Celebrating ten years of sharp practice

29-Jan-2015

The enhancement and adoption of revolutionary innovations that are delivering benefits to healthcare workers and hospital visitors across the world

Providing a safer more sustainable environment for healthcare workers and patients

Who would have thought that the search for a safer sharps disposal solution that began 14 years ago in the North of England, would result in the enhancement and adoption of revolutionary innovations that are delivering benefits to healthcare workers and hospital visitors across the world?

Following extensive trials, The Northern Waste Consortium project team discovered what they believed was the answer to their sharps disposal issues. At the time the system was already being used in many healthcare facilities in Australia and New Zealand. The proven solution and its subsequently developed enhancements have placed the UK at the forefront of global safety and environmental sustainability.

Neil Robinson and Dan Daniels, via weblink

Neil Robinson and Dan Daniels, via weblink

Welcoming customers and colleagues to a celebration of ten years of continuous success, Sharpsmart UK’s managing director, Neil Robinson, said: “We’re here to take a nostalgic look back and provide some interesting industry observations, whilst celebrating ten years with some of those who were the original pioneers.

“We’ll look back at the vision and the challenges that the designer, Dan Daniels, embarked on when he the first invented this unique product.”

In a video link live from Melbourne, Australia, Dan Daniels, Sharpsmart designer, owner and CEO, explained: “Back in the 80s, we were looking at how we could introduce safer techniques in our hospitals. I, like many healthcare workers, was concerned about needlestick injuries. No one had really analysed all the reasons for, or provided a solution for eliminating sharps injuries.

“I researched the subject extensively and found that to make a sharps container totally safe, you needed to incorporate13 engineered safety features. The problems we were faced with was how do we build it, wash it and sanitise it, make it look brand new every single time it was returned to the healthcare facility and most importantly to do it for a similar price to a disposable container.

“Quite a challenge I am sure you would agree to design something so fundamentally different and to get a change of mind-set within the healthcare environment,” said Dan.

“We spent a lot of money to develop the vision. That was difficult for a small company in Melbourne,” said Dan. “Just to work out how to seal the container included the development of 24 tools and took over two years in the making. We developed ways for the safety tray to work with the smallest syringe to ensure one-handed operation. We only succeeded in our vision because we invest all the money back into the further enhancement of the product and the supporting systems.”

Dan explained: “The disposal of a single-use container is very simple. Our process involves a large amount of people and needs to be really well coordinated. The team in the UK is the most sophisticated, most advanced that we have anywhere in the World. They’ve developed many of the ways we now work across the World.

“We have continued with the development of other systems, such as the C64 which is the reusable clinical waste collection system.”

Considering the design issues of Sharpsmart, the most challenging related to the extreme temperatures experienced around the world whilst ensuring continued reliability of performance. Dan said: “We had to buy in many different types of plastics and an aerospace quality bearing, to ensure the tray works at -18 to +40oC. We specified from the outset that the container should be intrinsically safe when experiencing a 1.8m drop test and be leak-proof in all orientations.”

Bins are handled robotically

Bins are handled robotically

Turning to UK developments, Dan explained: “It took three years to get through some of the contractual and red tape issues. My thanks to Bob Pinkerton and Sheila Morgan of the Northern Clinical Waste Consortium who saw the vision and who have driven through the change.
“The market at the time was using cheap, throwaway containers. They were not really safe containers.”

In summary, Dan added: “The UK is growing at more than 30% a year for Sharpsmart. There are three plants in the UK, and we have plans afoot to develop more.

“The UK leads the whole World in quality control.”

Next up was world-renowned independent consultant on sharps injuries, Terry Grimmond, who via a web link, said: “There are 100,000 sharps injuries annually in the UK, Hopefully that’s coming down, but that’s 100,000 people who may suffer with severe emotional stress following an unnecessary injury.”

Terry highlighted the hierarchy of sharps injury control:

  • Elimination of hazards - e.g. needle-less dry delivery system (i.e. don’t use a sharp)
  • Engineering controls - e.g. engineering systems or safety engineered devices (SEDs)
  • Administrative control - e.g. standard precautions procedures
  • Workplace practice controls (rules) - e.g. no re-capping, no needle removal, sharps container siting
  • Personal protective equipment - double gloving

Detailing a UK study, Terry said: “Adams and Elliott looked at the SI (sharps injury) rate before and after education on SIs across four wards. An 18% reduction was achieved, purely by education. A 70% reduction was achieved using education and safety engineered devices. But that was just four wards, which was manageable. Bigger areas require increased resources.”

Terry cautioned: “Fines of several hundred thousand pounds are common for hospitals that incur a sharps injury.”

Terry went on to describe some extensive recent research he undertook in the UK to evaluate the effectiveness of safety engineered sharps devices. He described how he went ‘dumpster-diving’, “sorting out everything that came out of a typical sharps container.” Terry said: “I evaluated all the devices (SEDs) to see if they had been used correctly. I discovered that over one third of UK SEDs are not correctly activated.”

Looking at the current, wider use of safety engineered devices (SEDs), Terry said: “If you still have SIs following the introduction of an SED, then change to a safer one. Using an SED correctly would probably reduce container-associated SIs by around 83%.

“Not all SEDs are expensive. When they were first invented they were 5 to 20 times more expensive than the traditional devices, now the difference is far less.”

Siting research in 2008 which found that 91% of nurses go to work fearing an SI, Terry said: “You must insist on getting access to your facility’s sharps policy and ensure that you have access to SEDs and even when SEDs are in use you still need the safest sharps container to ensure that you are protected.

