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Table 3 Sharps injury prevention in home healthcare according to Hierarchy of Controls

From: Understanding sharps injuries in home healthcare: The Safe Home Care qualitative methods study to identify pathways for injury prevention

Sharps injury prevention/control method Systems maps location of stakeholders to intervene (see Figures1,2) Intervention examples cited both in the study interviews and literature Study interviews: citation frequency on interventions Literature evidence on interventions
Elimination/ substitution Beginning Eliminate unnecessary injections/unnecessary sharps High (60% or more) [16-22,27,40,41]
- e.g. needleless IV-systems
Apply needleless medication alternatives
- e.g. jet injectors, aerosols via inhalation, mucosal vaccines tablets, transdermal patches
Engineering controls Beginning and middle Design and use sharps with injury prevention features High (60% or more) [11,16,26,27,40,41]
- e.g. existing retracting, sheathing, blunting technologies
- e.g. new sharps innovations
Design and use sharps disposal containers
Administrative controls Middle Promote and educate on safe use of sharps devices High (60% or more) [16,40-42]
Promote and educate on safe sharps disposal container use and community disposal practices
Implement and annually review a BBP exposure control plan
Ensure work practices in line with an exposure control plan
Minimize re-use among home users when possible
Personal protective equipment Middle and end Use gloves/double-glove Moderate (less than 50%) [16,26,40-42]
Use puncture resistant gloves
Apply protective clothing
- Goggles, face shields, masks, gowns
- Other barriers/ filters
  1. Sharps injury prevention methods, stakeholders’ location in the systems maps who can act at each method level, specific intervention examples, citation frequency in study interviews, and examples of literature documentation.