Simply Put – Medical Sharps

Medical Sharps, a simple view on the legislation

Injuries arising from sharps are a well-known risk in the healthcare sector. Medical sharps can be contaminated with an infected patient’s blood so can transmit pathogens that cause a range of diseases, including Hepatitis B, Hepatitis  C, and  human immunodeficiency virus (HIV). A little while ago, some new regulations (The Health and Safety (Sharp Instruments in Healthcare) Regulations 2013) came into force to help to minimise and to control the risks posed by needles and other ‘sharps’ in healthcare. These regulations supplement existing health and safety legislation that requires employers across all sectors to take effective action to control the risk from sharps injuries.

Under these Regulations, employers and contractors working in the healthcare sector are be required to:

• Have effective arrangements for the safe use and disposal. This includes:
  • using ‘safer sharps’ where reasonably practicable
  • restricting the practice of recapping of needles
  • placing sharps bins close to the point of use
• Provide the necessary information and training to workers
• Investigate and take action in response to work-related sharps injuries

Effective, safe management of medical sharps flows from existing health and safety legislation. In particular, the requirement to assess the risks, provide appropriate information and training, and to consult with employees. The Sharps Regulations follow the principles of the hierarchy of preventative control measures, set out in the Management of Health and Safety at Work Regulations and in the Control of Substances Hazardous to Health Regulations (COSHH). The Sharps Regulations build on this existing law and provide specific detail on requirements that must be taken by healthcare employers and by their contractors.

Need a bit more detail?

Avoid the unnecessary use of sharps (Reg 5(1)(a)) – Needles, scalpels etc will remain essential tools for effective medical care. The employer should, however, ensure that sharps are only used where they are required. By way of example: organisations that have

reviewed the use of sharps have identified staff using needles to carry out tasks for which they are not required (for example collection of urine samples from catheter bags). Needle-free equipment is available for
certain procedures and should be used, where it is reasonably practicable to do so.

Where it is not reasonably practicable to avoid the use of medical sharps, the Regulations require employers to:
Use safer sharps (incorporating protection mechanisms) – regulation 5(1)(b)
The employer must substitute traditional, unprotected medical sharps with a ‘safer sharp’ where it reasonably practicable to do so. The term ‘safer sharp’ means medical sharps that incorporate features or mechanisms to prevent or minimise the risk of accidental injury. For example, a range of syringes and needles are now available with a shield or cover that slides or pivots to cover the needle after use. The
following factors should be considered:

• the device must not compromise patient care
• the reliability of the device
• the caregiver should be able to maintain appropriate control over the procedure
• other safety hazards or sources of blood exposure that use of the device may introduce;
• ease of use (taking into account the existing clinical practices commonly in use by relevant health professionals – but not merely adopting existing custom and practice as the safest)
• is the safety mechanism design suitable for the application? The following are relevant:
  • if activation of the safety mechanism is straightforward, it is more likely to be used
  • if the safety mechanism is integral to the device (i.e., not a separate accessory) it cannot be lost or misplaced
  • for many uses, a single-handed or automatic activation will be preferable
  • an audible, tactile or visual signal that the safety mechanism has correctly activated is helpful to the user
  • the safety mechanism is not effective if it is easily reversible

If suitable safer sharps are not available to reduce the risk of injury, then the employer should ensure that safe procedures for working with and disposal of the sharp are in place.

Prevent the recapping of needles (Reg 5(1)(c)) – Injuries can occur after a needle has been used if the healthcare worker holds the needle in one hand and attempts to place a cap on the needle with the other hand (so-called two-handed recapping). Needles must not be recapped after use unless the employer’s risk assessment has identified that recapping is itself required to prevent a risk (e.g., to reduce the risk of contamination of sterile preparations). In these limited cases, appropriate devices to control the risk of injury to employees must be provided. For example, needle-blocks can be used to remove and hold the needle cap and so allow safe one-handed recapping.

Place secure containers and instructions for safe disposal of medical sharps close to the work area (Reg 5(1)(d)) – The COSHH requires systems to dispose of contaminated waste safely. The Sharps Regulations supplement this by requiring that clearly marked and secure containers be placed close to the areas where medical sharps are used. Instructions for staff on safe disposal of sharps must also be placed in those areas.
In many healthcare facilities sharps bins can be placed next to the healthcare worker so they can drop the used sharp straight into it. For example, in wards this can be achieved by placing the sharps container on
the dispensing trolley. However, some healthcare workers do not operate in premises in which they have control, for example paramedics or healthcare workers working in a patient’s home. In these cases, the employer’s risk assessment should select appropriate sharps, specify safe working procedures and provide suitable portable sharps containers and means for collection and replacement of those.

Dealing with Medical Sharps need not be difficult, but if yo need some further help then call us on 01509 550023 and see how we can help you.

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