What's the point? Why I care so much about sharps injuries


09 / 12 / 2015 2am

Robert Baughan is an assistant national officer for the trade union UNISON. He is a member of the NHS Staff Council Health, Safety and Wellbeing Partnership Group (HSWPG) and he also played a key role in the discussions preceding the 2010 European Union Sharps Directive.

At the beginning of this century, I heard Lynda Arnold speak of how, as a 23 year old nurse in September 1992, she sustained a needlestick injury when starting an intravenous line whilst working in a small hospital in the USA. She spoke of her feelings when the injury occurred and of the shock and devastation when, in April 1993, she was diagnosed with HIV. At the time of the injury, Lynda was told there was a 0.04 per cent chance of seroconversion, but unfortunately for Lynda she was one of the 0.04 per cent. Fortunately Lynda is still with us, however, in a recent blog she refers to her continued battle against HIV, with symptoms including bacterial infections, chronic obstructive pulmonary disease, memory loss, tremors and visual spatial deficits.

It was stories like Lynda’s that provided the spark for the campaign for safer sharps, a campaign that has been going since the turn of this century. It has involved trade unions such as UNISON and the RCN, and pressure groups such as the Safer Needles Network. The campaign has delivered significant improvements in working practices, including medical back-up, all of which have led to a significant reduction in the number of injuries seroconverting to HIV, Hep B or C. 

According to NHS Supply Chain data, 58 per cent of needlestick devices supplied are now safety devices, however, the current Health and Safety Executive (HSE) sharps inspection campaign has resulted in ten improvement notices in under a year. 

Each year thousands of NHS workers are still subjected to sharps injuries and NHS Employers estimate that this involves around 40,000 individuals per year (UNISON and the RCN believe it is as high as 100,000). Each one has to go through the agony of waiting to find out whether they will be the next Lynda, or worse.

In 2010, after a campaign lasting more than ten years, the European Union finally approved a European Directive that required member states to legislate for safer ways of working, including wherever practicable, avoiding the use of unprotected sharps. In 2013 the UK implemented this directive through the Health and safety (sharps instruments in healthcare) regulations

UNISON, the RCN and European Bio-safety Network have each produced their own guidance, however, the HSWPG guide is the first to be produced in partnership with the agreement of both employers and unions. It is based around a series of case studies of NHS providers who have worked in collaboration with trade unions to implement the regulations. It describes how this has resulted in safer working lives for their staff.

Employers should use this guide to review their risk assessments, policies, and procedures. It explains, step by step, what employers need to do when:

  • identifying the hazards and assessing the risks
  • deciding on and implementing the appropriate preventive measures (including advice on hierarchy of controls)
  • measuring and reviewing performance to ensure risks are being managed and that their preventive plan is effective
  • ensuring all sharps injuries are reported by establishing the right policies and procedures.
Staff must also play their part by reporting all sharps injuries, participating in any training provided and complying with the relevant safety procedures. 

It has been a long journey from the initial campaign, to the European directive and the sharps regulations. By reading and following this step-by-step guide you can help ensure there are no more cases such as Lynda’s.

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