Handling sharps in adult social care

Sharps injuries are a well-known risk in the health and social care sector.

Sharps contaminated with an infected patient's blood can transmit more than 20 diseases, including hepatitis B, C and human immunodeficiency virus (HIV).

Medical sharps (sharps) include any device used for a healthcare activity to puncture or lacerate the skin and include:

• needles, and anything attached to them such as syringes
• scalpels and scissors
• lancets
• broken glass items, such as ampoules or vials

Legislation

Health and Safety Executive guidance says an employer will need to act to manage the risks if workers:

• use sharps to provide care or other services to people
• provide care or other services to people who are likely to use sharps
• are involved in handling such equipment after use - for example in sterile services and waste disposal
• are likely to inadvertently come across used sharps - for example during laundering

Employers are legally required to assess risks from sharps injuries and put appropriate control measures in place.

Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 apply to organisations providing healthcare. This includes nursing homes and providers delivering healthcare in residential homes or people’s own homes.  Read the Guidance on the Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

Considerations for providers

Avoid the unnecessary use of sharps

Only use sharps when needed.

Needle-free equipment is available for certain procedures and should be used where it is reasonably practicable to do so.

Use safer sharps

Syringes and needles are available with a shield or cover. This slides or pivots to cover the needle after use to prevent or minimise the risk of accidental injury.

ASC providers should work with prescribers and healthcare providers to make sure safer sharps are used where possible.

Prevent the recapping of needles

You must not recap needles after use. You can if the employer’s risk assessment has identified that recapping is itself required to prevent a risk.

In these limited cases, appropriate devices to control the risk of injury to employees must be provided. For example, you can use needle-blocks to remove and hold the needle cap and allow safe one-handed recapping.

Safe disposal

Residential homes and care provided in people’s own homes

External healthcare professionals may use sharps as part of their routine practice. They should safely dispose of sharps using their own sharps disposal process.

Care workers may use sharps as part of a delegated task. There should be a safe sharps disposal process for staff to follow. This may include disposal via a waste contractor.

Care providers should make sure staff are aware of the use of sharps. They should assess the risk to the person receiving care and to care staff. They should take appropriate precautions to protect against sharps injury.

Self-administration

People may administer their own medicines and generate sharps waste. For example, people may administer their own insulin or take their own blood glucose readings.

People should dispose of sharps in a dedicated sharps waste bin. This can be prescribed or supplied by the local authority. They should make arrangements with the local authority to collect these as needed.

Providers should assess the risk of medicines self-administration. Include the use, safe storage and disposal of sharps.

Nursing homes

Sharps used by nurses in a nursing home should be disposed of in a dedicated sharps waste bin via the clinical waste contractor.

Sharps injury

Providers should adequately assess the risks from sharps injuries and put appropriate control measures in place.

Staff should be trained so they know how to work safely and without risk to health with the specific sharps equipment that they or others might use.

Staff should know what action to take in the event of a sharps injury or incident.

If care staff are injured by sharps at work, they must notify their employer as soon as practicable. The employer must have sufficiently robust arrangements to allow care staff to notify them in a timely manner. This includes where the employee works out-of-office hours or away from the employer’s premises.

If an employee has been injured by a sharp that has or may have exposed them to a blood-borne virus, the employer must:

• make sure that the employee has:
  • immediate access to medical advice
  • has been offered post-exposure prophylaxis and any other medical treatment, as advised by a doctor
• consider whether the employee should receive counselling

Employers must record sharps injuries when notified. The employer should investigate the circumstances and causes of the incident, and take any action needed.