Sharps Awareness

1. Preventing Bloodborne Pathogen(BBP) Exposures
Safe Work
Practices

2. This education will focus on primary methods used in reducing Sharps Injuries.
Exposure to Blood borne Pathogens through Contact Exposures will also be discussed.
• A “Needlestick” “Sharps” or “Percutaneous” injury is one in which a
health care worker is injured by a sharps object such as a needle, scalpel or
other sharp object resulting in exposure to BBP
• A “Contact” exposure is one in which a health care worker is exposed
through contact of mucous membranes or non-intact skin with blood,
tissue, or other potentially infectious bodily fluids. This includes Bite
exposures resulting in blood exposure to either person involved
The Centers for Disease Control and Prevention (CDC)
estimates that about 385,000 sharps-related injuries occur annually
among health care workers in hospitals.

3. Blood borne Pathogen Exposures
Can Cause Serious or Even Fatal Infections
The most serious health risks are:
• Hepatitis B virus (HBV)
• Hepatitis C virus (HCV)
• Human immunodeficiency virus (HIV) – the virus that causes AIDS
Hepatitis B vaccination is recommended for
all healthcare workers and has proved highly effective in
preventing infection in workers exposed to HBV
However, no vaccine exists to prevent HCV or HIV infection….
Preventing sharps injuries and contact exposures is the best way
to
protect yourself from these deadly infections!

4. The Background
WMH has experienced an increase in BBP Exposure Events
*partial year: data inclusive through 5/1/15
Frequency of Bloodborne Pathogen Exposures
by Type and Year, 2010-2015*
These events result in avoidable exposure and stress to our employees
and inconvenience to our customers and patients.

5. How Do Sharps Injuries Occur?*
* WMH 2010-2014
Injuries occur when :
• Passing or transferring
equipment
• Colliding with coworkers
• Decontaminating/proces
sing used equipment
• Recapping contaminated
needles
Injuries occur from sharps left in
unusual places:
• Laundry
• Mattresses
• Tables, trays, or other
surfaces

6. What Devices are Involved with Sharps Injuries?*
* WMH 2012-2014
Blade/scalpel

7. How Do We Prevent Exposures to BBPs?
The WMH BBP Exposure Prevention Safety Plan
Safety performance measures are integrated and linked to
overall vision, goals and objectives of WMH:
• Education and training
• Standardized policy & procedures
• Standard Precautions
• Evaluation and selection of devices
• Culture of Safety
• ensures safe working environment for employees
• serve the needs of patients
• Individual responsibility and accountability
• Focus on process improvement to achieve successful outcomes
Most Exposure Events are Preventable when Employees Use Safety Principles

8. What Strategies Exist to Eliminate Sharps Injuries?
• Eliminate or reduce the use of needles
and other sharps
• Use devices with safety features
to isolate sharps
Even when these strategies are used, safe work practices to minimize
the risk for remaining hazards must be employed!b
e employed

9. Sharps Safe Work Practices
Be Prepared
Be Aware
Dispose With Care

10. The Sharps Safety Continuum
• Prepare to use the device the moment the sharps
are first exposed
• Take precautions while using sharps
• Take precautions during cleanup
• Take precautions during disposal

11. • Ask if you do not know what to do, how to do it, how it
works! Lack of knowledge/experience contributes to
incidents
• Organize equipment at the point of use
• Use Standard Precautions and the appropriate Personal
Protective Equipment (PPE)
• Make sure work space has adequate lighting
 In low light settings, use verbal cuing and use of neutral zones
• Keep sharps pointed away from the user
Before Beginning a Procedure
Be Prepared

12. • Locate a sharps disposal container, or have one
nearby
• Assess the patient’s ability to cooperate
• Get help if necessary
• Ask the patient to avoid sudden movement
Be Prepared
Before Beginning a Procedure
articleStory

13. Be Aware
• Slow down and proceed safely!
• Maintain visual contact with sharps during use
• Be aware of staff nearby
• Control the location of sharps to avoid injury to yourself and
others
During a Procedure

14. During a Procedure
• Do not hand-pass exposed sharps from one
person to another
• Use predetermined neutral zone or tray for
placing/retrieving sharps
• Verbally Alert others when sharps are being
placed in a neutral zone
Be Aware

15. During a Procedure
• Activate safety feature of devices with
engineered sharps injury prevention features as
soon as procedure is completed
• Observe audible or visual cues that confirm the
feature is locked in place

