Sharps are objects that have the potential to cut or puncture human skin. Examples of these are needles, broken glass, razor blades, scalpel blades and so forth. Sharps become more dangerous if they have been in contact with organisms such as blood contaminated by hepatitis or AIDS. These sharps, if not handled correctly, can carry these organisms into the body, where an infection can then occur.
Sharps are monitored by the Health and Safety Executive. Infectious waste and sharps must be disposed of appropriately. Employers are expected to undertake risk assessments of their activities to reduce any risk. Such risk management will help the employer to identify the hazards, consider the nature of the work, evaluate, and implement, and monitor and review the control measures in place to reduce the risk.
A significant proportion of sharps injuries occur when staff fail to follow standard precautions. These incidents can be avoided if staff are educated and follow the training they have received.
- Ensure standard precautions for infection control are always in place.
- Establish clear procedures and policies within the care setting.
- Train staff to handle and dispose of sharps appropriately.
- Follow clinical waste disposal procedures.
- Ensure staff are immunised against Hepatitis B if they are expected to handle sharps.
- Use suitable gloves when handling sharps.
- Do not pass sharps directly from hand to hand.
- Handle sharps as little as possible and, where possible, use other objects such as forceps or a dustpan and brush to pick up the material.
- Never re-cap/re-sheath needles once used or prior to disposal.
- Formally report any injuries in the accident book and to the Health and Safety Executive.
- Any needles found should be considered potentially infected – this means the risks need to be managed appropriately.
Disposing of sharps
Anything that has the potential to cut or puncture human skin should be disposed of in a sharps bin. However, if an object does not carry this potential risk it should not be disposed of in a sharps bin. At this point you must assess whether the waste needs to be, for example, placed in clinical or domestic waste.
If you are undertaking a procedure that requires a sharp, you should take a sharps bin with you so the sharp can be discarded at the point of use. Once the sharp has been used, it should be placed into a sharps bin immediately. Under no circumstances should a sharp be retrieved once it has been placed in a sharps bin.
There are now a range of sharp medical instruments available that are designed to be safer to use by reducing the incidence of injuries. Where possible, employers should replace conventional medical devices with safer devices.
Sharps should never be disposed of in regular waste. They should always be placed into rigid, leak-proof sealable sharps bins that comply with British Standards 7320 and UN Standard 3291. When the containers are not in use they should be sealed to avoid injuring others.
Disposing of sharps bins
Sharp bins should never be overfilled nor the contents pushed down. Once the bin is three quarters full or is filled up to the mark that indicates it is full, the bin should be fully closed, signed and placed into safe storage until it can be collected for disposal.
Specialist hazardous waste companies should be used to collect and dispose of sharps bins. The company should be licensed to handle this type of waste. Your local Health and Safety Executive will be able to provide you with a list of appropriate licensed companies or advise you on where to find one.
Storing a sharps bin
Arrangements should be made for sharps containers to be stored and disposed of in an appropriate, secure manner. Each care setting should have a sharps policy and safe system with relevant contact details included within the policy.
Sharps bins should be assembled correctly so that the lid is securely fixed, and they should be labelled with all details fully filled in. Sharps bins should be stored in a secure place where they cannot fall. They should never be stored on the floor or on an uneven surface. When not in use they should be locked away or in some circumstances secured to a wall.
Should a member of staff or patient suffer from a sharps injury the wound should be encouraged to bleed. Do not suck the wound, but rinse it thoroughly under running water. Then cover the injury with a plaster or dressing.
The incident should be formally documented and medical advice should be sought immediately by contacting the Accident and Emergency Department at the nearest hospital.
The Health and Safety Executive can inspect healthcare settings to see how they manage the risk of sharps. They assess compliance with the Health and Safety at Work etc Act 1974 and the Management of Health and Safety at Work Regulations 1999. This is done by testing the systems in place within the health care setting. Control of Substances Hazardous to Health (COSHH) regulations may also be inspected by the Health and Safety Executive during an inspection. During a visit workers will be engaged with to gather further information of the practices in place. Feedback will be given to the organisation, including any areas of concern or enforcements needed. Inspectors will also offer advice on where practice can be improved.
Use the following items in the toolkit to put the ideas in the article into practice:
- Flowchart - Immediate action following a sharps accident (all providers)34.5 KB
- Policy - Sharps handling and waste (care homes)63.5 KB
About the author
Suzanne Averill, MSc, RGN, Nurse Consultant, Global Infection Prevention, currently works for the United Nations in South Sudan as the Health and Nutrition Cluster Coordinator. She has previously worked for the Health Protection Agency as the International Lead and in commissioning in the NHS as Head of Infection Control.
This article was first published in the April 2012 issue of Quality & Compliance Magazine.