November 13, 2023

National Injury Prevention Day: Strategies for Sharps Injury Prevention in Healthcare

Healthcare workers are tasked with delivering high-quality care to their patients. One key component of this role is ensuring that healthcare workers are also protecting themselves, in addition to prioritizing patient well-being. November 18 is National Injury Prevention Day, making it an opportune time for healthcare workers to understand where sharps-related injuries may occur and how to help prevent them.

The Centers for Disease Control and Prevention (CDC) estimates that each year, 385,000 needlestick and other sharps-related injuries are experienced by hospital-based healthcare staff. Of these injuries, suture needles and disposable syringes are the most common cause. Most (39%) of the injuries occur in inpatient units, especially medical floors, intensive care units, and operating rooms. Sharps-related injuries also occur in other healthcare settings, such as nursing homes, clinics, emergency care services, and private homes. According to the International Safety Center, nurses are subject to the highest number of sharps and needlestick injuries, followed by specialty doctors and surgery attendants.

Sharps injuries can occur through unsafe work practices, including:

  • Accidents during use
  • Passing or transferring contaminated sharp instruments or tools
  • Recapping contaminated needles
  • Colliding with coworkers
  • Improper decontamination of instruments
  • Leaving sharps in unusual places, such as in the laundry

These injuries can have various consequences, including:

  • Increased risk for bloodborne pathogen-related infections, including Human Immunodeficiency Virus (HIV) Hepatitis B virus (HBV), and Hepatitis C virus (HCV)
  • Cost of post-exposure treatment
  • Lost productivity due to time spent filling out paperwork and getting evaluations and care
  • A lack of trust in the safety of the workplace
  • Potential inspections or scrutiny from regulatory agencies

Healthcare workers should keep in mind that sharps-related injuries are preventable. One of the best ways to prevent sharps-related injuries is to assess workplace hazards and apply the hierarchy of safety and health controls. Within the hierarchy, some controls are more effective than others.

Hierarchy of Safety Controls

  • Engineering controls: This is the most effective safety control and includes devices that are designed to reduce the risk of a sharps-related injury, such as safer needle devices with built-in protection, blunt-tip suture needles, and needleless IV connectors.
  • Work practice controls: After engineering controls, work practice controls include ways to approach and perform tasks, such as discarding contaminated sharps immediately or as soon as possible and ensuring that sharps containers are easily accessible.
  • Administrative controls: These include the implementation of safe work practice controls by creating workplace policies, procedures, processes, and an exposure control plan as well as providing effective job safety training.
  • Personal Protective Equipment (PPE): Though the least effective control, PPE is required when the other safety controls alone are not sufficient to completely protect from a hazard. Gloves, masks, eye protection, and gowns may be recommended. In addition, OSHA’s Bloodborne Pathogens Standard 29 CFR 1910.1030 has specific requirements for PPE when there is reasonably anticipated contact with blood or other potentially infectious materials.

Sharps Injury Prevention Program Implementation

The CDC has a sharps prevention workbook for designing, implementing, and evaluating a sharps injury prevention program.

The workbook offers a series of organizational steps for sharps injury prevention, designed to ensure that a sharps injury prevention program is integrated into existing safety programs, reflects the status of an organization’s prevention activities, and targets appropriate areas for performance improvement.

  1. Develop organizational capacity: To establish an institution-wide program, joint responsibility should be held by members of a multidisciplinary leadership team that is focused on eliminating sharps injuries among healthcare personnel. Representation from senior-level management is important to provide visible leadership and demonstrate the workplace’s commitment to the injury prevention program.
  2. Assess program operation processes: Five operational processes support a sharps injury prevention program, and a baseline assessment of each process is needed for effective program planning. The processes are:
    • Assessing the culture of safety in the work environment
    • Establishing procedures for sharps injury reporting
    • Analyzing sharps injury data
    • Selecting, evaluating, and implementing safety devices
    • Educating and training healthcare personnel on sharps injury prevention
  3. Prepare baseline profile of injuries and prevention activities: Using data currently available in your organization, you can develop a profile of how injuries are occurring and generate a list of current prevention strategies.
  4. Determine intervention priorities: Not all problems can be addressed at one time, so healthcare organizations should decide which sharps injury problems will receive priority attention. Organizations can determine priorities based on injuries that pose the greatest risk for bloodborne virus transmission, the frequency of injury with a particular device, and a specific problem contributing to a high frequency of injuries.
  5. Develop and implement action plans: Intervention action plans provide a road map for monitoring progress and measuring performance improvements in a sharps injury prevention program. The CDC recommends two intervention action plans — one focuses on implementing and measuring interventions to reduce specific types of injuries, and the other focuses on measuring the improvements that stem from the program processes.
  6. Monitor performance improvement: To monitor overall progress, use data from each operational process as well as a checklist of activities and an implementation timeline.

On this National Injury Prevention Day, make sure your workplace has the resources it needs to help prevent sharps-related injuries. To learn more about sharps disposal and injury prevention, please review Stericycle’s webinar.

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