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For 26 years I was a staff nurse and loved my practice. But one day at work in the summer of 1998, I was stuck by a needle protruding from a sharps container. I didn’t know it then, but my life was changed forever that day. A few months later I learned that the fatigue, weight loss, and other symptoms were due to Hepatitis C and HIV, that I had contracted from that needlestick. In the beginning, I didn’t know if I’d survive or what my life would be like. One thing I was sure of is that this injury was preventable – and I didn’t want to see this happen to anyone else.

The law as it stands

Currently, the primary legislation covering sharps safety is the 1999-2000 Needlestick Safety and Prevention Act. This landmark legislation updated the Office of Safety And Health Administration (OSHA) guidelines, compelling employers to use work practice controls and safer needle devices that are engineered to eliminate or minimize exposure to bloodborne pathogens resulting from needlestick injuries.

As a result of the act, employers must:

  • Demonstrate that they are reviewing new technology that can reduce risk of exposure to bloodborne pathogens by updating exposure control plans and documenting the decision-making process on implementing such technology.
  • Maintain a sharps injury log to track the type and brand of device used, the department or area where the incident occurred, and an explanation of the incident. The log must be maintained in a manner to protect the confidentiality of the injured employee.
  • Solicit input from employees responsible for direct patient care in the identification, evaluation, and selection of effective safety devices and work practice controls, as part of the ongoing exposure control plan development process. Efforts to encourage staff input must be documented in the plan.


Read the full text of the Needlestick Safety and Prevention Act

Moving things forward

While the changes made by the Needlestick Act, particularly the emphasis placed on employers to ensure a safe working environment for nurses, were a positive first step, we believe that there is still much work to do. To that end, in 2012 ANA joined 18 other nursing and health care organizations to back a new position statement aimed at moving the debate about sharps safety forward and prompt further, tighter legislation.

The intention was to create a new framework behind which health care employers and workers, professional organizations, federal agencies, manufacturers, and educational institutions could unite and work together to produce solutions that keep both patients and practitioners safe.

Created by the International Healthcare Worker Safety Center at the University of Virginia, the paper – “Moving the Sharps Safety Agenda Forward in the United States: Consensus Statement and Call to Action” – provides recommendations in five key areas:

Improving sharps safety in surgical settings

  • Health care workers in surgical settings should collaborate to develop and implement sharps safety standards and practices.
  • Site-specific sharps safety policies should be adopted for every operating room.
  • Professional groups and manufacturers should encourage the use of blunt suture needles where appropriate.
  • Increase Bloodborne Pathogens Standard compliance in surgical settings.

Understanding and reducing exposure risks in non-hospital settings

  • Increase the OSHA focus on enforcement of the Bloodborne Pathogens Standard in non-hospital settings.
  • Support epidemiological research that evaluates risks to workers.
  • Ensure sharps safety is a priority and appropriate devices and educational and training materials are available.

Involving frontline health care workers in the selection of safety devices

  • Professional organizations educate their members about the Needlestick Act's provisions.
  • Employers consistently involve frontline workers in the selection of devices, as required by regulation.
  • Conduct research to assess whether and to what extent health care workers are being included in the device selection process.

Addressing gaps in safety devices: the need for continued innovation

  • Assess and prioritize device needs for specific clinical applications, monitor progress in closing existing gaps, and identify future needs.
  • Develop suture and scalpel safety designs that both reduce risk, and are comfortable and intuitive for surgeons' use.

Enhancing education and training

  • Develop standardized curricula on bloodborne pathogen exposure prevention and the selection and use of safety-engineered devices.
  • Employers provide annual instruction to all workers at risk of sharps injuries on the appropriate use and disposal of safety devices.
  • Develop training strategies for the introduction of new devices, so frontline workers understand proper use and disposal.

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The American Nurses Foundation is a separate charitable organization under Section 501(c)(3) of the Internal Revenue Code. The Foundation does not engage in political campaign activities or communications.

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