Infection Prevention & Control Guideline Sharp Safe Handling and Use

Transcription

1 Infection Prevention & Control Guideline Sharp Safe Handling and Use Reference No: G_IPC_41 Version: 4 Ratified by: Infection Prevention Committee Date ratified: Name of originator/author: Infection Prevention Team Name of approving committee/responsible individual: Date issued: 19 th July 2018 Review date: Target audience: Distributed via: Infection Prevention Committee All staff Website / Intranet Chair: Elaine Baylis QPM Chief Executive: Andrew Morgan

2 Version Lincolnshire Community Health Services Sharp Safe Handling and Use Version Control Sheet Section/Para /Appendix Version/Description of Amendments 1 One New document 2 One Audit tool added Poster added References updated 3 Two Whole document 4 Two Section 3.2, 3.3, Two Section 5.1, 5.4 Change PCT to LCHS/Trust and Infection Prevention and Control Team to Infection Prevention team Add staff responsibility to report incidents Add Medical Devices Committee and Link Champions Add Occ Health report to IC Committee Added Transportation of sharps in vehicles. Changed title of guidelines Dispose of sharps container after three months. Date Jan 2011 June 2014 June 2014 June 2014 Author/ Amended by C Day L Roberts L Roberts L Roberts 9 Two Section 7 Added Monitoring June 2014 L Roberts 10 Two Section 8 (Added DOH 2011) June 2014 L Roberts 11 Two Appendix C Changed EA template June 2014 L Roberts 12 Three Whole document, 3.4, Appendix A 13 Four Whole document Changed Headers and footers, Remove report to IPC committee quarterly, Removed audit tool Changed headers and footers July 2016 May 2018 L Roberts S Fixter 14 Four Section 5.2 Safety needles added June 2018 S Fixter 15 Four Appendix A and B Appendix A clearer version added. Appendix B added 16 Four 3.4 Added health and safety section June 2018 June 2018 S Fixter S Fixter 17 Four 3.2 Added RIDDOR June 18 S Fixter 2

3 Guidance Statement Lincolnshire Community Health Services Sharp safe Handling and Use Background Statement Responsibilities The purpose of this guidance is to implement a coordinated approach for the management of sharps in line with current Department of Health requirements. This guidance is comprehensive, formally approved and ratified, and disseminated through approved channels. It will be implemented for Lincolnshire Community Health Services. Compliance with the guidance will be the responsibility of all Trust clinical staff who use/handle sharps. Training The Health and Safety Team with the assistance of The Infection Prevention Team will deliver any training associated with this guidance. Dissemination Resource implication Website. This guidance has been developed in line with the NHS Litigation Authority guidelines to provide a framework for staff within NHS Organisations to ensure the appropriate production, management and review of organisation-wide policies. 3

4 Infection Prevention & Control Guideline Sharp Safe Handling & Use Table of contents Guidance Statement Statement Scope of this guideline Responsibilities Managers Employees Health and safety The Infection Prevention Team Occupational Health Definition Key practice points Risk Assess Before use During use After use Insulin pens and sharps disposal (includes syringes, needles, lancets) of patients performing their own care Monitoring Evidence base Appendix A: Sharps Waste Assembly Poster Appendix B: Sharps Waste Disposal Poster Appendix: Equality Analysis

5 Lincolnshire Community Health Services Sharp safe Handling and Use 1. Statement The safe handling and disposal of needles and other sharp instruments forms part of an overall strategy of clinical waste disposal to protect staff, patients and the public from exposure to blood borne pathogens. The management and assessment of the risk associated with the use of sharps is paramount and safe systems of work and engineering controls must be in place to minimize identified risks in accordance with the Control of Substances Hazardous to Health (COSHH) Regulations. Lincolnshire Community Health Services (LCHS) is committed to the protection of staff and patients resulting from the transmission of blood borne viruses (BBV) and to the prevention and reduction of accidents associated with sharp handling and use. 2. Scope of this guideline This guidance is for all staff working within Lincolnshire Community Health Services. It is inclusive for visitors to LCHS premises to include student, locum and bank staff, contractors and volunteers. 3. Responsibilities 3.1 Managers Managers have the responsibility for the standards of clinical practice by their staff in the health care setting. They must: Ensure that safer sharps are available for staff to use and that the use of non-safer sharps is minimized Ensure all individuals are appropriately trained. Inform new employees of their responsibilities under this guidance. Ensure that all employees within their area of responsibility comply with this guidance. Ensure that risk assessments are carried out in relation to this guideline together with any audit required by the organisation 3.2 Employees All employees have a responsibility to abide by this guidance and any decisions arising from the implementation of them. Any decision to vary from this guidance must be fully documented with the associated rationale stated. All employees have a responsibility to report sharps related injuries and complete a Datix report and RIDDOR Health and safety The Health & Safety (Sharp Instruments in Healthcare) Regulations 2013 dictates that employers must ensure that risks are assessed and that appropriate control measures to reduce harm are established in place. This will include supervised practice and training of staff in the safe use of sharp devices. The training and management should include the management/follow up of associated injuries, the disposal of sharps in line with the Waste Regulations, the avoidance of unnecessary use of sharps, prevention of re-capping after use, the use of safer sharps where it is reasonably practicable to do so and the monitoring of compliance. 5

