PREVENTION AND

MANAGEMENT OF
SHARP INJURIES
SHARP INJURIES

■ CDC estimates ~385 000 sharp injuries

annually among hospital-based HCW.
■ Increased risk for blood-borne virus
transmission.
■ Half or more of sharps injuries go unreported.
■ Costly to personnel and healthcare system.
Risk of Seroconversion due to Sharp
Injury from a known positive source

Virus Risk (Range)

Hep B virus 6-30%
Hep C virus ~2%
HIV 0.3%

*Risk for HBV applies if not HB vaccinated.

Cost of Sharps Injuries
One sharp injuries can cause a number of direct or
indirect costs for the health care facility including,
■Baseline & follow-up laboratory testing
■Cost of treatment for infected staff.
■Cost of replacing staff
■Emotional costs
■Societal costs
■Lost productivity
■Loss of income/ career
How do sharps injuries
happen?
■ Who gets injured?
■ Where do they happen?
■ When do injuries occur?
■ What devices are involved?
■ How can they be prevented?
Who gets injured?

Nurse Physician Technician Others

Where do sharp injuries occur?

Patient room (inpatient) 39%

Operating room 27%
Outpatient 8%
A&E 8%
Laboratory 5%
Others 13%
When do sharps injuries
occur?
During use 41%
After use / before disposal 40%
During and after disposal 15%
Other 4%
What devices are involved in
sharps injuries?
6 devices account for 78% of all injuries..

Disposable syringes 30%

Suture needles 20%
Winged-steel needles 12%
Intravenous catheter stylets 5%
Phlebotomy needles 3%
scalpels 3%
Sharp Injuries in the operating
room
■ Cuts/ needle sticks occur in as many as 15% of
operations.
– Risk increases with longer, more invasive, higher
blood loss procedures.
■ Suture needle injuries are most frequent.
– Fingers used to manipulate needles and tissue.
■ Up 16% of injuries occur while passing sharps.
 First strategy

Eliminate or reduce unnecessary needle

use.
How can needle used be
eliminate or reduced?
■ Use needle-free IV delivery systems
■ Use alternate routes for medical delivery and
specimen collection when available and safe
for pt care.
 Second strategy

Use devices with safety features

engineered to prevent sharp injuries
 Blunt needle

vacutainers

Safety branula
 Third strategy

Use safe practices to minimize risk

for hazard
Injury related to work
practices
■ Injuries occur because of the following:
– Passing or transferring equipment
– Recapping contaminated needles
– Colliding with coworker
– Decontaminating / processing used equipment
■ Injuries occur from sharps left in unusual places:
– Laundry
– Mattress
– Tables, tray or surfaces
The sharp safety continuum

■ Prepare to use the device the moment the

sharps are first exposed.
■ Take precautions while using sharps.
■ Take precautions during cleanup.
■ Take precaution during disposal.
Sharp safety practices

■ Be prepared
■ Be aware
■ Dispose with care
Be prepared
Before beginning a procedure:
■ Organize equipment at the point of use.
■ Make sure work space has adequate lighting.
■ Keep sharps pointed away from the user.
■ Locate a sharps disposal container, or have
one nearby.
■ Assess the pt’s ability to cooperate.
■ Get help if necessary.
■ Ask the pt to avoid sudden movement.
Be aware
During the procedure:
■ Maintain visual contact with sharps during
use.
■ Be aware of staff nearby.
■ Control the location of sharps to avoid injury
to yourself and others.
■ Do not handpass exposed sharps from one to
another.
■ Use predetermined neutral zone for placing /
retrieving sharps.
■ Alert others when sharps are being passed.
Clean up and dispose with care

During clean up
■ Be accountable for sharps you use.
■ Check procedure trays, waste materials, and
bedding for exposed sharp before handling.
■ Look for sharps / equipment left behind
inadvertently.
Clean up and dispose with care

While disposing of sharps

■ Inspect container
■ Keep hands behind sharps
■ Never put hands or fingers into sharp container
■ If you dispose sharps with attached tubing
– Be aware that tubing attached to sharps can
recoil and lead to injury.
– Maintain control of both tubing and the device
during disposal.
Clean up and dispose with care

After disposing of sharps

■ Visually inspect sharps container for
overfilling
■ Replace containers before they become
overfilled
■ Keep filled containers for disposal in a secure
area.
Clean up and dispose with care

■ If you find improperly disposed sharps in

work environment
■ Handle carefully
■ Keep hands behind sharps at all times
■ Use mechanical device if you cannot safely
pick up sharps by hand
What to do following sharps
injury.
■ Allow blood to flow freely and wash under running
water.
■ Wipe with antiseptic and apply dressing as necessary.
■ Report immediately.
■ Test to be done:
– Anti HIV
– Anti hep C
– Hep B antigen
– Hep B antibody
THANK YOU