Sharps containers reduce injuries

Clinical bottom line

A relatively simple scheme to improve sharps disposal resulted in fewer injuries, and with lower overall costs.

Reference

IB Hatcher. Reducing sharps injuries among health care workers. A sharps container quality improvement project. Joint Commission Journal of Quality Improvement 2002 28: 410-414.

Study

This was a study that used the plan-do-study-act (PDSA) approach to reducing sharps injuries by introducing improved sharps containers at a hospital in Tennessee.

The planning stage involved available sharps containers, choosing one on various grounds, presenting it to management, trialling in key area, and then adjusted decisions based on experience and information.
The doing stage involved implementation of the chosen "letter-box" containers throughout the centre, with problem solving to ensure swift and effective change.
The study stage involved evaluation, including complaints or suggestions from staff using a special telephone number. This highlighted a number of problems.
These were acted upon with the container manufacturer to redesign the boxes to eliminate the problems.

This was followed by a second cycle to measure injury rates and staff satisfaction.

Results

In the period before the introduction of the new disposal system the injury rate from disposal of needles was 24 a year. In the period after their introduction it was 14 a year, despite an increase of over 10% in the workforce.

The increased acquisition cost of the new boxes was $10,000 a year. Estimated savings from reduced testing and prophylaxis against hepatitis and HIV infection was $72,000 a year, making a saving of $62,000 a year. Cost of employee days lost from work were not included in the cost calculation.

Comment

This was a relatively simple scheme, but one that was rather well done. there were several times where this scheme might have stalled, but each time sensible action overcame difficulties. better safety came with reduced overall costs.