5(a) Safe Use and Disposal of Sharps

1. INTRODUCTION

1.1 Many needlestick injuries are preventable providing staff are informed of the
appropriate procedures which will minimise the risks associated with handling sharps.
The following practices should be taught to all staff likely to handle sharps, at
induction/orientation and regularly thereafter.

1.2 Non-compliance with these guidelines may carry medico-legal or health and safety
legislation implications.

1.3 Definitions:

Clean / used sharp describes a sharp that has been used for a “clean” procedure such
as drawing up injections. Such a sharp will not have had contact with a patient’s
blood or body fluids and poses less of a risk to the HCW should a sharps injury occur,
although from a Health and Safety perspective such injuries are still of significance.

Contaminated / dirty sharp describes a sharp that has been used invasively and has
had contact with a patient’s blood or tissues thus posing a higher risk of potential
cross-infection with a blood-borne virus should a sharps injury occur.

2. ASSEMBLY OF SHARPS CONTAINERS

2.1 Only approved sharps containers must be used which comply with current standards.
(BS 7320:1990, UN 3292)

2.2 Ensure that the sharps container is correctly assembled and that the lid is securely
fitted. Follow the manufacturer’s recommendations for assembly, as all containers
differ.

2.3 Label the sharps container with the date of assembly, the name of the member of staff
who assembled it and location e.g. ward, GP practice.

3. LOCATION OF SHARPS CONTAINER

3.1 Adequate sharps containers must be available. Ideally, they should be available in all
places of regular use.

3.2 Containers should be available in a range of sizes appropriate to the number of sharps
generated and where they will be used. For example, small containers (designed for
disposal of needles only) are available for portable use at the bedside or for home
care. Many can be fitted to sharps trays specifically for this purpose.

3.3 All sharps containers must be stored out of the reach of children and others who may
be at risk.

-1-
REVIEW DATE: APRIL 2010
3.4 Sharps disposable bins must never be stored on the floor or above shoulder level.

3.5 Sharps containers should be placed on a secure, stable surface. Most manufacturers
have free brackets available to mount them on the wall or trolleys.

3.6 Wherever possible, sharps containers must be taken to the point of use to ensure
immediate disposal.

4. SAFE DISPOSAL OF USED SHARPS

4.1 It is the responsibility of the individual who has used the sharp equipment, to safely
dispose of it in an approved container. Sharps must not be left for others to clear
away.

4.2 Place all disposable sharps into an approved (BS 7320:1990, UN 3292) puncture
proof sharps container immediately at the point of use. Some containers have a
temporary closure, which should be activated between uses.

4.3 Fill sharps containers to the ‘fill’ line only. Do not overfill any sharps container, as
this is a significant risk to both you and others.

4.4 Full sharps containers should be kept in a dedicated, lockable, labelled area. A
registered waste company must remove clinical waste. Good practice is weekly
collections. Keep transfer notes on site.

4.5 Re-sheathing sharps should not occur unless absolutely necessary e.g. in dentistry
when using non-disposable syringe cartridges. Only re-sheath if an approved device
is available or staff are trained and competent in using the single-handed re-sheathing
technique.

4.6 Do not attempt to remove the needle from the syringe. Discard the needle and syringe
as a single unit, into an approved sharps container. However, if small (portable)
boxes are in use these are often designed to hold needles only which should be
removed using the device in situ on the box.

4.7 If the needle has to be removed, e.g. when transferring blood to a container or if the
needle is disposable and the syringe is not as with some dental anaesthetic syringes,
needle forceps or another appropriate device must be used to remove the needle.
Many companies now manufacture safety devices specifically for this purpose.

4.8 Needle-free devices are available for a wide range of sharps procedures and
individual departments should review such devices if considered appropriate.

5. LOCKING SHARPS CONTAINERS

5.1 Sharps containers should be available in adequate numbers to ensure they are not
overfilled and must be locked, labelled and disposed of when they are three quarters
full.

5.2 Ensure sharps containers are labelled appropriately when locked prior to disposal.

5.3 Do not place sharps containers into yellow clinical waste bags for final disposal.

-2-
REVIEW DATE: APRIL 2010
6. COMMUNITY STAFF USING SHARPS

6.1 Community staff attending patients in their own homes must have access to
appropriately sized sharps containers compliant with relevant standards.

6.2 Removal of full sharps containers from patients’ homes who are housebound must be
arranged by the practitioner responsible for that patient’s care e.g. PCT or GP and
must be collected by a registered waste company or local council.

6.3 Transporting sharps boxes from client to client must be undertaken in a responsible
and safe manner following a local risk assessment. Ideally, sharps boxes should be
transported in a rigid, robust container to avoid accidents occurring. Sharps boxes
must not be left unattended in community staff cars.

7. PATIENT’S OWN SHARPS

7.1 Many patients self-administer medications e.g. diabetics. A variety of administration

7.2 Patients self-administering medication must be supervised and trained in safe

7.3 Appropriate equipment must be provided for the patient either by their GP or hospital
consultant/nurse specialist (now on prescription). Small portable sharps boxes
complying with relevant standards must be used. These must be returned to the
patient’s GP practice / hospital department if distributed from there for disposal as
clinical waste. Care must be taken to ensure returned sharps boxes are transported
appropriately by the patient to minimise risk to the individual and members of the
public.

7.4 Patient’s own sharps boxes must not be disposed of into the household waste stream.

7.5 Care must be taken by HCWs using self-administration systems on behalf of patients.
An assessment of risk must be undertaken especially regarding needle disposal.

8. PROTECTIVE CLOTHING AND VENEPUNCTURE

8.1 Gloves must be worn when handling or using sharps.

8.2 Gloves cannot prevent needle-stick injuries but they may reduce the likelihood of
infection by reducing the volume of blood inoculated during the incident.

8.3 Some individuals highly experienced in venepuncture may prefer not to wear gloves
because of a perceived reduction in manual dexterity. However, all experienced staff
and new trainees, including doctors, should be taught and encouraged to wear gloves
whilst taking blood.

8.4 The following is advised:

• Gloves must always be available for venepuncture.

-3-
REVIEW DATE: APRIL 2010
 • Everyone taking blood should wear gloves if they have cuts or abrasions on their
hands which cannot be covered by waterproof dressings.
• Gloves should also be worn if the patient is uncooperative or restless. (Expert
Advisory Group, 1998)

9. RISK ASSESSMENT OF WORK PRACTICES

9.1 Safe systems of work must always be followed and staff should keep themselves
informed of new methods of working. Consideration should be given to the
evaluation and introduction of new safety devices such as:

• Needleless intravenous systems;

9.2 Risk assessments should be carried out when new work practices are introduced or
before new equipment is purchased.

-4-
REVIEW DATE: APRIL 2010