DISPOSAL OF SHARPS SAFELY, AVOIDING THE RISK OF NEEDLE-STICK INJURIES The disposal of sharps has always been a hazardous procedure for all health care staff. It is therefore important to examine the hazards and to consider ways to minimise the risks. In recent years it has become more important to be aware of the risks surrounding the taking of blood. It is recommended that all health care professionals who carry out the procedure should be properly trained (Dougherty 1996) and where possible use a closed system-letting device, e.g Vacutainers. It has been suggested that 16% of occupational health injuries that occur in the hospital setting are sharps injuries which are attributable to venepuncture and recapping of needles, all of which are potentially preventable by following the correct disposal of sharps (DOH 2001) The hazards of Hepatitis B and C and Human Immunodeficiency Virus (HIV) infections are well documented, however the effects which these diseases have on individuals varies in severity and many of them will remain asymptomatic. This leaves staff with no clue as to the diagnosis of the patient and so places those caring for these patients at greater risk of infection. Whilst all these infections can be transmitted, Hepatitis B and C are much more virulent and appear to be able to survive outside the body for longer. Vaccination is available to protect staff from Hepatitis B but as yet there is no such protection against Hepatitis C even though the disease is similar in aetiology to Hepatitis B and is potentially as hazardous.
THE EFFECTS OF NEEDLE-STICK INJURIES It is the responsibility of the person using the sharp to ensure that it is safely disposed of. However, accidents do happen, and in these situations it is important that other health care professionals offer support and do not apportion the blame. A needle stick injury can be very disturbing for health staff who are only too aware of the diseases that can be transmitted via this route. The risk of contracting HIV or Hepatitis B is often paramount in peoples minds and any member of staff who feels that they have been at risk will need support and counselling until the incident can be brought to a satisfactory conclusion. It is important that the injured member of staff contacts the Occupational Health Dept. as soon as possible as this will ensure that the injured persons best interests are served and that the incident is properly investigated.
COMMON CAUSES OF SHARPS INJURIES RESHEATHING NEEDLES. Needles should not be re-sheathed unless absolutely necessary and if they are then a one handed scoop method should be adopted, i.e. the sheath is placed on a surface and the needle inserted using one hand only. Since the sheath is not held at all, the risk of needlestick injury is eliminated. DISPOSAL OF SHARPS All sharps must be disposed of safely and correctly immediately after use TYPES OF SHARPS WHICH CAUSE INJURY Care should always be taken when using the types of sharps which cause the most injury e.g. needles, scalpels and suture needles. TIMING OF EXPOSURE It is important to know the timing of the exposure in relation to the task being performed in order to help minimise the number of injuries. SHARPS CONTAINERS All sharps container bins must comply to British Standards Specifications for Sharps Containers (1990), be accessible but safe, and be disposed of when three quarters full. STAFF EDUCATION Staff tend to resist recommendations made by other people. For an education programme to be successful, Health Care Workers must be actively involved in developing the programme themselves.
ACTION TO BE TAKEN IN THE CASE OF A NEEDLE-STICK INJURY Encourage bleeding from the affected site Wash the injured area or irrigate with water or normal saline as appropriate Cover with a suitable dressing, e.g. waterproof Complete an accident form Inform immediate manager Go to Occupational Health, GP or Accident and Emergency Dept. as appropriate REMEMBER BEFORE DISPOSAL, DO NOT RESHEATH NEEDLES, BENS OR BREAK THEM DISPOSE OF USED NEEDLES AND SYRINGES DIRECTLY INTO A DESIGNATED SHARPS DISPOSAL BOX AS NEAR AS POSSIBLE TO THE POINT OF USE AS POSSIBLE. SHARPS BOXES MUST BE LOCATED IN EVERY WARD AND DEPARTMENT ALL CARRIED SHARPS MUST BE PLACED IN A SAFE CONTAINER FOR TRANSPORT PURPOSES CLOSE SHARPS BOXES SECURELY WHEN THREE QUARTERS FULL, LABEL WITH WARD/DEPT. DETAILS AND SEND FOR INCINERATION DO NOT OVERFILL!