Transcription

Prevention and management of needlestick (sharps) injuries andcontamination incidents PolicySolent NHS Trust policies can only be considered to be valid and up-to-date ifviewed on the intranet. Please visit the intranet for the latest version.This policy provides a clear, evidence-basedframework to ensure safe practice when sharpsare used, thereby minimising injuries caused bycontaminated sharps. It provides guidance toensure that when inoculation or contaminationPurpose of Agreementincidents do occur; the incident is promptly riskassessed and the healthcare worker is offeredappropriate treatment to reduce the risk ofinfection and counselling support to reducedistress.Document TypexPolicyReference NumberSolent NHST /Policy/OH13VersionV4Name of Approving Committees/GroupsTrust Policy GroupOperational DateJune 2018Document Review DateJune 2021Document Sponsor (Job Title)Head of people & Organisational Development/Head of Occupational Health & WellbeingDocument Manager (Job Title)Lead Nurse, Occupational HealthDocument developed in consultation withIntranet LocationWebsite LocationKeywords (for website/intranet uploading)Occupational Health & Wellbeing team, InfectionPrevention and Control team, Sexual Healthteam & Health & Safety team.Solent Policies – Occupational HealthLocation in FOI Publication SchemeOur Policies and proceduresPolicy, sharps, inoculation, contamination, HIV,PEP, Ratification, NHSLA

Amendments Summary:Please fill the table below:AmendIssuedNoPageSubjectAction DateReview Log:Include details of when the document was last reviewed:VersionReview Date Lead NameRatification ProcessNumber23.9.12C.MorantPolicy group331.1.151.6.16G.WardG.WardPolicy groupPolicy group4May 2018G.WardPolicy groupNotesChanges inreportingproceduresChanges due to safersharps legislationPolicy refresh

SUMMARY OF POLICYQUICK REFERENCE GUIDEFor quick reference the guide below is a summary of actions required. This does not negate the needfor the people involved in the process to be aware of and to follow the detail of this policy.1. Wherever possible the use of Sharps should be avoided and safer Sharps Devices used whereavailable. Sharps injuries and contamination incidents should be prevented wherever possibleby appropriate use and implementation of Standard Precautions such as good hand hygiene;appropriate use of personal protective equipment (e.g. gloves) and safe handling and disposal ofneedles and other sharp instruments. The HSE regulations, the Health and Safety (SharpInstruments in Healthcare) Regulations 2013, outline the following: the need to avoid theunnecessary use of sharps; use safer sharps which incorporate protection mechanisms; preventrecapping of needles; place secure containers and instructions for safe disposal of medicalsharps close to the work area.2. After a Needlestick injury (NSI) / other type of sharps injury or contamination incident there is arisk of transmission of Blood Borne Viruses (BBV) from affected patients to health care workers(HCW) (and vice versa to a lesser extent) and the incidents must therefore be managedcorrectly. The viruses include hepatitis B, hepatitis C and Human Immunodeficiency Virus (HIV).3. After a NSI / sharps injury or contamination incident: allow the puncture site to bleed; wash thewound / exposed area with soap and water; in the case of a splash to the eyes, irrigate eyes withsterile water (before and after contact lens removal); report the incident to the OccupationalHealth Department (OH) on 07775 800 333 0r 0300 123 3392 or, if out-of-hours, to the localEmergency Department (ED). Inform manager and report via adverse incident reporting system.4. All NSI / sharps injuries and contamination incidents reported to OH or ED will be fully assessedand managed as set out below and in the full policy. This will include a risk assessment of theincident, blood sample for long term storage from the recipient and arrangement of BBV virusscreen from the source patient. ED will inform OH of out-of-hours incidents the next working dayand affected HCW should also contact OH the next working day to arrange follow up.5. If the source patient is known to be HIV positive or at high risk of HIV, the recipient must beassessed for the provision of HIV Post Exposure Prophylaxis (PEP). If the NSI / sharps injury is‘high risk’ (deep injury; visible blood on the device causing injury) and the source is HIV positiveor at high risk of HIV, PEP will be prescribed. This will be done by ED for out-of-hours incidents orthe local Sexual Health clinic in ‘office- hours’ (after referral by OH). PEP follow- up is by SexualHealth.6. If HIV PEP is required, timing is crucial and ideally it should be started within 1 hour of theincident (but can be given up to 48-72 hours), and this should be considered as a ‘medicalemergency’. Overall, however, the risk of acquiring HIV infection following occupationalexposure to HIV-infected blood is low (approximately 1 in 300).7. If the source patient is a carrier of hepatitis B, the recipient must receive a booster dose ofhepatitis B vaccine or, if unvaccinated, must commence an accelerated course of hepatitis Bvaccine and be considered for hepatitis B immunoglobulin (after discussion with ConsultantVirologist).8. There is a requirement for OH to liaise with Health and Safety Manager to report cases with aBBV positive source patient to the Health and Safety Executive (HSE) via Reporting Injuries,Diseases and Dangerous Occurrences Regulations (RIDDOR) and to Public Health England.

