Safe Working Practices ● scissors
- strategies designed as a guide on ● metal wire
how to perform a task with minimum ● retractors
risk to people, equipment, ● clamps
environment and process ● pins
- may be in the form: ● staples
● cutters
● written rules and proper operating ● glass items
procedures
● administrative guidelines to inform In dentistry, these sharps include:
the workers of proper conduct in
work ● anesthetic needles
● trainings ● suture needles
● engineering controls that provides ● burs
protection to the equipment as well ● scalpels
to the user ● endodontic files
● visual alerts or graphic presentation ● orthodontic wire and bands
of safety practices ● broken instruments
● metal matrix bands
- in infection control, safe working ● broken anesthetic cartridges
practices are implemented to reduce
the risk of exposing health workers There are 4 risk periods where sharps injury
and patient alike to microbes can happen:
acquired by contact with blood, body ● During preparation
fluids, non-intact skin and mucous - the moment where the sharps are
membrane first exposed
- it is a part of standard precaution ● While in use
- these practices are designed to both ● During the clean up
protect DHCP and prevent DHCP ● During disposals or after using the
from spreading infections among sharps
patients
Studies show that the incidence of sharp or
Sharps Safety needlestick injuries occur most during use,
Sharps and Needlestick Injury after use and before disposal.
Sharps
- medical term for devices with sharp
points or edges that can puncture or
cut skin
- includes:
● needles
● scalpels
● lancets
● razor blade
Incidental punctures by contaminated Administrative Controls (Work Practices)
needles exposes the health worker to - Needles
number of possible infectious diseases ● Do not uncover or unwrap the sharp
especially blood-borne viruses such as: object until it is time to use it
● Always be aware of where the sharp
● Hepatitis B object is
● Hepatitis C ● Ensure the needle is pointed away
● HIV (Human Immunodeficiency from the user, and maintain visual
Virus) which leads to AIDS contact with the sharp at all times
(Acquired Immune Deficiency ● When working with sharps, avoid
Syndrome) placing your hand or part of your
body in the "line-of-fire."
Hierarchy of Control for Sharps Injury ● Never hand a sharp object to
someone else or put it on a tray for
another person to pick up
● Tell the people you are working with
when you plan to set the object
down or pick it up
● Do not walk around the room with an
uncapped needle
● Do not break or shear the needle
shaft from the hub
- this may aerosolize the material
● Do not bend the needle
Elimination and Substitution ● Do not remove the needle from the
- most effective in reducing hazards disposable syringe
however, the most difficult to ● Do not re-cap a needle
implement ● If you absolutely must re-cap a
needle, do not hold the cap while
Engineering Control attempting to reinsert the needle
- use of device that is designed to ● Use the one-handed "scoop"
eliminate or reduce the risk of technique
needlestick injuries and other
percutaneous injuries reduce the Administrative Controls (Work Practices)
exposure to blood-borne pathogens - Blades and Scalpels
brought by sharps injury ● Use disposable safety scalpels with
a fixed blade when possible so that
the need to remove and replace the
blade is eliminated
● Do not use blades without a handle
- the handle serves as a barrier
between your hand and the sharp
● If working with a blade or razor,
always cut away from yourself
- use forceps or a tool to hold the 4. Medication containers (single and
specimen multidose vials, ampules, and bags)
● Do not manipulate the blade on a are entered with a new needle and
scalpel with your hands new syringe, even when obtaining
- only perform this task if you have additional doses for the same patient
received training on how to do it 5. Use single-dose vials for parenteral
safely medications when possible
6. Do not use single-dose (single-use)
Administrative Controls (Work Practices) medication vials, ampules, and bags
- Safe Disposal of Sharps or bottles of intravenous solution for
● Never throw treated or untreated more than one patient
sharps containers or sharps directly 7. Do not combine the leftover contents
into garbage cans or dumpsters of single-use vials for later use
● Sharps can puncture regular waste 8. The following apply if multidose vials
bags and endanger waste handlers are used:
- if a needle is sticking out of the
container, do not push it in with your a) dedicate multidose vials to a single
hands patient whenever possible
● Dispose of needles and syringes in b) if multidose vials will be used for
puncture-resistant (hard-walled) more than one patient, they should
containers be restricted to a centralized
- for medical waste sharps, the sharps medication area and should not
waste container needs to have the enter the immediate patient
biohazard symbol and the word treatment area (e.g., dental
"Biohazard, “ there is no requirement operatory) to prevent inadvertent
for the sharps container to be red contamination
- for non-medical waste sharps (i.e. c) if a multidose vial enters the
no human pathogenic potential), the immediate patient treatment area, it
container should not have the should be dedicated for
biohazard symbol or the word single-patient use and discarded
"Biohazard." immediately after use
d) date multidose vials when first
Safe Injection Practices opened and discard within 28 days,
1. Prepare injections using aseptic unless the manufacturer specifies a
technique in a clean area shorter or longer date for that
2. Disinfect the rubber septum on a opened vial
medication vial with alcohol before e) do not use fluid infusion or
piercing administration sets (e.g., IV bags,
3. Do not use needles or syringes* for tubings, connections) for more than
more than one patient one patient
- this includes manufactured prefilled
syringes and other devices such as
insulin pens
Management of Sharps Injury