SHARPS INJURY PREVENTION

Learning Objectives Identify the different types of sharps. Identify risks posed by needles and other sharps. Recall safe practices for needles and other sharps. Recognize sharps that have engineered sharps injury

protection. Know what Personal Protective Equipment includes. Know how to report an exposure incident.

Sharps - Definition

Definition: any needles, syringes with needles, scalpels, blades, broken ampules or other articles that could cause wounds or punctures to personnel handling them.

Must be discarded into special containers without risk to disposal personnel.

Risks Posed by Sharps

Transmission of blood borne pathogens to someone injured by the sharp.

Between 600,000 and 800,000 sharp injuries occur among healthcare workers annually according to OSHA.

Blood Borne Pathogen Transmission

Sharps injuries can be associated with occupational transmission of more than 20 blood borne pathogens: Most common pathogens:

Hepatitis B (HBV) Hepatitis C (HCV) Human immunodeficiency virus (HIV)

Sharps injuries can lead to serious or fatal infections.

About ½ of sharp injuries go unreported. A culture of safety should be promoted by:

Reporting injuries and hazards. Supporting involvement of staff in selection of

sharps injury prevention devices. Providing education and training on sharps injury

prevention.

Culture of Safety

Hypodermic needles Blood collection needles Suture needles Needles used in IV delivery systems Glass capillary tubes Used disposable razors

Sharps that Frequently Cause Injury

Physicians Nurses Lab technicians Phlebotomists Mid-level providers Housekeepers Laundry personnel And others

Who is at Risk?

Drawing blood IM injections IV access Suturing Handling laundry Collecting filled sharps containers And more

Procedures Linked to Injuries

Occupational Exposure to bloodborne pathogens (29 CFR §1910.1030)

Revised in January 2001 Covers all occupational exposure to blood and

other potentially infectious material Available at www.osha.gov

OSHA Requirements

Healthcare facilities must: Develop and periodically review an exposure

control plan. Offer safer medical devices to reduce or

eliminate exposure incidents. Seek employee input in selection of safer

medical devices and implementation of work practice controls.

Offer the Hep B vaccine to workers.

OSHA Bloodborne Pathogen Standard

OSHA requires healthcare providers to: Identify jobs and tasks in which occupational

exposure to blood or other potentially infectious material occurs.

Consider and implement safer medical devices. Seek input from healthcare workers in

identification, evaluation and selection of safer medical devices and work practice controls.

Update plan annually.

Exposure Control Plan

Follow standard precautions. Use engineering and work practice controls. Wear personal protective equipment. Avoid recapping, bending or breaking of

needles and sharps.

Methods to Reduce Exposure

CDC recommends standard precautions: Assume all blood and body fluids are infectious. Every patient is treated as potentially infected

with a bloodborne pathogen. All healthcare workers must use standard

precautions whenever there is a chance of exposure to blood or other potentially infectious material.

Workers must use hand hygiene!

Standard Precautions

Avoid recapping, bending or breaking needles and sharps.

Use a one hand technique if medical procedure requires recapping.

Place used sharps immediately into puncture-resistant containers.

Carry sealed specimen containers in an outer container.

Avoid touching contaminated broken glass with bare hands.

Safe Practices

A protective device that can be used to protect healthcare workers from accidental needlesticks and other sharp injuries.

Generally take the same form and are used for the same application as their traditional non-safety counterparts, EXCEPT:

Protective devices are designed to prevent personnel from coming into contact with an exposed needle or other sharp.

Safe Medical Device

Needleless systems, such as needleless IV line connectors;

Sharps with engineered sharps injury protection, such as self-sheathing needles on syringes.

Two Types of Safer Medical Devices

NOW YOU SEE IT. NOW YOU DON’T.

Device that does not use a needle for Collection of body fluids Administration of medication/fluids; or Any other procedure with potential percutaneous

exposure to a contaminated sharp.

Needleless Systems

Needleless System

Non-needle sharps or needle devices with built-in safety features or mechanisms that reduce the risk of exposure incidents.

Uses: Withdrawing body fluids Accessing a vein or artery Administering medications or other fluids

Engineered Sharps Injury Protection

Example of Hypodermic Syringe with Retractable technology

Example of Phlebotomy Needle with Self-blunting Feature

Needleguard Safety Feature

PPE Equipment worn to minimize exposure to

infectious materials or chemicals. Required by the Bloodborne Pathogens

Standard if exposure to blood and other potentially infectious materials is anticipated.

pps://www.osha.gov/SLTC/etools/hospital/hazards/ppe/ppe.html

Personal Protective Equipment

Know where protective wear is stored Gloves, gowns, mask, face protector, etc.

Protective Clothing

Used to collect blood Break when inserted into putty Break during centrifugation Replace with non-glass material or Wrap in puncture-resistant film or Look at products that can measure Hematocrit

without a centrifuge.

Risks of Glass Capillary Tubes

All contaminated sharps must be discarded in a sharps container – OSHA requirement

Place sharps in container immediately after use.

Place containers in patient rooms. Do not overfill container. Follow your practice’s procedures for disposal of sharps and container.

Sharp Disposal Containers

An exposure incident has occurred if Blood or other potentially infectious material (not

your own) has come into direct contact with your eyes, mouth, mucous membranes or open wounds; or

You have punctured your skin with a contaminated sharp object.

Exposure Incident

Report all exposures Complete necessary paperwork to help

document exposure. Employer will provide a medical evaluation,

counseling, treatments, information, etc. as needed for you.

Exposure Incident

Hepatitis vaccine is recommended if you have not been vaccinated.

Post-exposure prophylaxis should be started if clinically indicated. E.g.. HIV should be started within hours after exposure.

Post-exposure

Use devices with safety features. Know how to use them.

Never recap needles. Always dispose of used and contaminated

sharps immediately in the proper container. Be aware of hazards of non-needle sharps:

Broken glass, scalpels, blades, etc. Report all sharp related injuries.

SUMMARY

OSHA Bloodborne Pathogens Fact Sheet: https://www.osha.gov/OshDoc/

data_BloodborneFacts/bbfact01.pdfA: CDC: https://

www.osha.gov/OshDoc/data_BloodborneFacts/bbfact01.pdf

http://www.cdc.gov/sharpssafety/pdf/sharpssafety_poster3.pdf

Resources