Introduction: The incidence of sharps injuries (SI) in the United States fell significantly with mandatory use of safety engineered devices (SED) in 2001 but has remained static since. More than half of SI from SED are due to non-activation of devices, and monitoring of activations is recommended. This paper outlines the findings of a sharps container (SC) contents audit conducted in Florida in September 2013.
Methods: Reusable 22 liter sharps containers (Sharpsmart, Daniels Sharpsmart Inc., Chicago IL) were randomly selected from five healthcare facilities (HCF) in central Florida. Wearing protective apparel, the operator opened, decanted and enumerated all hollow-bore needles and sorted them into: conventional vs. SED; capped vs. uncapped; and activated vs. non-activated SED.
Results: 261L of sharps (40.3kg) from 18 SC from four hospitals and one large family clinic were enumerated?) and 21.6% of SED were not activated.
Discussion: It is disturbing that 39.9% of conventional needles were capped prior to discard, and 42.5% of all devices were discarded as a “naked” sharp. In this small sampling, it is worrisome that 12 years after U.S. SED legislation, 64.3% of healthcare professionals (HCP) placed themselves at risk by recapping or discarding naked needles. Many non-activated phlebotomy devices were visibly blood-contaminated. The reasons given for non-activation of SED (ease of use, device preference, perception of patient adverse event, training) must be addressed.
Conclusion: The high proportion of devices being capped or discarded with an unprotected sharp may be a possible reason for the continued high SI incidence in the United States. A new vigor encompassing competency training, safety ownership and adoption of passive SED wherever possible is needed to protect HCP.
Grimmond, T. (2014) Use and activation of safety engineered sharps devices in a sample of 5 Florida healthcare facilities. The Journal of the Association of Occupational Health Professionals in Healthcare. 34(1), p.13-15.