Reducing Hidden Risks: Why Sharps Injuries Still Go Unreported

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(This is the first of a series of articles from the conversation with Heitman.)

Sharps injuries remain a serious occupational hazard for health care workers, yet many facilities continue to underestimate the problem. Budget constraints, cultural habits, and underreporting contribute to a widespread lack of awareness about the true scope of the issue.

In this Infection Control Today^® (ICT^®) interview with Amanda Heitman, BSN, RN, CNOR, perioperative educational consultant for Periop Anew, and supervisor of education of surgical services at WakeMed in Cary, North Carolina. She is also a member of the ICT Editorial Advisory Board.

A key challenge, Heitman said, is that staff often do not report sharps injuries. Many health care workers fear being blamed or feel ashamed, assuming the incident was their own fault. As a result, leadership teams may be unaware of the frequency of these injuries. Without data, there is little motivation to implement safer engineering controls or change long-standing habits.

An option for safe scalpel handling is QlickSmart's BladeFLASK Scalpel Blade Remover

(Image credit QlickSmart)

Heitman said that the culture of not reporting injuries is changing. “One of my first questions when I'm presenting is having everyone raise their hand for who has ever had a sharps injury before. All of them are speaking up now directly because they want a safer work environment, as they've been exposed to this risk for too long.”

Even when organizations do acknowledge the risk, they may balk at the upfront cost of newer safety devices. However, those initial expenses pale in comparison to the hidden costs of injuries, ranging from blood testing and rehabilitation to staffing shortages, compliance fines, workers’ compensation, and litigation. A single incident can ripple across scheduling, productivity, and even patient safety.

Fortunately, solutions exist. OSHA’s updated 2023 clarifications underscore the importance of using engineering controls for sharps safety, particularly in the operating room. One such innovation is the single-handed scalpel blade remover, some devices cocreated by Michael Sinnott, MBBS, FACEM, FRACP, from QlickSmart that enables safe blade removal without direct contact. These tools are already in use worldwide but remain surprisingly underutilized in US hospitals.

Sinnott is also an associate professor at the University of Queensland and the Queensland University of Technology, and the cofounder of StaffandPatientSafety.org.

Professional groups like the Association for periOperative Registered Nurses (AORN) and the Association for Surgical Technologists (AST) have endorsed these devices, yet many clinicians remain unaware they exist. Infection preventionists can play a critical role in spreading awareness, advocating for adoption, and encouraging accurate reporting.

As more staff begin to speak up for their own safety—not just their patients’—the culture is starting to shift. However, true progress depends on combining updated tools, clear education, and a workplace culture that values transparency over tradition.