Best practices for sharps use

Best practices for sharps use

Best practices for sharps use

 

Eliminating unnecessary sharps use is the most effective way to prevent sharps related injuries and reduce the amount of sharps waste we produce.

Therefore, you should always consider if there is a way to carry out the treatment, such as orally or rectally, that can remove the need for sharps. When it is necessary for you to use a sharp it’s important that you follow your best practice guidelines to reduce the risk of injury.

To carry out your sharps procedure safely, you must:

  • Always carry out proper hand hygiene practices, including wearing gloves when necessary.
  • Dispose of all single use PPB immediately after use. One pair of gloves should be used per procedure for patient.
  • Carry out appropriate skin preparation and disinfection before administering an injection,such as water for 60–70% alcohol     solution, depending on the injection.
  • Discard all used devices immediately into the correct sharps receptable in the area in which they were used. Single use syringes and needles a one unit and must be discarded together.

You must also:

  •   Examine the packaging of all sharps to be used. Check that they have not been tampered with, punctured or damaged by exposure to moisture. If they have, discard them
  • Avoid recapping any sharps. If recapping a needle is unavoidable, you must use the one handed scoop method
  • Keep your sharps bin within arms reach and At eye height
  • Only sell sharps containers until they are 3/4 full. Do not overfill sharps containers. Once it is 75% full, seal it and arrange for its   disposal
  • Use forceps to reposition a sharp that is sticking out of a sharps box. You should never use your hands
  • Seal all sharps containers with a tamper proof lid When they are full.
  •     Immediately report any sharps related injuries or accidents.PEP treatment, given after exposure to HIV becomes ineffective after 72 hours. Therefore, it’s vital that you promptly seek medical help.

Hand hygiene Hand hygiene is a very important step in preventing the spread of microorganisms. Hand hygiene covers handwashing, anti-septic hand wash or hand rub and surgical hand antisepsis

Hand Hygiene should always be carried out before:

  • Prepare injection material
  • Give injections
  • Come into direct contact with patients
  • Put on gloves. Gloves must only be put on clean, dry hands.

 

Hand hygiene should always be carried out after you:

  • Finish an injection session.
  • Have any direct contact with the patient
  • Remove your gloves

You must always carry out hand hygiene steps between clients. You should avoid giving injections if you are experiencing a local infection or other condition. Any small cuts should be covered with an appropriate covering.

 

Hand hygiene is vital. You must carry out hand hygiene procedures before and after contact with every patient.

The World Health Organization recommends that:

  • If your hands are visibly dirty or contaminated, you should wash them with antibacterial wash or plain soap and running water, then dry them using a single use paper towel.
  • If your hands are clean and are not visibly soiled, you should clean them with an alcohol-based hand product to decontaminate them and dry them using a single use paper towel.

If you have non-intact skin and have been exposed to blood or bodily fluid you must use antibacterial or plain soap, running water and paper towels, even if your hands are clean.

Hand Hygiene and PPE

Before starting any task of putting on gloves you should ensure that your hands are completely dry.

You need to wear gloves when:

  • you are at risk of coming into contact with blood or other bodily fluids like saliva or non-intact skin
  • you are performing Venepuncture or venous access injections, as you are at risk of blood exposure
  • your patients skin is not intact, for example if they have eczema, a skin infection or burn

If both your skin and the skin of your patient is intact and you’re carrying out intradermal, subcutaneous and intramuscular injections you should not wear gloves.

There is also no need to wear eye protection, masks or special protective clothing unless there is the risk of blood or bodily fluid splashes when carrying out the procedure.

Practices that increase accidents

Using sharps poses many risks to the user. Therefore, it is important that you’re aware of the actions that could increase your risk of experiencing a sharps related injury.

You are at an increased risk if you:

  • Carry out unnecessary injections
  • use two hands to recap used needles
  • Position your patient poorly
  • Have a poor phlebotomy technique
  • Have a lack of sharps boxes within arms reach
  • Try to dismantle used sharps
  • Do not properly segregate your sharps waste. This will be covered in more detail in the next module.

