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 spread over 20 diseases, including hepatitis B, hepatitis C and HIV (human immunodeficiency virus).

Medical sharps include any device used for a healthcare activity to puncture or lacerate the skin, including:

• needles and anything attached to them, such as syringes
• scalpels and scissors
• lancets.

Broken glass items, such as ampoules or vials, also pose a risk and should be disposed of safely

Legislation

Guidance from the Health and Safety Executive (HSE) 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 accidentally 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
• providers delivering healthcare in residential homes or people’s own homes.

See 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. You should use it 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.

Always work with prescribers and healthcare providers to use safer sharps where possible.

Prevent the recapping of needles

You must not recap needles after use unless the employer’s risk assessment has identified that it is required to prevent a risk.

In these limited cases, provide appropriate devices to control the risk of injury to employees. 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 through a waste contractor.

Make sure staff are aware how to use sharps. Assess the risk to the person receiving care and to care staff and 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 arrange with the local authority to collect these as needed.

When you assess the risk of medicines self-administration include the use, safe storage and disposal of sharps.

Nursing homes

When nurses use sharps in a nursing home, they should dispose of sharps in a dedicated sharps waste bin provided by the clinical waste contractor.

Sharps injury

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

Train your staff 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 if there is a sharps injury or incident.

If 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 staff to notify them in a timely way. This includes where the employee works out of normal office hours.

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

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

You must record sharps injuries when notified. You should:

• investigate the circumstances and causes of the incident
• take any action needed.