Table 3 Sharps injury prevention in home healthcare according to Hierarchy of Controls
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) | |
- 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) | |
- 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) | |
● 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%) | |
●Use puncture resistant gloves | ||||
● Apply protective clothing | ||||
- Goggles, face shields, masks, gowns | ||||
- Other barriers/ filters |