AORN releases RPs on sharps safety

The Association of perioperative Registered Nurses (AORN) has released a new "Recommended Practices for Sharps Safety," which replaces the "Guidance Statement: Sharps Injury Prevention in the Perioperative Setting" issued in 2005.

Surveillance data indicates that sharps injuries continue to increase in surgical settings, says Mary J. Ogg, MSN, RN, CNOR, perioperative nursing specialist at AORN. Half a million healthcare workers receive these injuries each year, Ogg says.

Sharps injuries have been linked to the occupational transmission of the hepatitis B virus (HBV), hepatitis C virus (HCV), & HIV, Ogg says. And healthcare workers aren't the only ones at risk. There have been 132 cases documented in which healthcare providers transmitted HBV, HCV, or HIV to patients. "Sharps injuries carry a heavy emotional and economic burden," Ogg says. "Recognizing the increased risk to surgical patients and the perioperative team for a bloodborne pathogens exposure from sharps injuries, AORN transitioned the guidance statement to a recommended practice."

The recommended practice is based on the Occupational Safety and Health Administration's (OSHA's) "Bloodborne Pathogen Standard 29CFR 1910.1030 Hierarchy of Controls." It addresses elimination of the hazard, engineering controls, workplace controls, administrative controls, and the wearing of proper personal protective equipment (PPE).

Sections of this RP that have the highest level of evidence, such as Cochrane reviews, randomized controlled trails, and regulatory requirements, and make the most impact in reducing sharps injuries include double gloving, use of blunt tip suture needles, use of the neutral zone, and elimination of sharps objects, Ogg says. Double gloving can reduce the potential for injury by 87%, and blunt tip suture needles can reduce the potential by 54%, she says.

"An important recommendation for the ambulatory surgery setting is establishing a written bloodborne pathogens exposure control plan that is reviewed and updated annually," Ogg says. "The ambulatory surgery center must establish a process for selecting and evaluating sharps safety devices as part of the exposure control plan. The interventions that a surgery center can implement now to improve sharps safety are double gloving and using a neutral or safe zone for passing sharps."


The 2013 edition of "Perioperative Standards and Recommended Practices" is available at in a variety of formats. A PDF of the single chapter "Recommended Practices for Sharps Safety" is available for $70.