Handling Sharps and Needles
Sharps Containers (also referred to as Sharps Disposal Containers, Medical Waste Disposal Containers, Biomedical Waste Disposal Containers, etc.) are specially made containers used to contain hazardous "piercing" instruments and reduce the chance of spreading infection. It is standard practice in developed and even underdeveloped countries for used needles to be placed immediately into a sharps container after a single use, with only a few exceptions to the general rule. Needles are dropped into the container without touching the outside of the container. Needles should never be pushed or forced into the container, as damage to the container and/or needlestick injuries may result. Proper use of a sharps container includes pick up by or delivery to an approved "red bag" or medical waste treatment site. In addition to this pre-existing safety measure, all U.S. medical and educational staff are federally required to be tested on their knowledge of bloodborne pathogens.
A sharps container is a term for a specially-made container that is predominantly used for medical needles and any other sharp medical instruments, such as an IV catheter. They are available in one of two types:
Single-use sharps containers - which are disposed of with the waste inside.
Reusable sharps containers - which are robotically emptied and sterilized before being returned for re-use.
Sharps is the term used to describe any item that is capable of puncturing the skin such as syringes, needles, lancets, broken glass with blood on it, scalpels, etc. Because these 'sharps' potentially have disease-carrying blood or other potentially infectious materials on them, they are capable of 'injecting' that blood or fluid into anyone who comes in contact with them. Examples of sharps include:
- Needles, syringes, lancets, broken glass with blood on it
- Suture needles, scalpel blades, butterflies (both traditional and safety)
- Vacutainer tubes (both plastic and glass)
- Phlebotomy needles with vacutainer tube holder attached
- Capillary tubes (both plastic and glass)
- IV catheters
- Dental anesthetic carpules with blood
- Dental wires and endodontic files
- Other sharp objects contaminated with blood such as box cutters and broken glass
For regulated businesses, such as healthcare faculties, in addition to sharps, regulated medical waste is defined by OSHA as:
- Pathology and microbiological waste
- Liquid or semi-liquid blood or other potentially infectious materials (OPIM*)
- Items caked with dried blood or OPIM
- Items that could release blood or OPIM
*OPIM: semen, vaginal secretions; fluids from around the spine, brain, joints, lungs, heart, and abdomen; saliva in a dental procedure; any body fluid with visible blood; any unidentifiable body fluid; and unfixed tissue.
Examples of non-sharps regulated medical waste include Tubing with blood in it and Blood-soaked gauze. Regulated medical waste does not include urine, feces, sputum, sweat, tears, or saliva or any items containing or once containing these fluids such as urine cups, incontinence pads, or diapers.
Before you use a sharp object, such as a needle or scalpel, make sure you have all the items you need close by. This includes items like alcohol swabs, gauze, and bandages.
Also, know where the sharps disposal container is. Check to make sure there is enough room in the container for your object to fit. It should not be more than 2/3 full.
Some needles have a protective device, such as a needle shield, sheath, or blunting, that you activate after you remove the needle from the patient. This allows you to handle the needle safely, without the risk of exposing yourself to blood or body fluids. If you are using this kind of needle, make sure you know how it works before you use it.
Follow these guidelines when you work with sharps.
- Do not uncover or unwrap the sharp object until it is time to use it.
- Keep the object pointed away from you and other persons at all times.
- Never recap or bend a sharp object.
- Keep your fingers away from the tip of the object.
- If the object is reusable, put it in a secure, closed container after you use it.
- Never hand a sharp object to someone else or put it on a tray for another person to pick up.
- Tell the people you are working with when you plan to set the object down or pick it up.
Make sure the disposal container is made for disposing of sharp objects. Replace containers when they are 2/3 full.
Other important tips include:
- Never put your fingers into the sharps container.
- If the needle has tubing attached to it, hold the needle and the tubing when you put it in the sharps container.
- Sharps containers should be at eye level and within your reach.
- If a needle is sticking out of the container, do not push it in with your hands. Call to have the container removed. Or, a trained person may use tongs to push the needle back into the container.
- If you find an uncovered sharp object outside of a disposal container, it is safe to pick it up only if you can grasp the non-sharp end. If you cannot, use tongs to pick it up and dispose of it.
According to OSHA, healthcare employees must have access to sharps containers that are easily accessible to the immediate area where sharps are used (29 CFR 1910.1030(d)(4)(iii)(A)(2)(i)).
The FDA recommends that used needles and other sharps be immediately placed in FDA-cleared sharps disposal containers. The FDA has evaluated the safety and effectiveness of these containers and has cleared them for use by health care professionals and the public to help reduce the risk of injury and infections from sharps.
FDA-cleared sharps disposal containers are made from rigid plastic and come marked with a line that indicates when the container should be considered full, which means it’s time to dispose of the container.
How do the Bloodborne Pathogens standard and the Needlestick Safety and Prevention Act apply to you? OSHA's Bloodborne Pathogens standard (29 CFR 1910.1030), including its 2001 revisions, applies to all employers who have an employee(s) with occupational exposure (i.e., reasonably anticipated skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials (OPIM) that may result from the performance of the employee's duties). These employers must implement the requirements set forth in the standard. Some of the new and clarified provisions in the standard apply only to healthcare settings, but other provisions, particularly the requirements to update the Exposure Control Plan and to keep a sharps injury log, apply to non-healthcare as well as healthcare settings. Make sure your staff are properly trained in OSHA compliance standards and have the required tools to perform their job safely.Sources: www.osha.gov, www.fda.gov, U.S. National Library of Medicine and http://www.sharpscontainers.org/