# Sharps & Medical Waste Management

## Overview

Infection Prevention and Control (IPC) during procedures includes the safe management of ‘sharps’, encompasses high-level measures such as health facility design and management, protocol-based measures such as adherence to national and facility level guidelines, and individual actions by each health care provider and ancillary staff member. The health care provider is encouraged to familiarise themselves with their facility’s specific IPC protocols and reporting systems, which is outside the scope of this module.

This module describes how to segregate waste into different disposal units for safety.

## Sharps Bins

These are colour coded, non-penetrable, rigid containers.

### Items for sharps bin disposal

1. Needles

2. Lancets

3. Scalpels & stitch cutters

4. Glass objects such as broken ampoules

5. Blood specimen tubes

6. Other sharp or jagged items that may cut persons working with waste

### How to use sharps safely

1. Always keep needles capped and scalpels sealed until directly before use.

2. Always use safety engineered devices when they are available.

3. Always dispose of sharps directly after use in a sharps container. If there is no container within arm’s length, transport sharps for disposal in a rigid plastic or metal dish.

4. If available, always use a blunt fill needle to draw up medication.

5. Avoid recapping needles. If you have to, scoop and pick up the cap off a surface using the needle, then secure it using your hand; never hold the cap in your hand while recapping a needle.

6. Avoid bringing your hand in front of sharps while using them; for example, don’t palpate a vein while inserting a needle.

7. If your patient is uncooperative, ask for help restraining them.

8. Get vaccinated against hepatitis B and get tested for HIV regularly.

### How to use a sharps bin

1. When a sharps bin reaches the fill line (⅔ full), ask relevant staff to seal and replace it.

2. Drop the needle and syringe into the bin as

   one unit
   one unit

   Where sharps bins are in short supply, it is tempting to disconnect the needle from the syringe, but this unsafe practice leads to sharps injuries with contaminated needles.

   .

3. If you cannot obtain a sharps container, use a heavy-duty plastic household container that stays upright and has a tight-fitting, puncture-proof lid. Label the container as “Sharps Biohazard”.

## Red bins

### Items for red bin disposal

Any items contaminated with blood and body fluids such as:

1. Used dressings/gauze/linen savers

2. Used syringes

3. Used alcohol swabs

4. Used IV lines & cannulae

5. Used personal protective equipment (PPE)

### How to use red bins safely

1. Red bins may not always be in your immediate environment, but your sterile pack contains a red waste bag, which should be opened and placed within easy reach for waste disposal during and after the procedure.

2. After the procedure, discard your red bag into the red bin, not into general waste.

## White/general bins

### Items for white bin disposal

General, uncontaminated waste such as:

1. Clean packaging like cardboard boxes & plastic wrap

2. Patients’ general waste such as food waste & paper

## References

1. WHO Best Practices for Injections and Related Procedures Toolkit. World Health Organization: Geneva; 2010.

2. World Health Organization. Make Smart Injection Choices — Prevent Needlestick Injury.