Sharps injuries: Strategies and solutions to protect healthcare workers | Lorena Tonarelli


Around one million needlestick injuries occur every year among care workers across Europe. Medical journalist Lorena Tonareli takes a look at how healthcare settings can reduce the risks and ensure a safe workplace for staff. 

Despite sharp injuries being a significant occupational hazard, healthcare workers still miss out on potentially life-saving training and other interventions, as providers fail to comply with current regulations.

The UK government agency Health and Safety Executive (HSE) published the results of inspections carried out in 2015-16 within 40 NHS organisations across England, Scotland and Wales. They reveal that a massive 83 per cent were not complying with sharps regulations

Failure to provide staff with adequate safety information and training was the second most common type of breach, after unsafe use and disposal of medical sharps. 

Why does it matter?
Injuries from needle sticks or other sharps are a significant occupational hazard to healthcare workers, especially nurses and assistants, who provide the majority of hands-on care.

The current number of these injuries is unknown, largely because of widespread under-reporting – only about a third of healthcare workers disclose incidents when they happen, according to research. But the latest available figures, from 2010, indicate that one million needlestick injuries occur annually among care workers across Europe.

In healthcare environments, a major concern associated with sharp-related injuries is the possibility of exposure to blood-borne infectious agents, such as viruses, which can lead to the development of potentially fatal illnesses.

A serious, widespread problem
According to the Eye of the needle 2014 report by Public Health England, in the UK, between 2004 and 2013 sharp injuries accounted for over 70 per cent of all cases of exposure to blood or other body fluids. What’s more, 1,478 healthcare workers were exposed to HIV and 2,566 to hepatitis C, because of a sharp injury.

The consequences for staff (and their families and colleagues) can be detrimental, for this kind of exposure will inevitably cause enormous stress, anxiety and reduced quality of life. 

Counting the cost
The financial impact on healthcare providers must also be considered. A 2016 review of studies conducted in the past two decades in the US, Europe, Australia and Asia concluded that managing a single sharp injury can cost 650 to 750 international US dollars (I$)

Against this backdrop, reducing the risk of sharp injuries in healthcare settings is clearly vital to ensuring a safe workplace. And, here is the good news: the majority of these injuries, and potential exposure to infectious agents, can be prevented. And there are laws in place to ensure this happens. 

The Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 require UK healthcare providers to implement relevant safety procedures and to monitor incidents. Additionally, employers need to provide their staff with the necessary education and training.

Empowering through knowledge
The last point is of particular importance. Healthcare workers at both managerial and frontline levels must be empowered to develop and maintain a strong understanding of the core principles of health and safety, including risk assessment and incident reporting and investigation, so they can follow them consistently and, in doing so, protect themselves and their colleagues. 

Richard Evens, commercial director of the British Safety Council, says: “Evidence from the healthcare sector has demonstrated that, in combination with a more widespread use of safety-engineered medical sharps, training can significantly reduce the risk of sharp-related injuries. In one study, training cut needle stick injuries from around 47 per cent to 8 per cent.”

Other preventive strategies
Importantly, education and training need to be part of a comprehensive and integrated approach, involving a number of other evidence-based strategies.

NHS Employers highlights these strategies in their Managing the risks of sharp injuries report, published in December 2015 to support the implementation of the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013. 

A first, important step is for managers with health and safety responsibilities to carry out an assessment of the risk of sharp injuries in their facility. The aim is to identify potential hazards and the workers who are most at risk of being harmed, so that appropriate precautions can be taken.

Incident reporting is also crucial, for at least two reasons. It helps ensure that injured workers receive prompt treatment, and that each incident is properly investigated, thus enabling measures to be put swiftly in place to prevent its re-occurrence.

As ever, risk assessment, incident reporting and investigation are key to addressing safety concerns. Additional strategies, specific to the prevention of sharp injuries, include replacing conventional needles and other sharps with safer devices and implementing safe working practices such as the use of protective clothing.

The take-home message?
Despite new regulations and compelling evidence that sharp injuries can be prevented, healthcare providers are not doing enough to address the problem.

Investing more in training and other preventive strategies has the potential to significantly reduce accidents, resulting in safer and healthier workplaces – a win-win accomplishment for staff and providers.

Lorena Tonarelli is a health and medical journalist. Follow her on Twitter @LTHealthMedical

Find out more

Download these briefings, produced by the NHS European Office and NHS Employers, for everything you need to know:

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