Sharps Injury
Prevention

Objectives
Housing Works is committed to maintaining a culture of safety and aims to actively
reduce the risk of syringe injuries for staff, consumers, patients, clients, and others.
We do this by providing syringe injury prevention equipment, syringe injury
prevention training, and contracted handling and disposal services in accordance
with state law and regulations.
After watching this module, you’ll be able to do the following:
• Define sharps and sharps injury prevention
• Describe the connection between harm reduction and sharps injury prevention
• Describe Housing Works Exposure Control Plan
• Identify risks
• Learn how to handle sharps safely
• Learn how to dispose of sharps
• Describe the needlestick protocol
• Identify best practices for infection control
• Describe how to handle spills and using spill kits
• Review overdose prevention at Housing Works

Sharps Injury Prevention: Common Questions
What is a sharp?
• The word sharp or sharps refers to a syringe, needle, or lancet.
Where might sharps be found within the Housing Works community?
• Sharps are most often used by licensed practitioners in Housing Works medical facilities.
• Sharps are also used by Housing Works staff, residents, or community members who manage serious
health conditions by self-administering injections or performing blood tests. For example, people with
diabetes use syringes to inject their own insulin and use lancets every day to test their blood glucose.
• Sharps may also be used by a person who is injecting hormones as part of a medical transition.
• Sharps may also be used by people who use drugs.
• A person using a Sharp in one of our facilities may be a staff member, a consumer, a patient, a client, a
visitor, or a customer.

Sharps Injury Prevention: Common Questions
What is covered under the Sharps Injury Prevention Program?
• Housing Works provides specific guidance outlined in the Sharps Injury Prevention Program
Policy and in this training. This policy supersedes all other documents -- including this
training. The policy outlines the Housing Works plan for education, equipment, proper
handling and disposal, managing spills, and needlestick protocols.
Why is it important for all Housing Works staff members to learn about sharps?
• As an organization that provides healthcare and operates using the Harm Reduction
model, sharps are (and will always be) present at our sites and facilities.
• We seek to reduce harm associated with the presence of sharps, and we aim to educate all
staff to increase proficiency around sharps injury prevention and community safety.

What is Harm
Reduction?
• Harm reduction is set of practical
strategies and ideas aimed at reducing
negative consequences associated with
drug use.
• Harm reduction is a movement for
social justice built on a belief in, and
respect for, the rights of people who
use substances.
• Harm reduction incorporates a
spectrum of strategies from safer use to
managed use to abstinence to meet
people who use substances where they
are.

Principles of Harm Reduction
The National Harm Reduction Coalition considers the following principles central to harm reduction practice:
1. Accepts, for better and or worse, that licit and illicit drug use is part of our world and chooses to work to minimize its harmful effects rather
than simply ignore or condemn them.
2. Understands drug use as a complex, multi-faceted phenomenon that encompasses a continuum of behaviors from severe abuse to
total abstinence and acknowledges that some ways of using drugs are clearly safer than others.
3. Establishes quality of individual and community life and well-being–not necessarily cessation of all drug use–as the criteria for successful
interventions and policies.
4. Calls for the non-judgmental, non-coercive provision of services and resources to people who use drugs and the communities in which they
live in order to assist them in reducing attendant harm.
5. Ensures that drug users and those with a history of drug use routinely have a real voice in the creation of programs and policies designed to
serve them.
6. Affirms drugs users themselves as the primary agents of reducing the harms of their drug use and seeks to empower users to share
information and support each other in strategies which meet their actual conditions of use.
7. Recognizes that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination and other social inequalities
affect both people’s vulnerability to and capacity for effectively dealing with drug-related harm.
8. Does not attempt to minimize or ignore the real and tragic harm and danger associated with licit and illicit drug use.