6 The Trust reports needlestick injuries via the Health & Safety Committee 3.4 The Infection Prevention Team The Infection Prevention Team will: Advise managers and staff concerning the use of sharps in conjunction with Medical Devices and Health and Safety Committees Review the guidance in response to the publication of any urgent communications from the Department of Health and at least on a three yearly basis. Assist Managers/Link Champions with the audit of compliance with the guidance as required by the organisation. 3.5 Occupational Health Occupational health departments have a responsibility to: Investigate/support any staff experiencing adverse incident associated with sharps use. 4. Definition A sharps injury or needle-stick injury has been defined as an injury where a used needle or other sharp contaminated with blood or other high-risk body fluid penetrates the skin. In general clinical settings, sharps injuries are predominantly caused by needle devices and are associated with venepuncture, recapping (re-sheathing) of needles and disassembling of equipment. Sharps include needles, sharp-edged or pointed surgical instruments, broken glassware or any sharp item that may have been contaminated in use by blood or body fluids and which may cause laceration or puncture wounds. Sharp tissues such as bone or teeth may also pose risk of injury. Other examples include: Disposable needle & syringe Pre-filled cartridge syringe Needle attached to IV line Winged steel needle (butterfly needle) IV Cannula Suture needles Razors Scissors Medication ampoule Capillary tubes 5. Key practice points 5.1 Risk Assess Identify devices with potential to cause injury Handle devices safely Avoid passing sharp instruments by hand 6

7 Only one person at a time should have contact with sharps Use a neutral area to reduce risk when passing instruments Do not leave sharps exposed in the workplace Use instruments not fingers to retract and remove sharps Aim sharps away from own or assistants hands Use instruments to tie sutures, not fingers Do not disassemble, bend, clip or re-sheath devices Dispose of devices at point of use in an approved sharps container Know what action to take if an accidental injury occurs. Transportation of sharps in vehicles of staff ALL HEALTHCARE WORKERS NEED TO KNOW WHAT ACTION TO TAKE FOLLOWING AN ACCIDENTAL INOCULATION INJURY Refer to guideline on intranet G_IPC _18 Prevention and management of Inoculation Exposure Injury 5.2 Before use Ensure sharps receptacles conform to the BS 7320:1990 specification. Ensure the sharps receptacles are correctly assembled and that the manufacturer s instructions are followed i.e. the label must be clearly and legibly completed to include the name of the person who has assembled the unit, the location where the unit is used and the date of assembly, (Appendix A) Provide sharps receptacles at all locations where sharps are to be used, ensuring that they are secure and in a safe position out of reach of vulnerable people i.e. children and confused patients who may not appreciate the risks associated with this type of waste. Use the correct sized waste receptacle. Large objects should not be pushed into small containers. Safer devices must be used where available (for example use of safety needles/safety syringes with retractable needles). 5.3 During use All health care providers must be competent in procedures when using sharps. Wear appropriate personal protective equipment (refer to the Use of Gloves Guidance). Ensure that the sharps receptacle is located in a safe position where it cannot be knocked over or interfered with by unauthorized individuals. Never move an open sharps container. The flap opening (partial closure mechanism) on the sharps container lid MUST be closed between uses. Always carry the sharps container by the handle and away from the body. Do not disassemble devices. Needles and syringes should be disposed of as a single unit. Used needles must never be re-sheathed, bent, cut or broken. Sharps must not be passed from hand to hand. 7

