Needlestick and sharps injuries remain one of the most common occupational hazards in healthcare. Despite being largely preventable, they carry a real risk of exposure to bloodborne pathogens including Hepatitis B, Hepatitis C, and HIV, and the consequences for a healthcare professional can be significant, both clinically and emotionally.
For clinical settings of all sizes, having clear safe sharps practices in place both good clinical governance and regulatory requirement. The Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 place a legal duty on employers to prevent sharps injuries where reasonably practicable, including through the use of safer sharps devices where available.
This article outlines the key areas that contribute to needlestick injury prevention, from handling technique and safety-engineered devices, to correct sharps disposal and what to do if an injury does occur.
Safe Handling Technique
Many needlestick injuries commonly occur in the moments immediately after a procedure itself. Recapping a used needle, passing a sharp between colleagues, or reaching into a cluttered tray are among the most common causes. Good technique and disciplined habits at the point of use significantly reduce these risks.
Key safe handling principles include:
- Never recap a used needle using two hands. If recapping is absolutely necessary, a one-handed scoop technique should be used.
- Dispose of sharps immediately after use, directly into an appropriate sharps bin at the point of care.
- Never pass sharps directly between hands. Use a tray or neutral zone where the sharp is placed and then retrieved.
- Never leave sharps unattended on work surfaces or in clinical trays.
- Ensure sharps bins are within easy reach before beginning any procedure.
- Do not overfill sharps containers. They should be closed and replaced when the fill line is reached, not when they are completely full.
These behaviours should be embedded as standard practice across all clinical staff, including those who handle sharps less frequently. Familiarity and routine are among the most effective preventative measures available.
Safety-Engineered Medical Devices
Beyond technique, the equipment itself can play a significant role in reducing injury risk. Some medical devices are engineered with safety features designed to protect the clinician immediately after a sharp is used, addressing the window when the majority of needlestick injuries occur. Here are a few examples:
Shielded Safety Needles
A variety of needles are available with an integrated safety shield that can be activated with one hand immediately after the needle is withdrawn from the vein. The shield permanently locks into place over the needle tip without the need for a hard surface to activate it.
Examples of these are BD Vacutainer Eclipse and Eclipse Signal needles, featuring a bevel-up orientation toward the shield which means there is no requirement to reposition the needle during activation, keeping the mechanism engagement practical and consistent.
Because the shield deploys at the point of withdrawal rather than requiring a separate step, it addresses the high-risk period immediately after venepuncture where a significant proportion of needlestick injuries occur.
Safety Blood Collection Sets
Winged needles designed for venepuncture such as the BD Vacutainer Safety-Lok Blood Collection Sets feature a forward-shielding safety mechanism with a translucent yellow shield that is pushed over the needle immediately after blood collection using a one-handed action.
VACUETTE Safety Blood Collection Sets are another example offering a different safety mechanism which is activated by pushing buttons on the hub whilst extracting the needle from the vein, retracting the needle tip into the hub itself.
Both of these sets allow one handed operation and generate an audible click. The shields lock securely into place once deployed, reducing the potential of injury after use.
Safety IV Catheters
For clinical settings where IV cannulation is performed, peripheral safety catheters such as the Braun Introcan Safety 3 feature a fully automatic passive safety mechanism. Unlike active safety devices that require deliberate user activation, the Introcan Safety 3 deploys its needle shield automatically as the needle is withdrawn from the catheter hub, with no manual step required.
This passive design removes the risk of forgetting to activate the safety feature, which is a meaningful advantage in fast-paced clinical environments.
Scalpel Blade Removal Devices
Scalpel blades present a particular injury risk when being removed from reusable handles, as the combination of a sharp edge and the force required to detach the blade creates an obvious hazard. Removing a blade by hand, even with a clip or instrument, carries a meaningful risk of laceration.
Blade remover devices address this by providing a fixed mechanism that safely disengages the blade from the handle and contains it immediately within a puncture-resistant compartment. These can be obtained as units for single blades or as blade remover units which act as a bin holding many blades at a time. Once full, the entire unit is disposed of as sharps waste.
For clinical settings that use scalpels regularly, particularly in minor procedures, podiatry, or dermatology, a dedicated blade remover at the point of use is a straightforward and practical safety measure.
Correct Sharps Disposal
The correct sharps bin must be available at the point of use to prevent clinicians needing to carry an uncapped or unshielded sharp more than a step or two before it is contained.
Choosing the appropriate sharps container depends on the type of waste being generated. For routine phlebotomy and blood collection with no medicinal contamination, an orange sharps bin is the correct choice. Alternatively, yellow-lidded bins are used where sharps have been contaminated with medicinal products and purple sharps bins are reserved for cytotoxic and cytostatic waste.
We have covered sharps bin colour coding in more detail in our article on sharps disposal in clinical settings, which is worth reading alongside this guide for a full explanation of each waste stream.
Containers should be assembled and dated when first used, checked regularly against their fill line, and never overfilled. An overfull bin is a preventable source of injury, particularly when needles can spring back as additional items are added.
What To Do After a Needlestick Injury
Even with the best practices in place, injuries can still occur. Having a clear, practiced response is as important as prevention itself. The immediate steps following a needlestick or sharps injury are well established across NHS guidelines and should be known by every member of clinical staff.
Immediate first aid steps:
- Encourage the wound to bleed gently by squeezing around the site, ideally under running water. Do not suck the wound
- Wash thoroughly with soap and running water. Do not scrub the area or use antiseptics.
- Cover with a waterproof dressing once cleaned.
- If the mouth or eyes are involved, rinse with clean water or sterile saline for at least one to two minutes. Do not swallow rinse water.
Following first aid, the incident should be reported promptly to a manager or senior clinician, then proceeding as per clinic protocol. All sharps injuries should be formally recorded, both in the individual's records and through the practice's incident reporting process. This is important not only for the individual but for identifying patterns and improving safety across the wider team.
Supporting Safer Sharps Practice
Preventing needlestick injuries requires a combination of disciplined technique, appropriate equipment, and clear protocols. No single measure is sufficient on its own, but together they significantly reduce the risk for everyone working in a clinical environment.
At Medix Group, we supply a range of products that support safer sharps practice, including BD Vacutainer Eclipse and Eclipse Signal Needles, BD Vacutainer Safety-Lok Blood Collection Sets, Braun Introcan Safety 3 IV Catheters, and sharps bins in a variety of sizes and lid configurations.
Contact the Medix Group team to discuss your requirements and set up an account for your clinic.