“Using Sharpsmart gives the best return of investment than any other safety device,” said Terry. “Studies have proven that more than 20,000 healthcare workers in Australia have been protected from receiving an SI because of Sharpsmart.”

Bin washing

Bin washing

An informative tour of Sharpsmart’s processing facility highlighted the extremely high safety, processing and quality standards in place - the emptying of the bins, their thorough washing and double quality control inspection ensures that the containers are returned to the healthcare facility in pristine condition and that the operators are protected throughout the processing lifecycle.

The facility’s cytotoxic hood (which is installed over the robotic container emptying head) has now been adopted as the processing standard across the World.

Sharpsmart’s Ben Martyn demonstrates Vacsmart

Sharpsmart’s Ben Martyn demonstrates Vacsmart

The facility tour also took in the Auditsmart processing area which routinely audits containers from each hospital, providing a photographic record of the contents and identifying any non-compliance or under filling issues. These are traced back to the ward enabling any issues to be highlighted and rectified.

Relating the experiences of a ten-year Sharpsmart user, Sheila Morgan, infection prevention and control nurse at The Newcastle upon Tyne Hospitals NHS Trust, said: “In the late 90s we’d been evaluating safety and green issues and the systems that were around at the time.

“We learned about the Sharpsmart system and went to see how it was implemented in Australia and New Zealand - there was nowhere else to see it.

“It was very streamlined, very efficient, with the staff in control of what was going on. We implemented it extensively at the trust. We ran a trial, loading the boxes with biomarkers and showing they were safe to use when returned. It was identified that the reusable containers were actually cleaner than the single-use containers that were previously used. The contents are audited, there’s constant feedback of outcomes and we undertake a quarterly process review. It’s cost-effective sharps disposal.

“Siting is extremely important. We’ve put them onto several of our own trollies and also some specially designed Sharpsmart trollies so staff have ownership of how they take them to point of disposal.”

James Dixon, the trust’s waste officer, said: “Surprisingly, Sharpsmart works out cheaper than single-use container use and disposal. Although we originally anticipated Sharpsmart would be around £20,000 more annually, it ended up costing less.

“With my environmental background I’m concerned about the carbon issue. The full life cycle of Sharpsmart gives us 90% reduction in CO2 compared to the use of disposables.

“Plus we have Auditsmart,” said James. “Knowledge is power. I have my monthly ‘naughty list’ which enables you to ‘name and shame’ for inappropriate waste disposal. An e-mail goes out of what’s been put into the boxes. Considering the high cost of healthcare waste we are keen to avoid unnecessary disposal.

“We engage staff in segregation, advising on cost and environmental impact. We have annual savings of £75,000 across eight areas trust-wide.

“We’re producing more sharps due to clinical activity, but we’re reducing our costs through the use of the Auditsmart process.”

Dr Anne Woolridge, of Independent Safety Services Ltd, gave the audience an update on her current work on the transport of Ebola waste and the transport of healthcare waste related to ADR.

As this event was attended by Northern Waste Consortium members, Garry Pettigrew, managing director of Healthcare Environmental Services (HES), was invited to discuss the ongoing use of Sharpsmart once the Northern Consortium waste contract is transitioned to HES from October 2015. Garry said: “With the North East contract we recognised the success of Sharpsmart and it was part of our bid. The partnership will hopefully make this a better relationship for all going forward.”

Neil Robinson with the customer liaison team of Amber Marshall, Kate Chambers and Lauren Miller.

Neil Robinson with the customer liaison team of Amber Marshall, Kate Chambers and Lauren Miller.

Explaining the process that will be undertaken from October 2015, Neil Robinson said: “We will do a full optimisation, starting with a full site-wide ‘ward walk’ to ensure that accessories and containers are audited and that the sizes and point of care accessories are suited to the volumes being generated within each department.”

Summarising ten years of business success, Neil explained: “We have grown our business by around 35% each year for the past 10 years.

During this period we have prevented over 2,000 tonnes of plastic sharps waste from being incinerated, equating to five million single-use sharps bins. It is also estimated that the improved safety brought about by the introduction of Sharpsmart has prevented 5,109 needle-stick injuries across the UK.

“Our success and our ability to meet our customers’ needs is directly attributed to the fact that we do not approach sharps safety from the perspective of a waste company, we are a clinical company addressing the needs of our customers related to safety, sustainability, compliance and education.”

Neil also highlighted recent innovations and a campaign the company is undertaking to ‘make waste invisible within the healthcare environment’. “The new VacSmart system will reduce waste volume by 50 to 90% whilst proving a cleaner patient environment and reduce portering and transport logistics,” said Neil. “Our new focus on our primary care customers has also seen the development of a safe method of transporting and disposing of sharps within the community environment which can be utilised in the boot of community nurses’ cars.

“Other new areas we have focussed on are underground waste storage solutions, for outside use, and, for inside, cabinets and cupboards that look like furniture but are used to store bulk waste bins.”

A commemorative ‘gold’ Sharpsmart container was presented to the teams from Sunderland (pictured) and Newcastle

A commemorative ‘gold’ Sharpsmart container was presented to the teams from Sunderland (pictured) and Newcastle

Marking the tenth anniversary of Sharpsmart and its partnership with two members of the Northern Consortium, Neil Robinson presented representatives of The Newcastle upon Tyne Hospitals NHS Trust and City Hospitals Sunderland NHS Trust with commemorative ‘gold’ Sharpsmart containers.

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For further information, call Sharpsmart on 01388 810310, e-mail info @clinismart.co.uk or visit www.sharpsmart.co.uk