Contact details for local ED department:Southampton General:Switchboard-02380 777222A&E direct- 02381 206220Winchester:Switchboard-01962 863535A&E direct-01962 824950Queen Alexandra Portsmouth:Switchboard-023 92286000A&E direct-023 92286380Basingstoke:Switchboard- 01256 473202A&E direct-01256 314700Frimley ParkSwitchboard-01276 604604A&E direct-01276 604110/01276 526123

Table of ContentsItemContentsPage1INTRODUCTION AND PURPOSE62SCOPE AND DEFINITION63MANAGEMENT OF NEEDLESTICK (SHARPS) INJURIES AND CONTAMINATIONINCIDENTS PROCESS74ROLES AND RESPONSIBILITIES105TRAINING106EQUALITY IMPACT ASSESSMENT AND MENTAL CAPACITY107SUCCESS CRITERIA / MONITORING EFFECTIVENESS108REVIEW119REFERENCES AND LINKS TO OTHER DOCUMENTS1110GLOSSARY12AppendicesAppendix A : Equality Impact Assessment13Appendix B: Sharps Safety PosterSteps to take Should a Sharps or Contamination Injury occur (updated Oct2017)Appendix C: Algorhythm for Hepatitis B prophylaxis after reported exposureincident.15Appendix D: Trust approved safer sharps devices1716

1.INTRODUCTION & PURPOSE1.1Prevention of sharps injuries and contamination incidents is extremely important. HepatitisB (HBV), Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV) can be transmitted bypercutaneous injury e.g. where the skin is cut or penetrated by needles or other sharpobjects (a Needlestick / ‘sharps’ injury); or mucocutaneous injury (splash to mucousmembranes or broken skin) from patients to health care workers (and vice versa to a lesserextent). Therefore, Needlestick / sharps injuries and contamination incidents must bemanaged correctly as set out in this policy. Transmission of these Blood Borne Viruses (BBV)occurs from blood, visibly blood-stained body fluids, Cerebra Spinal Fluid, peritoneal, pleuraland amniotic fluids.1.2This policy has been developed to inform the Trust’s employees of the correct way tomanage NSI / sharps injuries and contamination incidents within the organisation and, bydoing so, to improve the safety and wellbeing of both staff and patients. It is also importantto emphasize that prevention of these injuries by safe handling and disposal of sharps andthe use of other relevant infection control procedures, such as safer sharps, appropriatehand hygiene and use of personal protective equipment, is extremely important.2.SCOPE & DEFINITIONS2.1This policy applies to all employees (including apprentices) who hold a contract ofemployment or engagement (including secondees, volunteers) within Solent NHS Trust, inline with Solent NHS Trust’s Equality, Diversity and Human Rights Policy. It also applies toexternal contractors, Agency workers, and other workers who are assigned to Solent NHSTrust.2.2Solent NHS Trust is committed to the principles of Equality and Diversity and will strive toeliminate unlawful discrimination in all its forms. We will strive towards demonstratingfairness and Equal Opportunities for users of services, carers, the wider community and ourstaff.2.32.3.1DEFINITIONS :‘sharp’ is any object, which can puncture the skin and may be contaminated by blood orbody fluids. This might include the following: hypodermic needles, suture needles, scalpelblades, pieces of bone, teeth splinters, glass ampoules, and pathological specimens2.3.2 NSI: Needlestick injury or injury from a ‘sharps’ source.2.3.3 Blood Borne Virus (BBV): a virus which is carried in the blood of an infected individual andwhich can be transmitted to another person exposed to the individual’s blood.2.3.4 HBV: Hepatitis B Virus2.3.5 HCV: Hepatitis C Virus2.3.6 HIV: Human Immunodeficiency Virus2.3.7 HIV PEP (Post Exposure Prophylaxis): HIV treatment medication given after a NSI / sharpsinjury from a known or high risk HIV positive source patient to reduce the risk ofseroconversion.2.3.8 OHW Occupational Health and Wellbeing Service.2.3.9 HSE: Health and Safety Executive2.3.10 RIDDOR: Reporting Injury, Disease, Dangerous Occurrence Regulations.