When using sharps, it’s important that you follow the best practice guidelines that we have outlined. Therefore, you should never:

  • Forget to clean your hands
  • wash a pair of gloves for reuse
  • reuse gloves, syringes, needles or lancets for more than one procedure or patient
  • allow a needle to touch any contaminated surface
  • change a syringes needle so you can use it on another patient. One syringe, one needle, one patient
  • combine leftover medication so that you can reuse it later
  • touch a puncture site After it has been disinfected
  • recap a needle using two hands
  • leave unprotected needles lying outside a sharps receptacle
  • overfill a sharps receptacle
  • store your sharps box on the floor
  • put your hands into Sharps bin or attempt to decant them
  • inject into a laboratory tube that you are holding in your hand
  • delay seeking medical help after an incident

Sharps injuries

Accidents that cause a sharps injury can have serious consequences and it’s important that you know what you should do in the event of one occurring.

If a used needle puncture’s or pierces your skin, you should:

  • Run the wound under water to encourage the wound to bleed
  • wash the wound under clean, running water and use plenty of soap to clean the area.
  • Once washed, you should dry the affected area and cover it with a waterproof dressing or plaster.

If you experience a sharps injury, you must never:

  • Suck the wound
  • scrub at the wound when you are washing

After you have cleaned and dressed the wound, you might need treatment to reduce the chance of getting an infection. Therefore, you should seek urgent medical advice by contacting your employer’s occupational health service and should report the injury to your employer.

Reporting a Sharps injury

Your employer is required to provide you with enough information and training so that you understand the specific company procedures that you must follow in the event of an emergency

This must include how you report an incident, what actions you should expect your organization to take when responding to an injury and what prophylaxis treatments are available to you. If you have any sharps related accident, you must follow the procedures that your employer has outlined for you and report your accident correctly and promptly.

When safer sharps are being chosen, your employer should consider the following factors

  • How reliable is the device?
  • will using the safer device compromise patient care in anyway?
  • can the caregiver maintain appropriate control over the procedure with the new device?
  • does the new device create any additional safety hazards or sources of blood exposure?
  • how easy is the new sharp to use?

Safer sharps

When selecting a safer sharp, it’s also important that your employer considers the design of the new device and if it’s suitable for the intended application. They should consider:

  • Is the safety mechanism straightforward to use?If the safety features are easy to operate, they are more likely to be used when using or disposing of a sharp.
  • Is the safety mechanism connected to the device? If it is connected then it is more likely to be used and not lost or forgotten  about.
  • Can the new safety feature be activated with a single hand or automatically?Often, these kinds of features are preferable because they are easier to use.
  • Does the safety mechanism provide an audible, tactile and visual signal to show that it has been activated?Having a clear  signal that the device has been activated is very helpful and makes the safety feature much easier to use.
  • Is the safety mechanism easily reversible?Safety features are more effective when they are irreversible.

Your employer is likely to consult you when they are selecting new, safer sharps. They will also ensure that you are aware of when and how to use the new equipment to help you carry out your duties safely.

Safe disposal of sharps

Managing healthcare waste securely is essential. Improperly disposing of your sharps waste could have significant consequences, as it poses a risk of infection and injury.

This module details how to segregate your sharps waste in accordance with UK guidelines. It helps you to identify ways that you can minimise your sharps waist and reduce your environmental impact.

The colour coding system outlined in this module is not mandatory or specified in the waste management regulations, however, businesses in England and Wales are legally, required to segregate their waist according to the categories outlined.

  • Waste stream segregation
  • Regulatory bodies
  • Implementing waste segregation systems
  • Sharps boxes
  • Recapping a needle
  • Disposing of sharps
  • Disposing of a sharps box

Non medically contaminated waste

Orange-lidded, yellow sharps boxes

In England and Wales, the sharps receptacles should only be used for non-medicinally contaminated sharps.

However, in Scotland and northern Ireland, these can be used to dispose of those non-Medicinally early contaminated and fully discharged medicinally-contaminated sharps if the waste is to be disposed of regionally. The conditions of this are:

  • They must be fully discharged
  • You must not intentionally discharge syringes just to put them in orange-lidded, yellow sharps boxes. All partially discharged syringes must be disposed of in yellow-lidded, yellow sharps boxes.

