MEDICATION
Promoting Sharps Injury Safety
Dr Debra Adams, Head of Infection Prevention and Control (Midland and East) at NHS Trust Development Authority, explores sharps injury safety, offering best practice advice in a bid to reduce harm to healthcare workers.
Sharps injuries to healthcare workers must not be accepted as an occupational hazard. They are the second most common healthcare injury, following back injuries, and the effects can be both physically and psychologically distressing for the injured party, as well as costly for employers.
All healthcare workers are at potential risk from a sharps injury. However, in the UK, almost 40% of NSIs and sharps injuries occurred to someone other than the original user of the device. Injuries occur most frequently when staff members are cleaning equipment, assisting in procedures, during waste collection or environmental cleaning.
The lifespan of blood-borne viruses outside the body is significant. Hepatitis B virus can survive for up to one week and Hepatitis C virus for up to three weeks, although HIV is not thought to survive well outside of the body. Therefore, NSIs and sharps injuries from what may be considered an ‘old’ device, used three weeks ago, can still lead to the transfer of blood-borne viruses.
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In light of this it is essential that all managers of care including acute and community settings, as well as care and nursing homes, are aware not only of their duty of care but also how legislation affects the management of their organisation.
What is a Sharps Injury? There are two types of sharps injury. A percutaneous injury is a break to the skin caused by a needlestick (NSI) or sharp contaminated with blood or bodily fluid.
A mucocutaneous injury occurs when body fluids come into contact with non-intact skin such as that found in eczema, open wounds, or mucous membranes such as the mouth and eyes.
How to Implement
Regulations All managers must acknowledge the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 which became national law as a result of the EU Directive on sharps injury prevention. EU member states were required to implement the Directive by May 2013 at the latest. It is clear that if abided by, the Regulations
can greatly reduce the risk of sharps injury incidents.
The key requirements that need to be implemented include:
• Risk assessment – is there risk of exposure to a blood-borne pathogen from NSIs and sharps injuries? Can the risk be eliminated or minimised?
• Risk elimination and prevention – undertake a review of practice. Eliminate unnecessary use of sharps. Identify whether the risk of exposure can be reduced by using safety devices, improving education and awareness, reviewing staffing levels, and ensuring personal protective equipment and appropriate sharps disposal systems are available at the point of use. Ensure the organisation has developed an occupational exposure policy.
• Training – incorporate use, safe handling and disposal of sharps procedures, improve occupational exposure awareness such as risks associated with exposure to blood and body fluid, recognise the importance of hepatitis B immunisation and encourage occupational exposure reporting.
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