3.MANAGING NEEDLESTICK (SHARPS) INJURIES AND CONTAMINATION INCIDENTS3.1SAFE SHARPS PRACTICE3.1.2The use of sharps should be avoided where possible. When their use is essential, particularcare is required in handling and disposal.3.1.3Solent NHS Trust requires all staff to use safety engineered hypodermic needles, butterflies,lancets, insulin needles, insulin pen needles, subcutaneous butterflies, and cannula asstandard (appendix D).3.1.4If staff identify a procedure where the safer device recommended is not appropriate theymust liaise with Infection Prevention or Health and Safety to discuss further. Only once allsafer alternatives have been considered and a risk assessment undertaken will the service begiven permission through H&S to return to using a non-safer device. Injuries resulting fromuse of non-safer devices where this procedure has not been followed will be considered abreach of this policy.3.1.5Should staff identify a procedure where safety would be enhanced by using a Safetyengineered device i.e. safer scalpels they should liaise with Infection Prevention team.3.2SAFE USE OF SHARPS BINS3.2.1Sharps must only be disposed of in designated sharps bins that meet the requirements andin accordance with HTM 07-01 Safe Management of Healthcare Waste (DH,2013) provides aframework for good practice to all producers of healthcare waste on the development andmanagement arrangements for the safe, economic disposal of healthcare waste.3.2.2Use appropriate designated sharps bins for specific types of waste e.g. yellow sharps binwith yellow lid, or yellow sharps bin with purple lid3.2.3Always assemble sharps bins correctly.3.3MANAGEMENT OF ALL NSI (SHARPS) INJURIES/CONTAMINATION INCIDENTS3.3.1Immediate ActionFirst Aid: see Poster Guidance.3.3.2Trust Reporting Procedure (NSI or contamination incident).3.3.2.1 Inform manager/person in charge and ensure Adverse Event form is completed and sent tothe Health & Safety Team.3.3.2.2 It is vital that staff report incidents immediately to OHW and out of hours to the local ED, sothat a local risk assessment can be made. See Poster Guidance.3.3.2.3 OHW is required to report cases with a BBV positive source patient to Health and SafetyExecutive (HSE) via Reporting Injuries, Diseases and Dangerous Occurrences Regulations(RIDDOR) and to Public Health England.3.4Attend OHW/ local Emergency Department (ED)3.4.1A risk assessment of the injury and exposure will be undertaken.

