Sharps safety; putting baby blankets in trays

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Q I am the nurse manager for surgical support services at a small rural hospital where we recently formed an occupational safety committee. We are developing a policy and procedure manual and I volunteered to write the section on the safe handling and disposal of contaminated sharps, needles and related objects. Are there any specific standards or guidelines that address this issue? Could you suggest any key topics that should be included in the manual?

A Occupational Safety Health Administration (OSHA) is a federal agency which issues and governs regulations relative to worker safety. OSHA does have strict regulations which include those relative to the proper handling of sharps such as needles and other devices used in a clinical environment. The Environmental Protection Agency (EPA) is another federal agency which is focused on environmental safety and preservation. There are EPA regulations that health care institutions must follow relative to the disposal of bio hazardous materials, including medical waste (e.g., disposable medical devices, supplies and the like contaminated with blood, body fluids or other organic matter). Contaminated, used needles and other sharp objects are considered bio-hazardous. OSHA and EPA regulations are governed by law and must be enforced and implemented. Violations are subject to severe penalties including fines, suspension of services and possible closures. All sharps need to be disposed of in an OSHA approved containment device clearly identifiable (labeled or color coded) as a contaminated sharps disposal container. Sharps containers can be made from a variety of materials including cardboard or plastic. (See Figure 1.) To be acceptable by OSHA, the container must be closable, puncture-resistant, and leak proof on all sides and the bottom. Sharps containers must be easily accessible to employees and located as close as feasible to the immediate area where sharps are used, such as patient care areas, surgical suite and support areas such as central sterile processing, laundry and the like. OSHA mandates that each sharps container must either be labeled with the universal biohazard symbol and the word “biohazard” (see Figure 2) or be color-coded red. Sharps containers shall be maintained upright throughout use, replaced routinely, and not be allowed to overfill. When removing sharps containers from the area of use, the containers shall be:

• Closed immediately prior to removal or replacement to prevent spillage or protrusion of contents during handling, storage, transport, and/or shipping
• Placed in a secondary container if leakage is possible. The secondary container must also be closable and constructed to contain all contents to prevent leakage during handling, storage, transport, and shipment. Secondary containers must also be labeled and or color-coded as previously noted.
• Upon closure, duct tape may be used to secure the lid of a sharps container. A solid lid must be used; the tape cannot serve as the lid itself.