Sharps safety in health care goes far beyond personal protective equipment. Amanda Heitman outlines a layered strategy of training, communication, and device innovation aimed at reducing needlestick injuries in even the busiest clinical environments.
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(This is the second of a series of articles from the conversation with Heitman. Find the first
Reducing needlestick and sharps injuries among health care workers requires more than tools—it takes clear communication, consistent training, and a commitment to best practices. Despite the availability of safety-engineered devices and protective equipment, staff injuries persist, often due to inconsistent use or lack of understanding of how to properly apply these tools.
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.
Communication is a key but often overlooked component of safety. Heitman, who is also a member of the ICT Editorial Advisory Board, explains that when teams communicate effectively, especially in high-risk areas like operating rooms, they are more likely to prevent injuries by reducing distractions and slowing down rushed procedures. In tandem with communication, staff should avoid high-risk behaviors such as recapping needles and instead employ a neutral zone for hands-free instrument passing.
"Communication is just a critical component of everything we do, and it just helps reduce the inherent risk of those injuries by minimizing our distractions. And sometimes we rush things, which can also be an extra risk. I always encourage staff to add those extra things with other sharps, like avoiding recapping syringes and on your needles, and then we also teach them how to do a hands-free passing technique with a neutral zone.”
The hands-free passing technique, when used consistently, significantly reduces the chance of hand-to-hand exposure. This is especially important when coupled with engineered safety devices like retractable syringe barrels or scalpel sheaths. However, the success of these devices depends heavily on compliance. Too often, users remove safety features out of habit or inconvenience, undermining their protective function.
Innovations like needle-free intravenous systems and blunt-tip suture needles offer safer alternatives that are gaining traction. However, while protective personal equipment (PPE) is widely used, it's actually one of the least effective methods in preventing sharps injuries. Even double-gloving often fails to stop injuries, highlighting the need for more reliable upstream interventions.
“That's probably the most universally identified way that we keep our staff safe. But it's almost actually the least effective,” Heitman said. “That's always another thing that I ask: How many of us were double-gloved when we got our injuries? [Many of] us say that we were, but it's helpful. But we try protective footwear, we try, and then the PPE also helps the nonclinical folks who are not like sterile at the field, because they're exposed to the sharps too.”
Heitman emphasizes the importance of regular evaluation and retraining on safety devices. Many facilities own appropriate tools but fail to provide adequate or ongoing training, especially for new hires. Without reinforcement, staff often revert to old habits, bypassing devices they don’t fully understand.
Consistent, sharp safety training, both at onboarding and on an annual basis, combined with effective policy enforcement, can help shift the workplace culture. Evaluating device usage, ensuring proper education, and supporting staff to consistently use safety features are key to reducing injuries across all departments, not just the operating room. With rising turnover and a changing workforce, maintaining this safety culture is more important than ever.