Harm
Reduction and
Sharps Injury
Prevention:
What's the
Connection?
• Housing Works serves people who use
substances, among other populations. Our
goal is to acknowledge the realities of drug use
while actively reducing harm for the person
using drugs and for the larger community.
• Housing Works staff and community members
may encounter individuals who use sharps
or use sharps themselves at Housing Works
clinics, facilities, thrift shops, and other sites.
Our goal is to empower all staff with evidence-
based best practices to reduce risk for all
members of the community.

Exposure
Control
Plan
• The Housing Works Exposure
Control Plan outlines all Housing
Works policies and procedures
regarding syringe safety.
• We will cover key elements of the
policy in this training, but please
refer to the policy posted on the
intranet for guidance.

Identifying Risk
Staff with the job classification listed below
are considered at reasonable risk for exposure to
sharps and other potentially infectious materials:
Direct Client Care (across all departments) Non-Direct Client Care
All Medical Staff Clinical Support Staff
Physicians Facilitates Staff
Nurse Practitioners Social Workers
Physician Assistants Case Managers
Psychiatrists/Psychologists CASACs
Registered and Licensed Practical Nurses Client Representatives
Medical Assistants Peer Workers
Security Staff
Residential Aid
Outreach Workers
Volunteers whose tasks
resemble those performed by
persons in the above job
classifications
NEW CHART

Identifying
Risk • Executive Directors/Senior Administration
• Finance
• OST
• Human Resources
• Nutritionists
• Medical Records Staff
• Messenger (for mail only)
• Pharmacy
• Volunteers whose tasks resemble the tasks performed by
those in the above job categories
Employees with the job classification
listed are not considered at reasonable
risk for exposure to sharps and other
potentially infectious materials:

How to Handle Sharps Safely:
Using Proper Containers
• All sites will appoint a Sharps Safety Point Person who will manage
the disposal contract, schedule, and maintain appropriate
educational materials.
• All sites will have a sharps container holder(s) and sharp
container(s). To get this equipment, the site will submit a Facilities
Work Order on the Intranet (The Lobby) in order to request
installation of a syringe container holder. A copy of the work order
request will be submitted to the Compliance Subcommittee
Chair. (Please Remove)

How to Handle Sharps Safely:
Managing a Sharps Container
The site regularly monitors the sharps container to identify capacity at 2/3 full.
The Sharps Safety Point Person will then remove the sharps container and ensure secure storage between
removals.
When moving containers of contaminated sharps
from the area of use, the containers shall be:
- Closable
- Constructed to contain all contents and prevent leakage during handling,
storage, transportation or shipping
- Labeled with a Biohazard sign in accordance with state laws.
When removing the sharps container, the Sharps Safety Point Person should wear clothing that provides
some protection against needlestick. This includes long pants, long sleeved shirts, and closed footwear.
Sites are responsible for reporting any additional maintenance issues to the facilities staff by placing
a Facilities Work Order on the Intranet (The Lobby).

How to Handle Sharps Safely:
Sharps Outside of Proper Containers
It is possible that a staff member or volunteer will encounter a sharp(s) which have not been placed safely in
the sharps container. If you encounter an inappropriately placed syringe, follow the steps listed below:
1. Clear others from the area who may accidentally touch or make physical contact with the sharp(s)
2. While you or someone else is maintaining distance around the area, have someone notify your supervisor or lead staff member on site
3. If you at a site where a member of facilities is present, get support
4. If you are handling the syringe yourself, always wear gloves (puncture proof when available) when handling sharps
5. Handling should be kept to a minimum and forceps should be used whenever possible
6. Never attempt to re-sheath a needle
7. Dispose of the syringe in the nearest appropriate container. If a sharps disposal container is not available, place the syringe in a puncture
resistant container with a secure lid
8. NEVER put sharps in a garbage can, recycling bin, or any other open container
9. Immediately place an incident report on the Intranet (The Lobby).

