Chain.
- Improved education and training and higher levels of awareness of the risks and preventive measures are also likely to contribute to reducing the numbers of NSIs in the UK.
Steps for remaining 'sharps safe' are summarised below.
- Avoid leaving sharps lying around;
- Avoid re-sheathing any used needles/razors;
- Do not bend/break needles before discarding them;
- Place contaminated sharps/razors in disposal containers approved to BS 7320:1990, immediately after use;
- Close the aperture to the sharps container when carrying or if left unsupervised, to prevent spillage or tampering;
- Lock the container when it is three-quarters full using the closure mechanism. Do not try to press sharps down to make more room;
- Place damaged sharps containers inside a larger sharps container. Lock and label the container with premises/departmental address prior to disposal.
- Do not place anything sharp inside a yellow hazardous waste bag as it may cause injury;
- Do not use makeshift containers, eg drinks cans, bottles, cardboard boxes, for sharps disposal. They may find their way into domestic waste, presenting a hazard to refuse workers and members of the public;
- Do not try to retrieve items from a sharps container;
- Do not place sharps containers on the floor, window sills or above shoulder level. They should be stored above knee level and below shoulder level;
- Carry sharps containers by the handle, away from the body;
- Keep all sharps waste in a designated, secure area until it is collected.
Further information on the safe use and disposal of sharps is available from The Medicines and Healthcare Products Regulatory Agency (MHRA).