1. SHARPS INJURY PREVENTION

2. Learning Objectives  Identify the different types of sharps.  Identify risks posed by needles and other sharps.  Recall safe practices for needles and other sharps.  Recognize sharps that have engineered sharps injury protection.  Know what Personal Protective Equipment includes.  Know how to report an exposure incident.

3. Sharps - Definition  Definition: any needles, syringes with needles, scalpels, blades, broken ampules or other articles that could cause wounds or punctures to personnel handling them.  Must be discarded into special containers without risk to disposal personnel.

4. Risks Posed by Sharps  Transmission of blood borne pathogens to someone injured by the sharp.  Between 600,000 and 800,000 sharp injuries occur among healthcare workers annually according to OSHA.

5. Blood Borne Pathogen Transmission Sharps injuries can be associated with occupational transmission of more than 20 blood borne pathogens:  Most common pathogens:  Hepatitis B (HBV)  Hepatitis C (HCV)  Human immunodeficiency virus (HIV)  Sharps injuries can lead to serious or fatal infections.

6.  About ½ of sharp injuries go unreported.  A culture of safety should be promoted by:  Reporting injuries and hazards.  Supporting involvement of staff in selection of sharps injury prevention devices.  Providing education and training on sharps injury prevention. Culture of Safety

7.  Hypodermic needles  Blood collection needles  Suture needles  Needles used in IV delivery systems  Glass capillary tubes  Used disposable razors Sharps that Frequently Cause Injury

8.  Physicians  Nurses  Lab technicians  Phlebotomists  Mid-level providers  Housekeepers  Laundry personnel  And others Who is at Risk?

9.  Drawing blood  IM injections  IV access  Suturing  Handling laundry  Collecting filled sharps containers  And more Procedures Linked to Injuries

10.  Occupational Exposure to bloodborne pathogens (29 CFR §1910.1030)  Revised in January 2001  Covers all occupational exposure to blood and other potentially infectious material  Available at www.osha.gov OSHA Requirements

11. Healthcare facilities must:  Develop and periodically review an exposure control plan.  Offer safer medical devices to reduce or eliminate exposure incidents.  Seek employee input in selection of safer medical devices and implementation of work practice controls.  Offer the Hep B vaccine to workers. OSHA Bloodborne Pathogen Standard

12.  OSHA requires healthcare providers to:  Identify jobs and tasks in which occupational exposure to blood or other potentially infectious material occurs.  Consider and implement safer medical devices.  Seek input from healthcare workers in identification, evaluation and selection of safer medical devices and work practice controls.  Update plan annually. Exposure Control Plan

13.  Follow standard precautions.  Use engineering and work practice controls.  Wear personal protective equipment.  Avoid recapping, bending or breaking of needles and sharps. Methods to Reduce Exposure

14.  CDC recommends standard precautions:  Assume all blood and body fluids are infectious.  Every patient is treated as potentially infected with a bloodborne pathogen.  All healthcare workers must use standard precautions whenever there is a chance of exposure to blood or other potentially infectious material.  Workers must use hand hygiene! Standard Precautions

15.  Avoid recapping, bending or breaking needles and sharps.  Use a one hand technique if medical procedure requires recapping.  Place used sharps immediately into puncture- resistant containers.  Carry sealed specimen containers in an outer container.  Avoid touching contaminated broken glass with bare hands. Safe Practices

16.  A protective device that can be used to protect healthcare workers from accidental needlesticks and other sharp injuries.  Generally take the same form and are used for the same application as their traditional non- safety counterparts, EXCEPT:  Protective devices are designed to prevent personnel from coming into contact with an exposed needle or other sharp. Safe Medical Device

17.  Needleless systems, such as needleless IV line connectors;  Sharps with engineered sharps injury protection, such as self-sheathing needles on syringes. Two Types of Safer Medical Devices

18. NOW YOU SEE IT.NOW YOU DON’T.

19.  Device that does not use a needle for  Collection of body fluids  Administration of medication/fluids; or  Any other procedure with potential percutaneous exposure to a contaminated sharp. Needleless Systems

20. Needleless System

21.  Non-needle sharps or needle devices with built-in safety features or mechanisms that reduce the risk of exposure incidents.  Uses:  Withdrawing body fluids  Accessing a vein or artery  Administering medications or other fluids Engineered Sharps Injury Protection

22. Example of Hypodermic Syringe with Retractable technology

23. Example of Phlebotomy Needle with Self-blunting Feature

24. Needleguard Safety Feature

25.  PPE  Equipment worn to minimize exposure to infectious materials or chemicals.  Required by the Bloodborne Pathogens Standard if exposure to blood and other potentially infectious materials is anticipated.  pps://www.osha.gov/SLTC/etools/hospital/haz ards/ppe/ppe.html Personal Protective Equipment

26.  Know where protective wear is stored  Gloves, gowns, mask, face protector, etc. Protective Clothing

27.  Used to collect blood  Break when inserted into putty  Break during centrifugation  Replace with non-glass material or  Wrap in puncture-resistant film or  Look at products that can measure Hematocrit without a centrifuge. Risks of Glass Capillary Tubes

28.  All contaminated sharps must be discarded in a sharps container – OSHA requirement  Place sharps in container immediately after use.  Place containers in patient rooms.  Do not overfill container.  Follow your practice’s procedures for disposal of sharps and container. Sharp Disposal Containers

29.  An exposure incident has occurred if  Blood or other potentially infectious material (not your own) has come into direct contact with your eyes, mouth, mucous membranes or open wounds; or  You have punctured your skin with a contaminated sharp object. Exposure Incident

30.  Report all exposures  Complete necessary paperwork to help document exposure.  Employer will provide a medical evaluation, counseling, treatments, information, etc. as needed for you. Exposure Incident

31.  Hepatitis vaccine is recommended if you have not been vaccinated.  Post-exposure prophylaxis should be started if clinically indicated. E.g.. HIV should be started within hours after exposure. Post-exposure

32.  Use devices with safety features. Know how to use them.  Never recap needles.  Always dispose of used and contaminated sharps immediately in the proper container.  Be aware of hazards of non-needle sharps:  Broken glass, scalpels, blades, etc.  Report all sharp related injuries. SUMMARY

34.  OSHA Bloodborne Pathogens Fact Sheet:  https://www.osha.gov/OshDoc/data_Bloodbo rneFacts/bbfact01.pdfA:  CDC:  https://www.osha.gov/OshDoc/data_Bloodbo rneFacts/bbfact01.pdf https://www.osha.gov/OshDoc/data_Bloodbo rneFacts/bbfact01.pdf  http://www.cdc.gov/sharpssafety/pdf/sharpss afety_poster3.pdf http://www.cdc.gov/sharpssafety/pdf/sharpss afety_poster3.pdf Resources