Advice for Implementing Sharps Safety Strategies

ICT invited members of industry to share their perspectives on sharps safety strategies.

What are the key benefits of proper and safe sharps disposal to healthcare workers and patients?

Hospital staff should look for several things when considering a sharps management system that will be simple and environmentally friendly while decreasing needlestick injuries. Reusable containers, vertical drops and a proactive exchange service should all be part of a sharps disposal process which includes installation, training and proactive exchange of containers. Users will want to select this type of comprehensive service for the safety, risk management and compliance with state regulations and agency standards (e.g., Joint Commission, CDC, OSHA, EPA, DOT). Sustainability and a reduced carbon footprint are important in a service too. Reusable containers free staff and inventory space. One reusable Stericycle container prevents 600 disposable ones from going to the landfill and eliminates disposal costs for RMW. Since 1986, hospitals using BioSystems containers have kept 125 million containers out of landfills.(1) This number equates to 169,000 pounds of carbon kept out of the environment and 8.7 million gallons of gas not burned.
Reference:
1. http://www.stericycle.com/carbon-footprint-- Jackie Rategan, market manager, sharps management system for Stericycle

While many facilities utilize safety sharp devices (hypodermic needles, phlebotomy, etc.), the proper and safe disposal of medical sharps into an appropriate safety container further helps to reduce the incidence of needlestick injuries among healthcare workers and patients. In addition, it also provides protection to downstream workers (housekeeping, waste haulers, etc.) who could come in contact with an inappropriately disposed sharp.
-- Debbie McDermott, CTSM, Covidien

There are ethical, legal and financial reasons for proper and safe sharps disposal. Ethically, we must first do no harm to patients. This means that no patient should expect to be stuck by a wayward needle that can infect them with a serious disease (e.g. HIV or hepatitis). Safe needle disposal, through occupational health and safety law (e.g., the Occupational Safety and Health Administration) and state law is a legal right. Without a safe sharps workplace, we cannot expect people to continue to work in health care and serve the public. An improperly disposed of needle also poses serious issues of public liability. Perhaps in response to needles washing up on beaches, the U.S. government passed the Needlestick Prevention Act, which holds the originator of the sharp liable for sharps injury -- even on the beach. Finally, needle theft is on the rise by illicit drug users. This means that proper disposal includes an aspect of crime prevention.
-- Preethy Kaibara, MD, Esq., FAAFP, ACLM, Safe Medical Technology, LLC
 

Key benefits include:
- Safe management of sharps waste including healthcare worker safety and patient/visitor safety
- Security of sharps containment to minimize risk of unauthorized access
- Environmental safety including reductions in landfilled volumes and product lifecycle greenhouse gas emissions
- Pride that their facility is supporting safety and sustainability initiatives
-- David Skinner, vice president, Daniels Sharpsmart Inc.

What should users look for when evaluating and purchasing sharps disposal systems and products?

A proactive exchange system is the single most important step for preventing sharps injuries. Containers that are changed by technicians on a regular schedule help eliminate staff needlestick injuries during disposal. In 2011, the ECRI Institute ranked needlestick injuries eighth on its list of Top 10 Health Technology Hazards. A leading cause is often due to over-filled containers. A cone shape like that of the BioSystems container provides ease of disposal and heightens staff awareness to be careful. According to an independent study1 of 53 hospitals using BioSystems, 78 percent eliminated disposal needlestick injuries altogether, while 92 percent of respondents decreased disposal sharps injuries to 01 per year. Additionally, costs decrease when sharps injuries are reduced along with the associated investigative costs.
Reference:
1. An independent survey of 53 hospitals EVS and infection control practitioners commissioned by Stericycle, 2011
-- Jackie Rategan, market manager, sharps management system for Stericycle

While many factors enter into playbased on the facilitys logistics, layout, practices and protocolsthe baseline for evaluating the efficacy of a sharps disposal program starts with understanding and adhering to OSHA and NIOSH requirements for sharps disposal containers.  This information can be found on the appropriate websites. Specifically, not allowing containers to be overfilled in use, and restriction of hand access during use, are key elements. Utilizing containers that incorporate engineering controls designed to help ensure these two criteria are met will remove much of the guess work, and help create a safer environment.

-- Debbie McDermott, CTSM, Covidien

Evaluation of sharps disposal has multiple considerations. Disposal first must be practical. Healthcare users need disposal units at the point of care. Otherwise, they risk being stuck through the transport of the needle to another location. The second opportunity to get stuck occurs from overfilled, overflowing sharps disposal containers. The healthcare worker now risks getting stuck with a needle from an unknown source. A good disposal system should not permit such overfill and should notify the user that the system user before overfill to change the container. Another consideration is what protection the disposal method has against theft. It should at minimum be lockable. Methods that destroy the needle (e.g., shredding, cutting) reduce theft more because the needle is no longer reusable. Finally, how are the sharps contained? Larger containers allow for longer use and less disposal costs. However, the container must be practical in the space the disposal system is used.
-- Preethy Kaibara, MD, Esq., FAAFP, ACLM, Safe Medical Technology, LLC

Areas to review include:
- Proven ability to reduce sharps injuries published in peer-reviewed journals
- Reusable containers with proven ability to reduce landfilled volumes and greenhouse gas emissions published in peer-reviewed journals
- High ratings on clinical evaluations by users
- Product compliance with OSHA, DOT, FDA and state regulatory requirements
- Product compliance with all of NIOSHs Guideline checklist for use, evaluation and selection of sharps containers.
- Reliable and quality service delivery by contractor
- High value for money
-- David Skinner, vice president, Daniels Sharpsmart Inc.

Compiled by Jessica Barreras