How to Handle Sharps Safely:
Safe Disposal/Handling
Why is safe disposal of used sharps critically important?
• Protects family members, workers, pets, and anyone who handles trash and recyclables from
illness and injury
• Prevents sharps from being reused or shared
• Prevents the spread of viral and bacterial infections like HIV, hepatitis C and syphilis
• Protects the environment
• The Sharps Safety Point Person will manage the sharps container, the disposal contract, and
secure storage of the containers between removals.
• If you witness improper handling of sharps at your site, please submit an Incident Report on
the Intranet (The Lobby) and notify your supervisor.

Safe
Disposal of
Sharps for
Individuals
Part of what we aim to do at
Housing Works is to inform
community members on how to
keep themselves safe when using or
handling sharps. We will cover best
practices in two steps:
1. Containment
2. Disposal

Safe Disposal
of Sharps for
Individuals:
Containment
DO:
 Obtain a sharps container for your home (see next slide
for information on how to obtain)
 Put sharps into your container as soon as you use them.
 Keep the container closed and away from children and
pets.
 Bring an appropriate container with you when you travel.
DO NOT:
× Put your used sharps container in the trash.
× Don’t flush sharps down the toilet or drop them into a
sewer drain.
× Don’t clip, bend, or put the cap back on used sharps.
× Don’t put sharps or sharps containers in with the
recyclables.
× Don’t put used sharps in soda cans, milk cartons, glass
bottles, or containers that can be broken or punctured.
× Coffee cans are not safe because the plastic lids come off
easily and may leak.
Containment is critical for safety
when using sharps. Here are some
best practices as outlined by the New
York State Department of Health:

Safe Disposal of
Sharps for
Individuals:
Obtaining Sharps
Containers
• Your local drugstore
• Syringe Exchange Programs
• NYS Safe Sharps Collection sites
• Visit: health.ny.gov/sharps-collection
• The American Diabetes Association can provide you with
additional information on how to obtain them.
• Call: (800) 342-2383
• Other options
• Visit:
health.ny.gov/diseases/aids/consumers/prevention/
Where to Obtain Sharps Containers

Safe Disposal of
Sharps for
Individuals:
Obtaining Sharps
• You can obtain clean sharps through our Housing
Works Harm Reduction Programs at:
• Ginny Shubert Center for Harm Reduction– 301 W
37th Street, NY, NY 10018
• Keith D. Cylar Community Health Center – 743-
749 E 9th Street, NY, NY 10009
Where to Obtain Sharps
New Slide

Safe Disposal of Sharps for
Individuals: Disposal
Below are four methods of disposing syringes and other sharps collection sites exist across New York State:
1. Housing Works Harm Reduction Programs at the Ginny Shubert Center for Harm Reduction and Keith D. Cylar Community
Health Center
2. Locate a hospital in your region
• Go to NYS Health Profiles to search by region or county and ask to be connected to their Sharps Coordinator
3. Locate a nursing home in your region
• Go to NYS Health Profiles to search by region or county and ask to be connected to their Sharps Coordinator
4. Pharmacies, health clinics, community-based organizations, mobile van programs, public transportation facilities, housing
projects, police stations, waste transfer stations and other venues have become settings for safe sharps and offer syringe
collection drop boxes (or "kiosks") to help facilitate the safe collection of used sharps.
• Go to Alternative Collection Site Directory to search for a location near you

Safe Disposal of Sharps for Individuals:
Disposal
• Service providers may share these directories to educate clients and to refer them to
convenient places in the community where they can safely dispose of their household
sharps.
• Although every attempt has been made to keep the directories updated, service
information may have changed since data was collected. Before visiting the location,
call the phone number of the site you are interested in to confirm program
information. Information posted on this website will be updated regularly as new
information becomes available.
• Facilities wishing to update information about their community sharps collection sites
should e-mail their updated information to ESAP@health.ny.gov