16. Clean Up and Dispose with Care
• Be accountable for sharps you use
• Check procedure trays, waste
materials, and bedding for
exposed sharps before handling
• Look for sharps/equipment left
behind inadvertently
During Cleanup

17. Clean Up and Dispose With Care
• Transport reusable sharps in a closed container
• Puncture proof container
• Properly labelled as bio-hazard
• Follow all transport procedures
• Secure the container to prevent spillage
During Cleanup

18. Clean Up and Dispose With Care
• Visually Inspect sharps container for overfilling
• Is sharps container large enough to accommodate
entire device?
• Keep hands behind the tip of sharps
• Never put hands or fingers into sharps container
While Disposing of Sharps

19. Clean Up and Dispose With Care
If you are disposing 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
While Disposing of Sharps

20. Clean Up and Dispose With Care
• Visually inspect sharps container for overfilling
• Replace containers before they become overfilled,
replace when ¾ full
• Keep filled containers
for disposal in a secure area
After Disposing of Sharps

21. Clean Up and Dispose With Care
Handle carefully
– Keep hands behind sharps
at all times
– Use mechanical device to
safely pick up sharps
If You Find Improperly Disposed
Sharps in Work Environment

22. Sharps Safe Work Practices
Be Prepared
Be Aware
Dispose With Care

23. Increased Risk Settings
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, 77% of injuries
– Fingers used to manipulate needles and tissue
• Up to 16% of injuries occur while
passing sharps hand to hand

24. Recommended Work Practices to adopt in
the OR to Reduce Sharps Injuries
• Needleless/no sharps alternatives
– Use alternative cutting methods such as blunt electro cautery and laser
devices when appropriate
– Substitute endoscopy surgery for open surgery when possible
• Engineering controls
– Use round-tipped scalpel blades instead of sharp-tipped blades
– Use blunt suture needle
• Work practice controls
– Use instruments rather than fingers
– Give verbal announcement when passing sharps
– Use “neutral zone” to avoid hand-to-hand passing of sharps

25. Conclusion
Preventing Sharps Injuries
Your Role
Be Prepared
Be Aware
Dispose With Care

26. You are Part of the Sharps Injury Prevention Process
Safety is 24/7/365 – make it a habit!
• Protect yourself with a Hepatitis B Vaccination
• Adhere to safe practices and assist and support coworkers in safer practices
• Understand the complete process for handling a sharp device
• Understand the product;
– Don’t use if you don’t know how, ask for training
• Create a safe work environment
– Minimize clutter
– Beware of obstacles
– Position yourself at the best angle
• Evaluate the situation and patient before selecting device
– If you feel unsafe DO NOT USE THE DEVICE; obtain assistance
• Examine product/device before use
– Don’t over pack cabinets as it can cause damage to devices
• Participate in training for devices and properly use sharps safety features
• Participate in surveys (e.g., safety culture) and device evaluations

27. • Always use Standard Precautions and your PPE
• Activate safety devices immediately after collection
• Never assume safety is completely activated – see, hear, and feel; don’t
rely on one single method to confirm activation
• Never recap, bend, shear, or break sharp
• Don’t put hands near or in sharps disposal container
• Replace sharps containers when 3/4 full
• Dispose of needle and holder as one unit
Remember…..

28. Incident Investigation
…if an exposure occurs
• Report injuries or blood/body fluid exposures, sharps injury hazards, and near
misses immediately
• Department Manager or Administrative Supervisor
• Employee Health or Infection Prevention
• Complete written documentation
• Expect managers to ask process focused questions for determination of how and
why the incident occurred
• Identify and apply intervention strategies to improve the process and minimize
the risk (combining behaviors, attitudes, perceptions)
Step 1: Provide Immediate Care to the Exposure Site
•Wash wounds and skin with soap and water.
•Flush mucous membranes with water.

30. Always Handle Sharps With Care
Questions ? Contact Employee Health or Infection Prevention
Please Complete the Post Test
and
Have a Safe Day!

31. References
http://www.osha.gov/OshDoc/data_BloodborneFacts/bbfact02.pdf
http://www.osha.gov/dts/shib/shib101503.html
http://www.osha.gov/OshDoc/data_BloodborneFacts/bbfact02.pdf
http://www.cdc.gov/niosh/docs/2012-123/pdfs/2012-123.pdf
http://www.cdc.gov/niosh/docs/2000-135/pdfs/2000-135.pdf
CDC: Preventing Needle sticks and Other Sharps Injuries Part III: Safe Work Practices