Frequency of use and activation of safety-engineered sharps devices: a sharps container audit in five Australian capital cities

Introduction

Sharps injuries (SI) among healthcare personnel (HCP) in Australia are of such concern the matter was brought before Parliament in 2013. Many SI from safety-engineered devices (SED) are due to nonactivation. Monitoring of activation is recommended. This paper outlines a sharps container (SC) contents audit conducted in Australian capital cities.

Methods

Reusable, 22 L SC (Sharpsmart, Daniels Corporation, Melbourne) were randomly selected from random healthcare facilities (HCF) in five cities. Wearing protective apparel, the operator opened and decanted SC and sorted hollow-bore needles (HBN) into: capped v. uncapped non-SED, and activated or non-fully activated SED. Volumes and weights were recorded for inter-study comparisons. WinPepi v2.78 was used to calculate probability (significance set at ≤ 0.05), relative-risk and 95% confidence limits.

Results

1212 L of sharps (167.9 kg) from 102 SC from 27 hospitals were audited. Many devices were bloodcontaminated. Of the 9651 HBN, 30.4% were SED and 19.4% of the SED were not, or partially, activated. Of the 6718 non-SED, 30.6% were capped needles or capped needle-syringes. City averages for capped or naked sharps ranged from 64.2% (Sydney) to 97.8% (Adelaide) while hospital averages ranged from 32.6 to 100%. Overall, 54.2% of devices were discarded ‘sharp’.

Conclusions

It is disturbing that 75.5% of hollow-bore needles were capped or naked, indicating a high proportion of Australian HCP are unnecessarily at risk of SI while handling sharps. The high non-use of SED and non-activation of SED needs researching.Widespread SED evaluation and adoption (automatic and semi-automatic SED where feasible), repetitive competency training and safety-ownership are needed. Legislation may be indicated.