Needlestick Protocol
In the event of a needlestick, please follow the below needlestick protocol:
1. Following exposure to blood or body fluids, the skin should be washed immediately with soap and water. Mucous
membranes, such as the eyes, should be flushed immediately with water.
2. Puncture wounds should be covered with a dry gauze dressing after cleansing the wound with soap and water.
3. The staff member must notify their supervisor immediately after a blood borne pathogen exposure and report as soon as
possible to the appropriate employee health service for further evaluation and possible treatment.
4. After receiving notification of needle stick injury, the supervisor should inform the staff member that treatment is
covered by Worker’s Compensation and immediately contact Human Resources to initiate the coordination of benefits as
applicable to Worker’s Compensation law. The supervisor should also refer the staff member to follow-up with Human
Resources after receiving initial medical treatment.
5. When presenting for medical treatment, the staff member should inform the clinical staff of the nature of the injury and
its eligibility for Worker’s Compensation coverage.
6. Staff members should not utilize their insurance nor pay out of pocket for any services.
7. Emergent services should be provided, and the Health Center Director should coordinate with the Human Resources,
Billing, and Pharmacy Departments regarding documentation, processing, and payments.
8. Post-exposure prophylaxis will be provided free of charge by Housing Works.
9. After evaluation by the medical staff, the staff member will notify the Associate Medical Director of the name of the
source client to facilitate testing of the client for HIV, Hepatitis B, and Hepatitis C.

Needlestick Protocol Continued
10. The medical provider will counsel the client and obtain consent for HIV and Hepatitis testing. Clients with known HIV, Hepatitis
B, or Hepatitis C will not be re-tested. The exposure prophylaxis will be started as soon as possible by a Housing Works provider
or the employee’s primary care provider, depending on employee’s preference.
11. If the employee chooses to receive treatment at Housing Works primary care, the employee will be followed up for post-
exposure prophylaxis based on current guidelines.
12. Results of the source client's testing shall be made available to the exposed staff member, who will be informed of applicable
laws and regulations concerning disclosure of the identity and infectious status of the source client.
13. The staff member and their supervisor will complete an incident report via The Lobby within 24 hours.
14. The completed incident report will be filed by Human Resources in the confidential personnel file of the injured staff member
along with the documentation of medical care received through employee health.
15. The Director of Nursing will provide the aggregated number of needle sticks/sharps injuries/exposures to blood-borne
pathogens to the Compliance Officer monthly. They will also investigate the events surrounding the injury including the
function of safety equipment used at the time of the incident.
16. The Department Supervisor will follow up with Compliance regarding the status of the incident and work with Compliance on a
plan of correction to avoid future needle sticks.
17. On a monthly, the FQHC Risk and Compliance Committee will receive and review aggregate data on the total number of
incidents related to needle stick injuries.

Infection Control
At our sites, it is necessary to follow Universal/Standard Precautions for infection control.
This includes:
• Maintaining cleanliness at all sites by wiping down surfaces and performing other standard cleaning
procedures
• Wearing appropriate PPE (Personal Protective Equipment) such as gloves, gowns, masks, eye, and face
protection
• Wash your hands after removing gloves
• Never reuse equipment for another patient/resident until it has been cleaned and reprocessed appropriately
• Place potentially contaminated or infectious waste in a container that is coded or labeled with a Bio-hazard
label in accordance with state law.
• Treat all human blood and body fluids as if they were infectious for blood borne pathogens. The CDC
recommends that these precautions apply to blood, all body fluids, secretions, excretions (except sweat), non-
intact skin, mucous membranes

Infection Control Continued
• Hand hygiene is the single most
effective measure to reduce the risk of
spreading infections.
• Staff and volunteers should always
wash their hands when they are visibly
soiled, before eating, and after using
the restroom.
• Alcohol-based hand sanitizers should
be used in conjunction with proper
hand washing, but alcohol-based
sanitizer cannot replace proper hand-
washing procedure.

