---
title: Sharps Injury Prevention Protocol
description: A comprehensive clinical reference on the prevention, management, and reporting of sharps injuries in healthcare settings.
keywords: [sharps injury, needlestick, exposure, bloodborne pathogens, occupational safety]
category: clinical
---

## Introduction

Sharps injuries, including needlesticks and other percutaneous exposures to blood and body fluids, pose a significant risk to healthcare workers (HCWs). These injuries can lead to the transmission of serious bloodborne pathogens, such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Implementing a comprehensive sharps injury prevention protocol is essential to protect HCWs and ensure compliance with occupational safety regulations.

## Risk Assessment and Exposure Prevention

### Identifying High-Risk Procedures
Certain medical procedures carry a higher risk of sharps injuries, including:
- Phlebotomy and intravenous (IV) line placement
- Intramuscular (IM) and subcutaneous (SC) injections
- Suturing and other surgical procedures
- Drawing blood samples
- Handling and disposing of sharps

HCWs should be trained to recognize these high-risk situations and take appropriate precautions.

### Use of Safety-Engineered Sharps Devices
The use of safety-engineered sharps devices, such as needles with retractable or shielded tips, is recommended to reduce the risk of sharps injuries. These devices should be used whenever feasible, and HCWs should be trained on their proper use and disposal.

### Personal Protective Equipment (PPE)
Appropriate PPE, including gloves, gowns, and eye protection, should be worn during any procedure with a risk of sharps exposure. HCWs should be trained on the proper donning and doffing of PPE to minimize the risk of contamination.

## Exposure Management and Reporting

### Initial Response
In the event of a sharps injury or other potential exposure, the HCW should immediately:
1. Wash the affected area with soap and water or flush with clean water if the exposure involves the eyes, nose, or mouth.
2. Report the incident to the appropriate supervisor or designated person responsible for exposure management.

### Exposure Assessment and Testing
The HCW's exposure should be assessed to determine the risk of bloodborne pathogen transmission. This assessment should consider the type of exposure, the source patient's infection status, and the HCW's vaccination and immune status.

Baseline testing for HBV, HCV, and HIV should be performed on the HCW, and the source patient should be tested if their status is unknown. If the source patient is known to be positive for any of these pathogens, the HCW should be tested and receive appropriate post-exposure prophylaxis (PEP) as per current guidelines.

### Reporting and Documentation
All sharps injuries and potential exposures must be reported and documented in accordance with institutional policies and local/national regulations. This documentation is essential for tracking and analyzing exposure incidents, as well as ensuring appropriate follow-up and reporting to relevant authorities.

## Post-Exposure Prophylaxis and Follow-up

### Hepatitis B Prophylaxis
For HCWs who are not immune to hepatitis B, the administration of hepatitis B immune globulin (HBIG) and/or hepatitis B vaccine is recommended based on the source patient's infection status and the HCW's vaccination history. The HBIG dose is 0.06 mL/kg, and the hepatitis B vaccine should be administered according to the recommended schedule.

### Hepatitis C Prophylaxis
Currently, there is no approved PEP for HCV exposure. However, the HCW should be monitored for the development of HCV infection, and early treatment should be initiated if the HCW becomes infected.

### HIV Prophylaxis
For high-risk HIV exposures, the HCW should be offered a 28-day course of antiretroviral PEP, as per current guidelines. The specific regimen should be determined based on the type of exposure and the source patient's viral load and resistance profile.

### Follow-up and Monitoring
The HCW should undergo follow-up testing and monitoring for the development of bloodborne infections at appropriate intervals, as recommended by current guidelines. This may include:
- HBV: Testing at 6 months
- HCV: Testing at 4-6 weeks and 4-6 months
- HIV: Testing at 6 weeks, 3 months, and 6 months

## Sharps Injury Prevention Program

### Comprehensive Approach
A successful sharps injury prevention program should incorporate the following elements:
1. Sharps injury risk assessment and exposure prevention strategies
2. Effective sharps disposal procedures and container placement
3. HCW education and training on safe sharps handling and disposal
4. Incident reporting, investigation, and data analysis
5. Continuous quality improvement and program evaluation

### Institutional Policies and Procedures
Institutions should develop and implement comprehensive policies and procedures for sharps injury prevention, exposure management, and post-exposure follow-up. These policies should be aligned with relevant occupational safety regulations and clinical guidelines, such as those from the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA).

### Continuous Improvement and Evaluation
The sharps injury prevention program should be regularly evaluated and updated to address emerging risks, incorporate new technologies and best practices, and ensure ongoing compliance with regulatory requirements. Incident data should be analyzed to identify trends and implement targeted interventions to reduce the risk of sharps injuries.

## Conclusion

Sharps injuries pose a significant threat to the health and safety of HCWs. Implementing a comprehensive sharps injury prevention protocol, which includes risk assessment, exposure prevention, incident management, and continuous program evaluation, is essential to protect HCWs and ensure compliance with occupational safety regulations. By prioritizing sharps injury prevention, healthcare institutions can create a safer work environment and minimize the risk of bloodborne pathogen transmission.