33.4.7.43.4.7.53.4.83.53.5.1OH / ED will arrange for a sample of the recipient’s blood to be stored (red-topbottle - ‘Long term storage’ should be requested on the pathology form).See Appendix B - algorithm for assessment of Hepatitis B prophylaxis following a reportedexposure.OH / ED will ask the clinical team caring for the source patient to obtain blood for HBV, HCVand HIV testing and storage. This blood sample should not be taken by the recipient.Appropriate consent must be obtained. In urgent, high risk cases the microbiologylaboratory will be informed by OH / ED and arrangements made for urgent testing.In high risk incidents HIV Post Exposure Prophylaxis (PEP) may be required and the initialprescription will be provided by ED for out-of–hours incidents and by the Sexual Healthdepartment for incidents in ‘office-hours’ (after referral by OH).PEP should be started within1 hour of the incident, although it can be given within 72 hours.OH will complete exposure incident form with the staff member.They will arrange appropriate blood testing and follow up in the weeks following theincident :Known HIV infected source patient: HIV test for recipient at 6, 12 and 24 weeksKnown HCV infected source patient: HCV RNA test for recipient at 6 and 12 weeks. Inaddition, anti-HCV test at 12 and 24 weeks.Known positive HBV source patient: test non-immune recipients from 6 weeks (HBsAg test).Unknown source patient: test recipient for HIV at 12 weeks and anti-HCV at 12 and 24 weeksKnown negative high-risk source patient e.g. i.v drug user: consider possible ‘window period’of seroconversion and test recipient for HIV at 12 weeks and anti-HCV at 24 weeksHIV PEP follow-up is in Sexual HealthGuidelines for obtaining source patient’s blood in NSI / sharps injuries and contaminationincidents:If the source patient’s risk of BBV carriage is high, consider liaising with Sexual Health / EDbefore testing. If the source patient’s risk of BBV carriage is low, proceed to blood testing.3.5.2 Ask source patients with capacity for consent to be tested for HBV, HCV & HIV in order tocomply with Department of Health recommendations. This consent is verbal and ideally mustnot be taken by the NSI / sharps injury recipient, but by a colleague or other member of staffin the clinical area.3.5.3 Inform the patient that a NSI / sharps injury has taken place and that specific BBV such asHBV, HCV and HIV can be transmitted after such an incident. Enquire as to whether there isany possibility of carriage or exposure to these viruses in the past.3.5.4 Inform the source patient that results will be made available to OHW / ED and recipient ofNSI.3.5.5 If a positive result is obtained from a source patient repeat the test for confirmation. If it isa true positive result, liaise with Sexual Health for advice on further management in thecase of HIV or with a Consultant Virologist in the case of hepatitis B or C.3.5.6 In the case of a deceased patient, it is appropriate to seek consent from a relative.Where thepatient is expected to regain capacity before a decision on testing is needed, testing shouldnot take place until consent has been obtained.3.5.7 Where a patient is not expected to regain capacity before a decision on testing needs to bemade, consider following a process based on British Medical Association guidance (2016)summarised below:3.5.7.1 Determine whether the patient has a valid and applicable advance decision to refusetreatment (ADRT) or whether there is anyone with legal authority to make the decision (egan attorney with the relevant decision making authority or a court-appointed deputy).3.5.7.2 If there is no ADRT or individual with legal authority, make a decision by assessing whether

