What are the common settings and causes of sharps injuries in healthcare and how can they be prevented?

From the Guidelines

Sharps injuries in healthcare most commonly occur in hospitals, clinics, and other institutions, such as schools and prisons, during activities involving needles or sharp instruments, and can be prevented by using safety-engineered devices and following proper disposal procedures. These injuries typically happen due to rushing, fatigue, inadequate training, or lack of safety devices. According to 1, safety-engineered devices must be used by all healthcare professionals and caregivers using sharps in all settings, and best practice for pen needles requires that both ends of the needle be protected.

Common Settings for Sharps Injuries

• Operating rooms
• Patient rooms
• Emergency departments
• Intensive care units
• Clinics
• Schools
• Prisons

Prevention Strategies

• Implementing engineering controls like safety-engineered devices with automatic needle retraction or shields
• Establishing clear work practice controls including no-recapping policies and proper sharps disposal containers at point-of-use
• Providing comprehensive education on proper handling techniques
• Ensuring personal protective equipment use
• Administrative controls such as regular safety audits, incident reporting systems, and adequate staffing levels

As noted in 1, sharps injuries are predominantly caused by needles and are associated mainly with venepuncture, administration of intravenous drugs, and recapping of needles, and can be prevented by adhering to national guidelines and agreed standards. Healthcare facilities should prioritize the use of safety-engineered devices and proper disposal procedures to minimize the risk of sharps injuries and bloodborne pathogen transmission.

From the Research

Settings of Sharps Injuries

• Sharps injuries can occur in various healthcare settings, including:
  • Laboratories 2
  • Operation theaters 3
  • Inpatient care 3
  • Emergency rooms 3
  • Surgical fields 4

Causes of Sharps Injuries

• The most common causes of sharps injuries include:
  • Phlebotomy 2
  • Injection 5
  • Venipuncture 5
  • Suture 5
  • Insertion and manipulation of IV catheters 5
  • Recapping 2
  • Needle disassembly by hand 2
  • Blood transfer from syringes into tubes 2

Prevention of Sharps Injuries

• Strategies to prevent sharps injuries include:
  • Education and training [(2,3,4,5)]
  • Use of safety-engineered sharps devices [(2,5)]
  • Double-gloving 6
  • Proper disposal of sharps 2
  • Vaccination against bloodborne pathogens 2
  • Implementation of safe sharps practices 2
  • Regular monitoring and surveillance 2

Occupations at Risk

• Healthcare workers at risk of sharps injuries include:
  • Nurses [(3,4,5)]
  • Physicians [(3,4,5)]
  • Technicians [(3,5)]
  • Cleaners 3
  • Medical students 4
  • Laboratory staff 2