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Needle-free systems

Prevention from sharp injuries in the hospital and healthcare sector

An excerpt from Council Directive 2010/32/EU

All hospitals have policies for avoiding, managing and reporting needlestick injuries but audits repeatedly show that there is under-reporting. Such injuries continue to occur both to front-line healthcare workers and to others, including hospital porters and cleaning staff. The major concern here is the risk of blood-borne infection and the possible far-reaching consequences, but minor injuries should not be overlooked. EC Directive 2010/32 is focused on eliminating, as far as possible, the risk of injury or infection to healthcare workers from medical sharps. It is scheduled for implementation by 11 May 2013, and as it is a Directive, it has to be incorporated in local law. It specifies the minimum requirements that Member States need to implement to protect workers. This Directive provides for “eliminating the unnecessary use of sharps by implementing changes in practice and on the basis of the results of the risk assessment, providing medical devices incorporating safety-engineered protection mechanisms”. It also expressly prohibits the recapping of needles and it emphasises the importance of regular, comprehensive and ongoing training for staff in the correct use of protective devices and safe systems of working. An excerpt from the Directive is given here.

Christine Clark PhD FRPharmS FCPP(Hon) – Editor HPE

Clause 1: Purpose The purpose of this framework agreement is:

l to achieve the safest possible working environment, l to prevent workers’ injuries caused by all medical sharps (including needle-sticks),

l to protect workers at risk, l to set up an integrated approach establishing policies in risk assessment, risk prevention, training, information, awareness raising and monitoring, l to put in place response and follow-up procedures.

Clause 2: Scope This agreement applies to all workers in the hospital and healthcare sector, and all who are under the managerial authority and supervision of the employers. Employers should deploy efforts to ensure that subcontractors follow the provisions laid down in this agreement.

Clause 3: Definitions Within the meaning of this agreement:

1. Workers: any persons employed by an employer including trainees and apprentices in the hospital and healthcare sector-directly related services and activities. Workers who are employed by temporary employment business within the meaning of Council Directive 91/383/EEC supplementing the measures to encourage improvements in the safety and health at work of workers with fixed-duration employment relationship or a temporary employment relationship1 of the agreement;

and Articles 3, 5 and 6 of Directive 2000/54/EC;

6. Specific preventative measures: measures taken to prevent injury and/ or transmission of infection in the provision of hospital and healthcare directly related services and activities, including the use of the safest equipment needed, based on the risk assessment and safe methods of handling the disposal of medical sharps;

7. Workers’ representatives: any person elected, chosen or designated in accordance with national law and/or practice to represent workers;

8. Worker’s health and safety representatives are defined in accordance with Article 3(c) of Directive 89/391/EEC as any person elected, chosen or designated in accordance with national law and/or practices to represent workers where problems arise relating to the safety and health protection of workers at work;

9. Subcontractor: any person who takes action in hospital and healthcare directly related services and activities within the framework of working contractual relations established with the employer.

Clause 4: Principles 1. A well trained, adequately resourced and secure health service workforce is essential to prevent the risk of injuries and infections from medical sharps. Exposure prevention is the key strategy for eliminating and minimising the risk of occupationally acquired injuries or infections;

fall within the scope

2. Workplaces covered: healthcare organisations/services in public and private sectors, and every other place where health services/activities are undertaken and delivered, under the managerial authority and supervision of the employer;

3. Employers: natural/legal persons/organisations having an employment relationship with workers.They are responsible for managing, organising and providing healthcare and directly related services/activities delivered by workers;

4. Sharps: objects or instruments necessary for the exercise of specific healthcare activities, which are able to cut, prick, cause injury and/or infection. Sharps are considered as work equipment within the meaning of Directive 89/655/EEC on work equipment;


5. Hierarchy of measures: is defined in order of effectiveness to avoid, eliminate and reduce risks as defined in Article 6 of Directive 89/391/EEC

2. The role of health and safety representatives is key in risk prevention and protection;

3. The employer has a duty to ensure the safety and health of workers in every aspect related to the work, including psycho-social factors and work organisation;

4. It shall be the responsibility of each worker to take care — as far as possible — of their own safety and health and that of other persons affected by their actions at work, in accordance with their training and the instructions given by their employer;

5. The employer shall develop an environment where workers and their representatives are participating in the development of health and safety policies and practices;

6. The principle of the following specific preventative measures indicated in clauses 5 to 10 of the present agreement means never assuming that there is no risk. The hierarchy of general principles of prevention according to Article 6 of Directive 89/391/EEC and Articles 3, 5 and 6 of

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