testing is in the best interests of the patient:3.5.7.3 Follow a structured decision-making process, including seeking views from the patient (ifconscious) and consulting a range of parties including relatives and those caring for thepatient or an independent mental capacity advocate (IMCA) if the patient has no-one else torepresent them.3.5.7.4 If it is decided that testing is in the best interests of the patient and the patient’srepresentative confirms that the patient would be expected to consent to the test if theyhad capacity, proceed with the test.3.5.7.5 If the patient regains capacity, inform them that the test has been undertaken and give themsufficient information to make an informed decision about whether to receive the results ofthe test and whether information about the test should be included in their medical record.3.63.6.1POST EXPOSURE PROPHYLAXIS (PEP)The Department of Health (DoH) recommends PEP for healthcare workers who have had asignificant occupational exposure to blood or other potentially infectious material from apatient or other source known to be HIV infected or considered to be at high risk ofinfection. A significant exposure is defined as: Percutaneous injury (e.g. from needles, instruments, significant bites which breakthe skin) Exposure of broken skin (e.g. eczema, cuts, abrasions) Exposure of mucous membranes, including the eyeHIV post-exposure prophylaxis (Guidance from the UK Chief Medical Officers’ ExpertAdvisory Group on AIDS. (September 2008)):3.6.2The DH does NOT recommend PEP: After an exposure through any route with low risk materials e.g. saliva, urine, faecesor vomit unless visibly bloodstained (e.g. saliva associated with dentistry)If a risk assessment has concluded that HIV infection of the source is highly unlikelyWhere the source is known to be HIV-negativeIf the source is known to have an undetectable viral load ( 200 copies HIV RNA/mL).However,PEP should be offered to those who are anxious about the risk of infection.Where a risk assessment suggests that HIV infection of the source is a potential risk,a request will be made to test the source for HIV. However, it may not always bepossible, or appropriate, to perform a test. In this case it will be up to you to decidewhether to continue treatment after further discussion with the treating clinician.You will need to balance the relative risk of transmission against the possibility ofside effects of the medication.If you decide not to start treatment you can still discuss with the Clinician at a laterdate, although commencing PEP is generally not recommended beyond 72 hourspost exposure.If the source of injury/exposure is unknown:In the majority of cases where the source of the exposure is completely unknown,the risk of HIV is so low that PEP should not be recommended. If you would stillprefer to take treatment then you should discuss this with the prescribing doctor.You can always stop treatment at a later date after further discussion with theclinician.

4.ROLES & RESPONSIBILITIES4.1Clinical Managers / Heads of Department have a responsibility to ensure that all staff withintheir department involved in NSI / sharps injuries or contamination incidents are managedappropriately and that preventive measures are in place.Line Managers are responsible for ensuring that NSI / sharps injures and contaminationincidents are managed appropriately as set out in this policy and that preventive measuresare put in place.All staff must co-operate with the Trust and line management on prevention and correctmanagement of NSI / sharps injuries and contamination incidents as set out in this policy.Occupational Health, Safety and Wellbeing Service will ensure NSI / sharps injuries andcontamination incidents are managed appropriately as set out in the process section of thispolicy and that advice on implementation of preventive measures is provided.Emergency Department (ED) is responsible for the management of NSI / sharps injuries outof-hours and for the initial administration of HIV PEP where indicated out-of-hours.Health and Safety Committee is responsible for receiving the results of audits of NSI / sharpsinjuries and contamination incidents and recommending any appropriate action to reduceany identified risks.4.24.34.44.54.65.TRAINING5.1Training needed to implement the policy and any ongoing training is provided by the IPCT asidentified by a ‘training needs analysis’. All training undertaken must be recorded on theOrganisational Learning Module (OLM) of the Electronic Staff Record (ESR) taken fromsigning in sheets.6.EQUALITY IMPACT ASSESSMENT AND MENTAL CAPACITY6.1The outcome of the assessment see Appendix A was there was no negative impact.7.SUCCESS CRITERIA / MONITORING EFFECTIVENESS7.1OHW will undertake an annual audit ( in accordance with local audit) of the management ofneedlestick /contamination incidents in the last 12 months. A summary of compliance willbe recorded. Any subsequent issues/findings resulting from the audit may be included instaff training and a review of this Policy /SOP will be considered.7.2Non-compliance incidents relating to this policy will be reported to the Health & Safety SubCommittee8.REVIEW8.1This Policy may be reviewed at any time at the request of either staff side or management,but will automatically be reviewed 3 years from initial approval and thereafter on a triennialbasis unless organisational changes, legislation, guidance or non-compliance prompt anearlier review.

