title: Sharps injury reduction using a sharps container with enhanced engineering: a 28 hospital nonrandomized intervention and cohort study.
abstract: BACKGROUND
  The decrease in reported sharps injuries (SI) in the United States has markedly slowed. Additional devices and strategies need investigation. Sharps containers are associated with SI, and more than 90% of these injuries are related to container design. This study addresses the hypothesis that containers with enhanced engineering can reduce SI.
  
  
  METHODS
  In a before/after intervention study from 2006 to 2008, we examined the impact of conversion to a sharps container with enhanced engineering (the Device) on SI categories in 14 Ascension Health hospitals (study group). The Device's safety features included large horizontal aperture, sensitive counterbalanced door, large atrium, and passive overfill prevention. Study group results were also compared with a control cohort of 14 contemporaneous size-matched, Ascension Health hospitals (control group).
  
  
  RESULTS
  The Device was associated with significant reductions in after-procedure (-30%), disposal-related (-57%), and container-associated (-81%) SI in the study group. No significant reductions occurred in container-associated sharps injuries in the control group. Hospitals using the Device had significantly fewer total SI than control hospitals.
  
  
  CONCLUSIONS
  Enhanced aperture design can significantly reduce container-associated sharps injuries. Other factors contributing to reduced injuries may include 1-hand deposit, safe closure, hand restriction, and preassembly. These results, from a country where sharps safety devices are widespread, are particularly applicable to countries where safety devices are not extensively used.
authors.affiliation: Grimmond and Associates, 3 Tarbett Road, Hillcrest, Hamilton, New Zealand. tg@gandassoc.com
authors.forename: Terry
authors.initials: T
authors.lastname: Grimmond
authors.forename: Suzann
authors.initials: S
authors.lastname: Bylund
authors.forename: Candace
authors.initials: C
authors.lastname: Anglea
authors.forename: Lou
authors.initials: L
authors.lastname: Beeke
authors.forename: Angela
authors.initials: A
authors.lastname: Callahan
authors.forename: Erik
authors.initials: E
authors.lastname: Christiansen
authors.forename: Kelly
authors.initials: K
authors.lastname: Flewelling
authors.forename: Kathleen
authors.initials: K
authors.lastname: McIntosh
authors.forename: Kay
authors.initials: K
authors.lastname: Richter
authors.forename: Monica
authors.initials: M
authors.lastname: Vitale
mesh_terms: D000062:Accidents, Occupational / Q000517:prevention & control* / Q000706:statistics & numerical data; D020811:Biomedical Technology; D015331:Cohort Studies; D004867:Equipment Design; D006761:Hospitals; D017744:Medical Waste Disposal / Q000379:methods*; D016602:Needlestick Injuries / Q000517:prevention & control*; D014481:United States
chemical_list: D017744:Medical Waste Disposal