Infection Control:
Hepatitis B and HIV
• Hepatitis B is caused by a virus that attacks the liver and can be passed through blood and
other body fluids.
• All Housing Works staff members who are required to have a Hepatitis B vaccine for their role
(primarily Healthcare workers), can get a vaccine for free at a Housing Works Healthcare site. If
you fall outside of this category but would like to inquire about getting this vaccine, please
reach out to a Housing Works Healthcare site to find out more information.
• HIV can also be transmitted through body fluids such as blood, semen, vaginal fluids, and
breast milk. To prevent exposure, all health care workers should use appropriate barrier
precautions to prevent skin and mucous membrane exposure when in contact with blood and
other body fluids of all patients.
• All known or suspected exposures must be reported immediately to a supervisor immediately.
• A confidential medical evaluation and follow up is available for all staff/volunteers.
• If the exposure is through a needlestick, please refer to the needlestick protocol.

How to Handle Spills and Use Spill Kits
• Spills refer to any exposed quantity of bodily fluids or any liquids which may contain bloodborne
pathogens.
• A spill kit contains the needed materials to safely address a spill and are located at each site. Find out
where the spill kit is located at your site so you know where to look, should you ever need to use it.
• Steps to effectively managing spills:
1. Prevent direct contact with the spill during the cleanup process and minimize the risk for infection,
disposable protective clothing must be worn. This includes gloves, combo mask/ safety shield, and
a protective apron.
2. Contain and remove a spill by applying a solidifying agent and using a scoop/scraper to collect the
contents in a biohazard bag.
3. Disinfect the contaminated surface area using a germicidal cleaning agent.
4. Dispose of any materials used to clean the spill, gloves, safety shield, wipes, and apron into a
biohazard bag and dispose of the bag in accordance with state law.
5. Sanitize hands using soap and water after the immediate cleanup is complete.

Overdose Prevention
• As a harm reduction organization, we understand that licit and illicit drug use is a
reality in our community. We serve individuals who use drugs every day, and we
serve many folks that are specifically using opioids.
• Did you know…
o In 2021, there were 80,816 overdose deaths due to opioid use in the United
States.
o 71,238 of those involved Synthetic Opioids (fentanyl), an increase of 23%
over the previous year.

Overdose
Prevention:
Know the
Facts
What is an overdose?
• An overdose (OD) happens when a toxic amount of a drug or a combination
of drugs overwhelms the body. Opioid overdose causes the person
to become non-responsive because opioids fit into specific receptors
that slow the also affect the drive to breathe. Lack of oxygen can quickly lead
to catastrophic consequences. Within 3-5 minutes without oxygen brain
damage starts to occur soon followed by death.
How can you tell if someone is overdosing?
• Common overdose symptoms  shallow breathing, weak pulse, clammy
skin, coma, death from respiratory arrest, cyanosis (bluish skin), severely
constricted pupils, non-responsive
How can a person reverse an opioid overdose?
• All staff members should be trained to safely administer Naloxone. Naloxone
is a medication used to counter the effects of opioid overdose.
How can I get trained to use Naloxone?
• Housing Works offers Overdose Prevention Training at all new hire
orientations and twice a month for any staff or volunteer. The full schedule of
training dates can be found by going to the Intranet (The Lobby) and going to
Useful Information  HW Learning  Get to Know: Naloxone Overdose
Prevention Trainings.

Exposure
Control Policy
The full Housing Works Sharps Injury Prevention Program
policy can be found on the Intranet. To find the policy,
complete the following steps:
1. Go to www.intranet.housingworks.org
2. Log in with your Housing Works email and password (same as
Outlook)
3. Click on “Useful Information” near the top of the page
4. Then, click on “HW Learning” from the list of topics below
5. Scroll to the grey block called “Get to Know: Exposure
Control” and click
6. The visible/downloadable policy can be found in the pink link
titled, “Exposure Control Policy”
7. The policy is also available by going to “Useful Information” 
“Policies and Procedures by Department”  “Health Services
Policies”

For More Information
• Additional questions or further support on sharps injury
prevention
Contact: Gillian Saunders
Director of Healthcare Compliance and Special
Projects
g.saunders@housingworks.org
• Urgent concerns
Contact: ShellyAnn Bell
Director of Nursing
s.bell@housingworks.org

Assessment
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