Sharps Safety: A Must-Read for Every OR Professional

Back to Basics: Sharps Safety

Basic components of an effective sharps safety program to prevent needlestick and sharps injuries.

Although OSHA’s bloodborne pathogens standard has been in place since 1992, needlestick and sharps injuries continue to occur. Don’t let it happen to you. This month’s AORN Journal “Back to Basics” article provides important reminders for periop RNs at all levels of experience.

Health care workers are at risk for needlestick and sharps injuries, especially those who work in fast-paced environments such as the OR where the handling of sharp instruments and devices is prevalent.

This month’s “Back to Basics: Sharps Safety” in AORN Journal outlines the basic components of an effective sharps safety program to prevent needlestick and sharps injuries. It focuses on the shared responsibility between the organization and the individual perioperative team members. This AORN Journal article is typically a members-only benefit. For a limited time, we are giving everyone access to read the full article written by Guidelines Editor-in-Chief Erin Kyle, DNP, RN, CNOR, NEA-BC.

Below are key points you should know.

Practice Point: Organization Responsibilities

• According to the NIOSH hierarchy of controls,* the most effective methods of preventing sharps injuries are through elimination or substitution of the hazard.
• The next most effective method of reducing the risk of injury is implementation of engineering controls that isolate individuals from the hazard. Engineering controls that personnel can use in perioperative and procedural settings include single-use scalpels and hypodermic needles that incorporate safety-engineered features (e.g., no disassembly or blade removal required), devices that allow for retraction or shielding of the blade into the handle during transfer between health care professionals or when not in use, and scalpel blades with rounded tip.
• Administrative and work practice controls are not as effective at reducing the risk of sharps injury as elimination, substitution, and engineering controls, but they are an important part of the exposure control plan.

Practice Point: Team Member Responsibilities

• Each member of the perioperative team is responsible for knowing about sharps safety. They should actively participate in activities that reduce the risk of sharps injury to themselves, their patients, and their colleagues.
• The input of front-line staff on the functionality of sharps injury–prevention technology is essential when considering and trialing items for purchase and use.
• When a scrubbed individual identifies a glove perforation and suspects that an injury has occurred, they should remove the gloves (and gown) and assess the skin for damage. If an injury has occurred, they should wash the area with soap and water and report the injury according to the facility's policy.

Practice Point: Disposal of Sharp Devices

• The scrub person must contain and isolate sharps in a containment device that meets the OSHA bloodborne pathogens standard.** Such devices must be puncture-resistant and labeled (i.e., orange or orange-red and contain the word “BIOHAZARD” and biohazard logo in a contrasting color) or color-coded (i.e., red). The sides and bottom of the containment device must be leakproof.
• If a sharp item is either intentionally or unintentionally removed from the sterile field, the RN circulator should don gloves and use an instrument to retrieve it carefully, show it to the scrub person, and then place it in a sharps containment device or counter.
• Perioperative personnel should discard all sharps at the end of the procedure after all counts are reconciled and the patient has been transported from the OR.

Perioperative personnel should prioritize sharps safety. Needlestick and sharps injuries remain prevalent in the fast-paced OR environment where the need to handle sharps is common. To learn more, read the Guideline for Sharps Safety and see “Back to Basics: Sharps Safety” in the January issue of AORN Journal.