A sample of NHS organisations has found more than 80% to be breaching sharps regulations, according to the national watchdog for work-related health and safety.
The most common type of breach was a failure to use safer needlesticks or their unsafe disposal. This was followed by breaches in information and training, and arrangements in the event of an injury, said the Health and Safety Executive.
“Generally, there was failure to use safer sharps where reasonably practicable, or inconsistent use of safer sharps across the organisation”
Health and Safety Executive
Following inspections at 40 organisations expected to have low levels of compliance – comprising 34 trusts in England as well as NHS boards in Scotland and Wales – the body issued 45% of them with notices for improvement.
These types of notices are given when there is a breach of regulations that will be likely to continue and the inspector has called for action to address this by a specific date.
The HSE findings are from a series of inspections it carried out in 2015-16 that were launched after the body received reports from a number of external sources that organisations were not complying with the Health and Safety (Sharps Instruments in Healthcare) Regulations 2013. It found 83% failed to fully comply with the sharps regulations.
Nursing Times recently reported on analysis of data from more than 120 hospital trusts in England that found unacceptable levels of compliance with the laws, which came into effect in May 2013.
This latest HSE report found that in more than 75% of organisations there were breaches in the use and disposal of needlesticks.
“Generally, there was failure to use safer sharps where reasonably practicable, or inconsistent use of safer sharps across the organisation,” said the HSE in its report.
“Used needles were left on [a] trolley rather than being disposed of in a sharps bin”
Health and Safety Executive
It cited examples including a lack of a sharps prevention strategy altogether, or a failure by organisations to provide needles with safety mechanisms that were readily available, such as with hollow bore hypodermic needles.
Other examples included where some organisations had introduced safer sharps, but there was still “widespread” use of unsafe devices, such as scalpels and winged IV cannula, and also some organisations storing safe and non-safe needlesticks together.
“This led to confusion for staff who were unsure which item to use, they could take the wrong item by mistake, or personal preferences informed their decision making,” said the report.
HSE also found a “number” of cases where sharps bins were placed at low level and potentially within reach of children. It also noted sharps bins were not always located at the point of their use.
“[This] was observed where used needles were left on [a] trolley rather than being disposed of in a sharps bin,” it said.
Meanwhile, there was often a failure to assess risks of exposure to blood borne viruses from sharps injuries, warned the report.
“The report highlights the work that still remains to be done by NHS trusts in enforcing this legislation and protecting staff from these injuries”
Inspectors also found problems with training, such as how to respond when patients provided their own insulin and standard needles, as well as inconsistent explanations from staff about how to use safety guards.
They found instances where there was not a robust system in place to investigate sharps-related injuries and learn from the findings.
In addition, the watchdog found a number of organisations that had failed to report incidents that fell under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013.
“Although this report is not representative of compliance levels in all NHS organisations [due to being based on a targeted sample], the failings described appear to represent common causes of non-compliance. These lessons can therefore be learned more widely,” concluded the HSE.
Unison said the report highlighted the further work that needed to be done to ensure NHS trusts were enforcing the legislation and protecting staff from injuries.
“Unison and the Safer Needles Network had long campaigned for this legislation to protect NHS staff from these unnecessary injuries and the risk of potentially fatal infections,” said Unison assistant national officer Robert Baughan.
“The report highlights the work that still remains to be done by NHS trusts in enforcing this legislation and protecting staff from these injuries,” he added.