9.REFERENCES AND LINKS TO OTHER DOCUMENTS9.19.1.1REFERENCESHealth and Safety (Sharp Instruments in Healthcare) regulations 2013 .Guidance foremployers and employees.Control of Substances Hazardous to Health (COSHH) Regulations (2002)Health & Social Care Act (DH, 2008) Code of Practice for health and adult social care on theprevention and control of infections and related guidance.DH (2013) Immunisation of healthcare and laboratory staff, in: Immunisation againstinfectious disease (the ‘Green Book’), Chapter 12,NHS Employer-Managing the risk of sharps injuries framework (2015)HIV Post- Exposure Prophylaxis. Guidelines from the UK Chief Medical Officers ExpertAdvisory Group on AIDS (2008)Portsmouth Hospitals NHS Trust Needlestick /Sharps Injury & Contamination Incidents:Prevention & Management (May 17).9.1.29.1.39.1.49.1.59.1.69.1.7

9.2LINKS TO RELATED SOLENT NHS TRUST DOCUMENTS Decontamination PolicyHealth & Safety PolicyFirst Aid At Work PolicyData Protection Caldicott &confidentiality PolicySerious Incidents requiringInvestigation PolicyReporting Adverse Incidents PolicyInfection and Prevention ControlStandard Precautions Policy10.GLOSSARY10.1See Definitions 2.3 Hand Hygiene PolicyAseptic Technique PolicyHealthcare Worker screening andImmunisation PolicySickness Absence PolicyWaste Management Policy

Appendix: AEquality Impact AssessmentStep 1 – Scoping; identify the policies aimsAnswer1. What are the main aims and objectives of thedocument?To ensure safe practice when sharps are used,therebyminimisinginjuriescausedbycontaminated sharps. To ensure that wheninoculation or contamination incidents do occur;the (24/7) the incident is promptly risk assessedand the healthcare worker/patient is offeredappropriate treatment to reduce the risk ofinfection and counselling support to reducedistress.2. Who will be affected by it?All employees/patients and service users3. What are the existing performanceindicators/measures for this? What are theoutcomes you want to achieve?Department of Health guidance (PHE- Integratedmanagement of HCW and Blood borne virus Oct2017).Safe management of Healthcare waste (HTM 0701,DH 2013)Health and Safety (SharpHealthcare) Regulations 2013.instrumentsinHealth & Safety at Work Act 1974Control of Substances Hazardous to HealthRegulations 2002National guidance from various sources includingNHS Employers Framework4. What information do you already have on theequality impact of this document?Assumption that this will potentially impact on adiverse group of service users5. Are there demographic changes or trends locallyto be considered?Not aware of any high risk areas within the Trustwhich would increase incidence of injury.6. What other information do you need?None

Step 2 - Assessing the Impact; consider the data andresearchYes1. Could the document unlawfully discriminateagainst any group?2. Can any group benefit or be excluded?NoAnswer (Evidence)xThis policy applies to all and isconsistent with current DHpolicy.Of potential safety benefits toall staff and patient / serviceusers in prevention of injuriesand treatment to preventinfections.x3. Can any group be denied fair & equal access to ortreatment as a result of this document?xThis policy applies to all and isconsistent with current DHpolicy/Health & Safety Policy4. Can this actively promote good relations with andbetween different groups?xAs all staff/patients/serviceusers are treated the same.5. Have you carried out any consultationinternally/externally with relevant individual groups?xInternally with OccupationalHealth & Wellbeing Team/ IPCteam/GU (Sexual Health)team.6. Have you used a variety of different methods ofconsultation/involvementAs above.Mental Capacity Act implications7. Will this document require a decision to be madeby or about a service user? (Refer to the MentalCapacity Act document for further information)xThis policy applies to staff andpart of the aim is to protectservice users.

