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Achieving safe sharps practice

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The use of sharps should be avoided where possible. However, when their use is essential, particular care is required in handling and disposal and, if possible, safer devices should be used.

Abstract

VOL: 99, ISSUE: 37, PAGE NO: 44

 

The use of sharps should be avoided where possible. However, when their use is essential, particular care is required in handling and disposal and, if possible, safer devices should be used.

 


 

Safe handling
Sharps should always be handled carefully. The components of safe handling are:

 


 

- Avoid using sharps if possible

 


 

- Do not resheath hypodermic needles after use. If this is vital, use a specific needle resheathing/removing device

 


 

- Use intravenous devices with a safety feature whenever possible

 


 

- Do not overfill sharps bins. Replace them when they are three-quarters full

 


 

- Wear gloves for venepuncture and intravenous therapy

 


 

- Obtain assistance when using a sharp with a confused patient

 


 

- Never leave sharps unattended

 


 

- Sharps bins should be available at the point of use, including drug and cardiac arrest trolleys

 


 

- Sharps bins should be located at waist height and never on the floor

 


 

- Do not pass sharps from hand to hand

 


 

- Before transporting a used syringe, for example, containing an arterial blood sample, remove the needle using a removal device and attach a blind hub.

 


 

Safe disposal
Used sharps must be disposed of safely. The components of safe disposal are:

 


 

- It is the user’s responsibility to dispose of used sharps as soon as possible after use

 


 

- Dispose of syringes and needles as a single unit

 


 

- Always carry a sharps bin by the handle and away from the body

 


 

- Never dispose of sharps in containers used for storage of other wastes, or place used sharps containers in clinical waste bags

 


 

- Dispose of used sharps in properly constructed containers that meet the requirements of BS 7320: 1990 Specification for sharps containers, and which are UN approved (Medical Devices Agency, 2001a)

 


 

- Label or tag sharps bins with the name of the ward and hospital, the date and your signature

 


 

- An adequate supply of sharps bins must be available

 


 

- Sharps bins must be sealed/locked before removing for disposal

 


 

- Full sharps bins awaiting collection in the clinical areas must be retained in a safe place

 


 

- Staff transporting used sharps bins must wear adequate protective clothing

 


 

- Sharps bins awaiting removal by a contractor should be stored in a secure, protected area.

 


 

Safety devices
The Medical Devices Agency (2001b) stipulates that: ‘Emphasis should be placed on the correct handling of sharps before, during and after use, and the safe disposal of such devices. Appropriate training of staff is essential in reducing the risks of needlestick and sharps injuries.

 


 

‘It is possible however for needlestick and sharps injuries to occur as a result of accidents and the risk of these may be reduced by the use of devices incorporating safety devices.’

 


 

A safety device is one that incorporates a built-in safety feature in its design, which is intended to reduce the risk of sharps/needlestick injury before, during and after its use (Medical Devices Agency, 2001b).

 


 

Safety devices must conform to the Medical Devices Regulations 2002 and must therefore carry a CE mark. The manufacturer of any device placed on the UK market must demonstrate that the device meets the essential requirements of the regulations without compromising the safety of the user or patient, or increasing the risks associated with the procedure being undertaken.

 


 

An integrated safety feature is part of the basic design of the device that cannot be removed. A passive safety feature is one that does not require the user to activate it and remains effective before, during and after use.

 


 

Integrated and passive safety features are the most likely to have an effect on the prevention of sharps/needlestick injuries, for example, retractable needles and needle-less connectors (Medical Devices Agency, 2001a).

 


 

Any safety product used must:

 


 

- Provide a barrier between hands and needle after use

 


 

- Allow or require workers’ hands to remain behind the needle at all times

 


 

- Have safety features that cannot be deactivated and remain protective throughout disposal to protect other staff members, for example, porters and waste disposal workers - Be simple and self-evident to operate and require little or no training for effective use - Be appropriate to the procedure to be undertaken and should be chosen following a risk assessment.

 


 

Many types of safety device are now available in the UK. New devices are continually being designed and produced, and further information can be obtained from the NHS Purchasing and Supply Agency and the Safer Needles Network (Box 1).

 


 

Personal protective equipment
- This should be used appropriately following a risk assessment:

 


 

- Gloves should be worn whenever contact with blood is anticipated. Although wearing gloves does not prevent injury, the effect of the needle being wiped on the glove may reduce the volume of blood to which the hand is exposed, thereby reducing the volume inoculated and the risk of infection. In some areas, double gloving may be considered

 


 

- Plastic aprons should be worn during procedures in which the body and/or clothing may be contaminated

 


 

- Facial protection should be worn whenever there is a risk of splash injury, and risk of contamination of the conjunctivae and mucous membranes

 


 

- Footwear should be considered where there is a risk of dropping sharp instruments or other items.

 


 

Summary To ensure safe sharps practice:

 


 

- Always assemble sharps containers correctly

 


 

- Always dispose of sharps at the point of use in a suitable container

 


 

- Do not resheath needles after use

 


 

- Dispose of syringes and needles as a single unit

 


 

- Always lock used sharps containers when ready for final disposal and do not overfill them

 


 

- Do not dispose of sharps with other clinical waste

 


 

- Do not place used sharps containers in yellow bags for disposal

 


 

- Evaluate safety devices before purchase and use

 


 

- Although wearing gloves does not prevent injury, the wiping effect of a glove on a needle may reduce the volume of blood inoculated.

 


 

FOOTNOTE
This extract was reproduced with permission from the Infection Control Nurses Association. Copies of Sharps Injury: Prevention and Risk Management can be obtained by contacting Fitwise on tel: 01506 811077; e-mail: liz@fitwise.co.uk. or by clicking on the ‘Publications’ icon at www.icna.co.uk

 


 

The cost is £5 for ICNA members and £10 for non-members.
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