In all regions, no sharps contaminated with cytotoxic or cytostatic substances may be disposed of in these boxes. Orange-lidded, yellow sharps boxes are usually treated upon disposal to be rendered safe; however, they may also be incinerated.

Medicinally contaminates waste

Yellow lidded sharps box

This type of sharps box should be used to dispose of medicinally contaminated sharps, including vials, bottles and ampules of medicine, clinical sharps and pharmaceutical waste.

Infectious sharps waste should also be disposed on in this waste stream, but it must not be used to dispose of sharps contaminated with cytotoxic or cytostatic substances.

Waste disposed of in a yellow-lidded, yellow sharps box will undergo disposal by incineration.

Infectious sharps waste and cytotoxic and cytostatic waste

Purple lidded sharps box

This type of sharps box should be used to dispose of clinical waste, mixed sharps, infectious waste and cytotoxic and cytostatic waste.

This also includes vials, bottles and ampules of cytotoxic and cytostatic medicine:

Cytotoxic substances are substances that are toxic to living cells, such as chemotherapy treatments that are used to destroy cancer cells.

Cytostatic substances are used to suppress cell growth. For example, some cancer hormone therapies are cytostatic as they inhibit the multiplication of cancer cells and stop the cancer growing.

Waste disposed of in a purple-lidded, yellow sharps box will undergo disposal by incineration.

 

 

Regulatory bodies

UK standards are well regulated, so it’s important that everyone using sharps complies with the standards detailed in the health technical memorandum 07-01

Any failure to comply with the standards will be dealt with by the appropriate regulating body:

Care quality commission (England)

Controls assurance (Northern Ireland)

Care inspectorate (Scotland)

Standards for health services (Wales)

Sharps boxes

 

All sharps receptacles must be:

  • Approved by the infection prevention and control team. All sharps bins must comply with the UN 3291 requirements
  • Easily accessible (at eye level and within easy reach) wherever clinical sharps are in use. They must be accessible by children.
  • Correctly assembled, solid, and secure
  • Stored securely while awaiting collection. They must not be accessible to children
  • Properly labelled prior to use. All boxes must be labelled with the organizations name, ward/department/clinic name, the name of the individual who assembled the box, the date the box was assembled and the name of the individual who closed, locked and disposed of the box
  • Dated before being sent to disposal

Recapping a needle

Recapping a needle is dangerous as it puts you at high risk of a puncture wound. Therefore, you should always avoid resheathing a needle

However, if you must resheath a needle for overriding safety reasons, then you should use the one-handed scoop technique

  1. Place the cap onto an even surface
  2. Using one hand, slide the needle into the cap. You should not be holding the cap when doing this.
  3. When the needle is fully within the cap, scoop it off the surface and use your other hand to ensure the cap is securely fastened 4. Once the cap is securely fastened, dispose of the needle in the correct sharps bin.

Disposing of sharps

It is important that you dispose of all sharps safely to reduce the risk of injury or infection. When disposing of a sharp, you must:

  • Ensure you can safely handle and dispose of your sharps before you begin a procedure.
  • Take the sharps container to your patient, wherever possible, rather than taking the sharps to the container
  • Discard all sharps items into the correct sharps box immediately after use.
  • Never separate single use needles and syringes prior to disposal. You should place the complete needle and syringe unit into the    correct sharps bin
  • Not put large pieces of broken glass or crockery into a sharps bin.

For non-disposable sharp items, you must always ensure they are rendered safe after use. You can do this by:

  • Using purpose-made blade or needle removal kits or forceps to safely remove scalpel blades and needles
  • Dispose of the scalpel blade or needle in the correct sharps bin

 

You will need to use a medical waste disposal company  we provide details of how at the end of this presentation.

When a sharps box is 3/4 full, no more sharps should be disposed of in it. Doing so puts you at a increased risk of injury

When a sharps box is full, you should:

  • Seal it with a tamper-proof lid
  • Ensure that it is correctly labelled
  • Follow your workplace procedures for storing the full sharps box while Awaits collection

Full sharps box should be stored in a secure area, away from the public, where no children or young people can access them. It’s important you follow your workplace guidelines to ensure that the sharps box is disposed of correctly.