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The Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 (also known as the Sharps Regulations) were implemented on 11th May 2013 to implement aspects of the European Council Directive 2010/32/EU that are not specifically addressed in existing GB legislation.
All employers are required under the existing health and safety law to ensure that all risks from sharps injuries are adequately assessed and appropriate control measures are put in place. In particular, the needs to assess the risks, provide appropriate information and training, and consult with employees. The Sharps Regulations build on the existing law and provide specific detail on requirements that must be taken by healthcare employers and their contractors. There are many parts of the regulations and we are looking now at some of these and the first is the use and disposal of medical sharps.
The Sharps Regulations follow the principles of the hierarchy of preventative control measures, set out in the Control of Substances Hazardous to Health Regulations. You must avoid the unnecessary use of sharps. Needles, scalpels and other sharps will remain essential tools for effective medical care. However, the employer should ensure that sharps are only used where they are required. For example, organisations that have reviewed the use of sharps have identified staff using needles to carry out tasks for which they are not required (for example collection of urine samples from catheter bags). Needle-free equipment is available for certain procedures and should be used, where it is reasonably practicable to do so.
Where it is not reasonably practicable to avoid the use of medical sharps, the Sharps Regulations require employers to substitute traditional, unprotected medical sharps with a ‘safer sharp’ where it reasonably practicable to do so. The term ‘safer sharp’ means medical sharps that incorporate features or mechanisms to prevent or minimise the risk of accidental injury. For example, a range of syringes and needles are now available with a shield or cover that slides or pivots to cover the needle after use.
‘Safer sharps’ do not necessarily remove all risks associated with the use of a sharp. In some circumstances, patients may provide needles for example, for the administration of insulin, which they expect a healthcare worker to use and the employer have not had an opportunity to ensure that it is a suitable ‘safer sharp’. The employer’s risk assessment should identify if their employees may be faced with such a request, and make arrangements to ensure that employees have safe systems of work and the appropriate information, training and equipment to deal with this situation.
It is important to prevent the recapping of needles. Injuries can occur after a needle has been used if the healthcare worker holds the needle in one hand and attempts to place a cap on the needle with the other hand, often called two-handed recapping.
Needles must not be recapped after use unless the employer’s risk assessment has identified that recapping is itself required to prevent a risk, for example when it is could reduce the risk of contamination of sterile preparations. In these limited cases, appropriate devices to control the risk of injury to employees must be provided. For example, needle-blocks can be used to remove and hold the needle cap and so allow safe one-handed recapping.
It is required to place secure containers and instructions for safe disposal of medical sharps close to the work area. COSHH requires systems to dispose of contaminated waste safely. The Sharps Regulations supplement this by requiring that clearly marked and secure containers are placed close to the areas where medical sharps are used. Instructions for staff on safe disposal of sharps must also be placed in those areas.
In many healthcare facilities, sharps bins can be placed next to the healthcare worker so they can drop the used sharp straight into it. For example, inwards, this can be achieved by placing the sharps container on the dispensing trolley. However, some healthcare workers do not operate in premises in which they have control, for example, paramedics or healthcare workers working in a patient’s home. In these cases, the employer’s risk assessment should select appropriate sharps, specify safe working procedures and provide suitable portable sharps containers and means for collection and replacement of those.
These regulations cover many more areas and you can find the full information in the download area of this course.