8 Sharps must be disposed into the appropriate coloured receptacle i.e. purple top for cytotoxic/cytotoxic wastes, orange for infectious wastes etc (see segregation chart at appendix B). 5.4 After use Sharps containers must not be filled above the fill line (i.e. 2/3 full). If transporting the sharps container in a motor vehicle, it must be closed and placed into a Daniels transport box within the motor vehicle s boot. Risk assessment of how long the sharps bin has been in use MUST be carried out and depending on contents disposed of within 3 months, which is recommended practice. Securely lock the container when full. Your name and date of disposal should be clearly written on the outside of the receptacle. Ensure that sealed receptacles awaiting collection are housed in a locked area which is inaccessible to unauthorised persons. Sharps must be disposed by incineration only. Sharps and/or their receptacles must never be placed inside waste sacks. Any damaged receptacles must be placed inside a larger sharps receptacle and sealed. It is the responsibility of the user to ensure that used sharps are disposed of in a safe manner. Used needles and syringes must not be disposed of in domestic waste. Healthcare staff are responsible for the safe disposal of their own sharps. 6. Insulin pens and sharps disposal (includes syringes, needles, lancets) of patients performing their own care Any insulin pen and removal of the needle must be solely undertaken by the user i.e. the patient An assessment must be undertaken to ensure that the patient is capable of continuing to use such devices e.g. that sight, dexterity, understanding, willingness and compliance are all satisfactory. If they are assessed as being unsafe an alternative method of insulin administration should be undertaken and advice sought. Under no circumstances must a health care provider assist the patient by either clipping or unscrewing the needle casing from the insulin pen as there is a potential for a needle stick/sharps injury to occur. Patients involved in their own care must be advised on the safe handling and disposal of sharps by their health care practitioner. NB In exceptional circumstances, where no other alternative course of action is available, staff may remove the needle as long as the used needle is that of a safety needle design). 7. Monitoring Minimum requirement to be monitored Process for monitoring e.g. audit Responsible individuals/group /committee Frequency of monitoring /audit Responsible individuals / group / committee (multidisciplinary) for review of results Responsible individuals / group / committee for development of action plan Responsible individuals / group / committee for monitoring of action plan 8

9 Monitor Audit Guidelines for Sharp Safe Handling and Use Manager/ Infection Prevention Team/ Link Champions As part of RIT audits I C committee IC Committee I C Committee 9

10 8. Evidence base Department of Health 2010: The Health & Social Care Act 2008 Code of Practice on the prevention and control of infections and related guidance Department of Health (2006) HTM Safe Management of healthcare waste. Department of Health, London. Department of Health (2011) Safe management of healthcare waste. Version:2.0: England Infection Control Nurses Association (2003) Reducing Sharps Injury, Prevention and Risk Management ICNA, Bathgate, UK. Medical Devices Agency (2004) Reducing needle stick and sharps injuries Department of Health, London. Medical Devices Agency (2001) MDA SN 2001 (19) Safe use and disposal of sharps. Department of Health, London. National Health Service Estates (2003) Diabetic Care Sharps Disposal National Institute for Clinical Excellence (2003) Clinical Guideline 2 Infection Control: Prevention of Health Care Associated Infection in Primary and Community Care Section 2 Standard principles pp NICE, London. Statutory Instrument 1994 No.3246 The Control of Substances Hazardous to Health Regulations HMSO. London. 10

11 Appendix A: Sharps Waste Assembly Poster Sharps waste Assembly 11

12 Appendix B: Sharps Waste Disposal Poster Sharps waste Disposal 12

13 Appendix: Equality Analysis Name of Policy/Procedure/Function* Sharp Safety Handling Equality Analysis Carried out by: Sarah Fixter Date: 15/05/2018 Equality & Human rights Lead : Rachael Higgins Date: Director\General Manager: Lisa Stalley Green Date:15/05/2018 *In this template the term policy\service is used as shorthand for what needs to be analysed. Policy\Service needs to be understood broadly to embrace the full range of policies, practices, activities and decisions: essentially everything we do, whether it is formally written down or whether it is informal custom and practice. This includes existing policies and any new policies under development. A. Briefly give an outline of the key objectives of the policy; what it s intended outcome is and who the intended beneficiaries are expected to be B. Does the policy have an impact on patients, carers or staff, or the wider community that we have links with? Please give details C. Is there is any evidence that the policy\service relates to an area with known inequalities? Please give details D. Will/Does the implementation of the policy\service result in different impacts for protected characteristics? The purpose of this document is to provide guidance to staff regarding the safe handling and use of sharps. All staff in LCHS no Disability Sexual Orientation Sex Gender Reassignment Yes No 13

14 Race Marriage/Civil Partnership Maternity/Pregnancy Age Religion or Belief Carers If you have answered Yes to any of the questions then you are required to carry out a full Equality Analysis which should be approved by the Equality and Human Rights Lead please go to section 2 The above named policy has been considered and does not require a full equality analysis Equality Analysis Carried out by: S Fixter Date: 15/05/