Sharps injuries: Defining prevention priorities

Objective: An institutional review of sharps injuries was conducted to assi st in establishing priorities for resource allocation in a sharps preventio n program. Design: A retrospective review of 221 sharps injuries occurring during a 1- year period was conducted by a 4-member multidisciplinary team. Each injury was categorized as either moderate/high, low, or unknown risk for acquisit ion of bloodborne diseases by using modified provincial definitions of occu pational risk for exposure to bloodborne pathogens. Results: A total of 119 injuries were considered to be moderate/high risk, and 93 were at low risk for acquisition of bloodborne disease. Nine injurie s could not be categorized. In 59% of high-risk injuries, education or chan ges in technique were identified as the primary preventive intervention. Pa ssive devices such as needleless intravenous administration sets could theo retically address prevention of the majority of low-risk injuries. Known av ailable safety devices could have prevented 33 (28%) high-risk injuries. Conclusion: Disposition of resources must take into consideration the risk of bloodborne disease acquisition and the efficiency and expense of the pre ventable methods employed. Institutional review of injuries combined with a cost analysis revealed that resources were best allocated to protective de vices at source (eg, safety syringes) and on a comprehensive, multidiscipli nary, and sustained educational program. Needleless intravenous infusion se ts would mainly prevent low-risk injuries at significant cost.