Case Study

8 Hospitals in Australia, New Zealand, Scotland

This is the first time in world literature that a sharps containment system has brought about such sharps injury reductions

Terry Grimmond

The Challenge

Eight Acute Care Hospitals in Australia, New Zealand and Scotland were experiencing an inflated number of sharps injuries. These included both container-related sharps injuries, and non container-related. All 8 hospitals recorded in this study were using disposable sharps containers. The seriousness of sharps injuries lies in the risk of acquisition of bloodborne pathogens. Worldwide, more than 100 healthcare workers have contracted HIV from work-related sharps injuries and many thousands have contracted HBV or HCV. Notwithstanding the emotional costs to injured healthcare workers and their families, the financial cost of each sharps injury follow-up is between US$500-$2500 and the annual costs associated with treatment of infection can be tens of thousands per infected healthcare worker and ultimately cost up to US$1 million

Our Approach


All facilities acknowledged that current practices were unsustainable and did not support the safety interests of their staff; they made a decision to roll out their facilities with Daniels Sharpsmart sharps containers and accessories throughout, removing their previous system that utilised disposable sharps containers. 


All sharps injury reports in both study periods were examined and the following data retrieved the total number of reported sharps injuries from all sharp items, e.g. needles, scalpels, scissors. The next step was identifying how the injury occurred using 7 standard, post-patient EPINet categories, and seven additional categories. These included 1. Recapping, 2. Other after use, before disposal, 3. Item left on disposal counter, 4. Putting item into disposal container, 5. Due to overfilled container, 6. Due to container opening/nature of sharp item, 7. Due to other reasons, 8. Protruded from disposal container, 9. Pierced side of disposal container, 10. Picking up from floor after bouncing out of container, 11. Picking up from floor after spillage or rupture of container, 12. Pierced side of inappropriate disposal container, 13, While collecting rubbish from waste bin. 14. All other (predominantly during patient procedure)


Of the above categories, 3-11 were grouped as CRSI. When records were insufficient to categorize sharps injuries per the above scheme, the staff member suffering the injury was contacted and further details obtained. In addition to sharps injury data, the average daily OB and average daily total full-time equivalent staff (FTE) for both study periods were sought from each hospital. 

Three major parameters, CRSI, Non-CRSI and Total SI per 100 OB/yr and per 100 FTE/yr, were compared for the two study periods. In addition, all 14 sharps injury categories were calculated per 100 FTE/yr and compared. All data was assessed statistically using a Paired t-test and significance was set at P<0.05. The study did not receive industry or grant funding. 

The Solution

Daniels Sharpsmart sharps containment systems proved superior in achieving sharps injury reduction. All hospitals studied adopted the Daniels Sharpsmart containment system including containers and supporting mounting and movement accessories throughout their facilities. The advanced safety features of the Sharpsmart's unique design - high profile, multiple mounting options, ability to achieve correct placement, and wide hands-resistant opening, proved results that no other sharps container had been able to support. 

The Outcome

Results indicated a significant decrease in Sharps Injuries associated with use of the Sharpsmart system. Total sharps injuries was reduced by 32.7%; Container related sharps injuries were reduced by 86.6% and non container-related sharps injuries reduced by 25.7%. This compares favourably with other EC such as needleless IV systems and safety syringes, which individually, may bring about reductions in Total sharps injuries of up to 30-35%. 


The use of the Daniels Sharpsmart sharps container system resulted in a significant reduction in Total Sharps Injuries (SI), Non-Container Related SI and Container Related SI in the acute care hospitals studied. This is the first time in world literature that a sharps containment system has brought about such SI reductions in all three parameters. It is postulated that the Sharpsmart system’s advanced safety features, high profile, multiple mounting options, correct placement, and institution-wide education brought about behavioural change through an ecosystemic effect. The Sharpsmart sharps management system offers a cost-effective means of significantly reducing Sharps Injuries


The Results

Reduction in total sharps injuries
Reduction in container related sharps injuries
Reduction in non container related sharps injuries