APPENDIX B:

APPENDIX C:

APPENDIX DSOLENT NHS TRUST APPROVED SAFER SHARPS DEVICESPhlebotomy use:Use of standard hypodermic is not approved.BD Eclipse Blood Collection Needle to use with vacutainerGreen 21G 32mm KFK217Black 22G 32mm KFK216Adaptor KFK037Phlebotomy use:Use of standard hypodermic is not approved.BD Vacutainer Safety-Lok Blood Collection set – short duration use.Green 21G 19mm needle 178mm tubing KFK253Green 21G 19mm needle 305mm tubing KFK056Light blue 23G 19mm needle 178mm tubing KFK254Light blue 23G 19mm needle 305mm tubing KFK058Dark blue 25G 19mm needle 178mm tubing KFK336Phlebotomy use:Use of standard hypodermic is not approved.BD Vacutainer Safety-Lok Blood Collection set with pre attachedholders – short duration use.

Drawing up needle: To be used in place of standard hypodermicneedles for drawing up. Filtered for glass ampoules and non-filteredfor bung or plastic containers.BD Blunt fill drawing up needles for plastic or rubber bung vials.BD blunt filter needles for glass ampulesFiltered 18G 1.2mm x 40mm FTR436Non Filtered 18G 1.2mm x 40mm FTR437Hypodermic needles: To be used in place of all standardhypodermic needles.BD Eclipse hypodermic needle with Smartslip TechnologyOrange 25G 0.5mm x 16mm FTR470Blue 23G 0.6mm x 25mm FTR471Green 21G 0.8mm x 40mm FTR 473Lancets: To be used in place of all other types of lancet.Green 21G 19mm needle 178mm tubing with adaptor KFK348Green 21G 19mm needle 305mm tubing with adaptor KFK347Light blue 23G 19mm needle 178mm tubing with adaptor FK350Light blue 23G 19mm needle 305mm tubing with adaptor FK349Unistik single-use safety lancets by Owen MumfordComfort Purple 28G1.8mm FTM054Gentle pink 30G 1.5mm FTM339Neonatal 18G 1.8mm FTM001Larger quantities available on request

Insulin needles: To replace all standard insulin needles.BD SafetyGlide Safety Insulin Syringe0.5ml 30G 0.30mm x 8mm FWD0850.5ml 29G 0.33mm x 1.7mm FWD057Other sizes are available within this rangeCannulation: To replace all standard cannula.BD Venflon Pro safetyBlue 22g FSP 639Pink 20g FSP 796Green 18g FSP 797Grey 16g FSP 798Orange 14gFSP 803Subcutaneous Infusions: To replace metal needle devicesintended to remain insitu.BD Saf-T-Intima for subcutaneous infusion therapyYellow 24G 0.7 x 19mm FSP 3559 (singleitem)Blue 22G 0.9 x 19mm FSP319Subcutaneous Infusions: To replace metal needle devicesintended to remain insitu.BD Saf-T-Intima with Y adaptor for subcutaneous infusion therapyPink 20G 1.1mm x 25mm FSP329Yellow 24G 0.7mm x 19mm FSP 324Blue 22G 0.9mm x 19mm FSP325

BD AutoShield Duo Order via non-catalogue requisitioning route and choose Bunzl as thesupplierusing reference 3296050,30mm(30G)x 5mmandBox penof 100.BD 5mm Safety Pen Needle for protectionboth onpatientendsReference: 329605.Drug Tariff Code: 360-5615NHSSC code: FTR1083Department Specific Items2” needle for joint injections or where standard 40mm needle is not long enough.SOL-CARE Safety Hypodermic NeedleNeedle protection device for injectionFor Special Care Dentistry onlySort byDefaultAscendingPage size10Cannula intravenous infusion set with integrated system and safety device 24g x 19mm polyurethane with Dual BDQ-Syte closed luer access split septum MPC: 383531Unit of issue: EachBrand: BD NexivaSupplier: BECTON DICKINSON UK LTD

Prevention and management of needlestick (sharps) injuries and . in the case of a splash to the eyes, irrigate eyes with sterile water (before and after contact lens removal); report the incident to the Occupational . lancets, insulin needles, insulin pen needles, subcutaneous butter