Making our EDs ‘sharps safe’; Understanding staff attitudes and current use of sharp safety devices

Ms Chantelle  Judge1, Dr Amy N.B. Johnston1,2, Dr Michael  Sinnott1,2, Dr Andy Wong1,3, Dr Rob Eley1,2
1Department of Emergency Medicine Princess Alexandra Hospital  , Brisbane Woollongabba, Australia, 2University of Queensland, Brisbane St Lucia, Australia, 3Queensland University of Technology,, Brisbane , Australia

Introduction: Despite the introduction of a range of safety policies and safer sharps equipment, designed to protect healthcare workers, the rates of percutaneous injuries from occupational exposure to sharps and associated risks of exposure to infectious diseases remains relatively constant(1,2). This has social, professional and economic implications(2). This study focused on a single busy emergency department (ED) and examined types and availability of sharps devices and incidences of inappropriate or unintended uses of sharps to help identify reasons why a clinician might choose a non-safety device over a safety device or an unsafe process over a safer process.
Methods: This mixed methods study used both stock availability audit and thematic analysis of interview data to explore factors that might impact on the risks of sharps injury.
Results: Semi-structured interviews with 30 participants;7 medical and 23 nursing staff, coupled with observational examination of available equipment, identified 3 classes of sharps device in operation; conventional devices (not safe), active (manual) safety devices (relatively safe) and passive (automatic) safety devices (very safe). When focusing on the use of these devices in venipuncture and cannulation, data suggested that most staff did not change, or only changed once, the equipment they used despite provision of newer, safer equipment. Staff identified a range of sharps risks, barriers and enablers to use of safety devices, but these did not appear to influence the procedures they used.
Conclusions: Understanding what ‘sharp’ equipment ED staff use, when they use it and the factors that motivate such usage, can inform development of policies to help reduce the risk and incidence of sharps injury. Culture change and ongoing skills development and practice might help to overcome entrenched procedures and increase voluntary engagement with safer sharps devices as well as to use clinical processes that limit risks of sharps injuries.

  1. Australian Council on Healthcare Standards (ACHS). Australasian Clinical Indicator Report: 2009–2016: 18th Edition. Sydney, Australia; ACHS; 2017.
  2. Pruss-Ustun A, Rapiti E, Hutin Y. Sharp’s injuries: Global burden of disease from sharps injuries to health-care workers. Geneva. World Health Organization. 2003

Dr Amy Johnston currently holds a conjoint senior research fellow/senior lecturer position between Metro South Hospital & Health Service, Department of Emergency Medicine (based at Princess Alexandra hospital) and School of Nursing, Midwifery and Social Work. She works across the academic and healthcare environments to conduct her own research as well as supporting clinicians to develop the skills and confidence to participate in, and conduct research projects relevant to their clinical work. Amy is a neurobiologist and nurse with extensive teaching and research experience and a particular interest in Emergency Department service delivery and patient flow. She also has an enduring interest in the scholarship of clinical learning and teaching, particularly focused on the biosciences. She has been contributing to nursing bioscience teaching for more than 25 years (since the inception of nursing degree programs in Australia).