PREVENTION OF SHARP INJURIES IN HOSPITALS AND HEALTH CARE ESTABLISHMENTS ORDER

AND HEALTH CARE ESTABLISHMENTS

SUBSIDIARY LEGISLATION 465.11

PREVENTION OF SHARP INJURIES IN HOSPITALS

AND HEALTH CARE ESTABLISHMENTS ORDER

28th May, 2013

LEGAL NOTICE 151 of 2013, as amended by Act XXXIII of 2024.

The title of this order is the Prevention of Sharp Injuries in

Hospitals and Health Care Establishments Order.

In this Order, unless the context otherwise requires

"employer" means any natural or legal person responsible for

managing, organising and providing healthcare and directly related

services or activities delivered by workers having an employment

relationship with a worker and includes contractors and sub-

contractors;

"hierarchy of measures" means the order of effectiveness of

measures taken to avoid, eliminate and reduce risks as defined in article

12(2) of the Health and Safety at Work Act;

"preventive measures" means those measures taken to prevent

injury and, or transmission of infection in the provision of hospital

and healthcare directly related services and activities, including the

use of the safest equipment needed, based on the risk assessment

and safe methods of handling the disposal of medical sharps;

"sharps" means objects or instruments necessary for the exercise

of specific healthcare activities, which are able to cut, prick, cause

injury and, or infection;

"worker" includes any person employed by an employer

including trainees, students and apprentices in the hospital and

healthcare sector and directly related services and activities

irrespective of whether such employment is of a permanent or

temporary nature;

"workers’ representatives" and "workers health and safety

representatives" shall have the same meaning as prescribed in the Health

and Safety at Work Act and relative subsidiary legislation;

"workplace" includes any healthcare organisation or service in

both the public or the private sectors, and every other place where

health services and, or activities are undertaken and delivered,

under the managerial authority and supervision of the employer.

The scope of this Order is to aim at achieving the safest

possible working environment for health care workers by

preventing injuries caused by medical sharps, including needle-

stick injuries, protecting all workers at risk through the

establishment of policies in risk assessment, risk prevention,

training, information, awareness raising and monitoring and putting

in place response and follow up procedures.

AND HEALTH CARE ESTABLISHMENTS

The provisions of this Order shall apply to all workers in the

hospital and healthcare sector, and all who are under the managerial

authority and supervision of an employer.

Without prejudice to any obligations under any other law, it

shall be the duty of the employer

(a) to ensure the safety and health of workers in every

aspect related to their work, including psycho-social

factors and work organisation;

(b) to develop an environment where workers and their

representatives are participating in the development of

health and safety policies and practices;

(c) to ensure the provision of training on the prevention of

the risk of injuries and infections from medical sharps;

(d) to provide the necessary resources to minimise the risk

of occupationally acquired injuries or infections;

(e) to promote a no blame culture focusing incident

reporting procedures on systemic factors rather than

individual mistakes.

Without prejudice to any obligations under any other law, it

shall be the duty of the worker

(a) to take care, as far as possible, of his own safety and

health and that of other persons affected by his actions

at work, in accordance with their training and

instructions given by his employer;

(b) to undertake the training offered by his employer on

the prevention of the risk of injuries and infections

from medical sharps;

(c) to make use of the resources supplied by the employer

to minimise the risk of occupationally acquired

injuries or infections.

It shall be the responsibility of the employers, workers and

workers’ representatives to work together to prevent and eliminate

risks, protect workers’ health and safety, and create a safe working

environment, carry out consultation regarding the choice and use of

safe equipment, identifying how best to carry out training,

information and awareness-raising processes.

(1) Risk-assessment procedures shall be conducted by the

employer in compliance with the requirements of the General

Provisions for Health and Safety at Work Places Regulations, and

the Protection of Workers from Risks related to Exposure to

Biological Agents at Work Regulations, and without prejudice to

the generality of the foregoing they shall

(a) include an exposure determination, taking into account

the importance of a well resourced and organised

working environment;

(b) take into account all situations where there is injury,

blood or other potentially infectious material;

AND HEALTH CARE ESTABLISHMENTS

(c) take into account technology, organisation of work,

working conditions, level of qualifications, work

related psycho-social factors and the influence of

factors related to the working environment.

(2) The aim of the risk assessment shall be to identify how

exposure could be eliminated and to consider possible alternative

systems.

Where the results of the risk assessment carried out in

terms of regulation 8 reveal a risk of injuries by medical sharps

and, or infection, workers’ exposure shall be eliminated by

implementing the following measures

(a) the specification and implementation of safe

procedures for the use and disposal of sharp medical

instruments and contaminated waste; such procedures

shall be regularly reassessed and shall form an integral

part of the measures for the information and training of

workers referred to in this Order;

(b) the elimination of the unnecessary use of sharps by

implementing changes in practice and on the basis of

the results of the risk assessment, providing medical

devices incorporating safety-engineered protection

mechanisms;

(c) the banning of the practice of recapping with

immediate effect;

(d) the placing of effective disposal procedures and

clearly marked and technically safe containers for the

handling of disposable sharps and injection equipment

as close as possible to the assessed areas where sharps

are being used or to be found;

(e) the prevention of the risk of infections

by

implementing safe systems of work, by

(i)

developing a coherent overall prevention policy,

which covers technology, organisation of work,

working conditions, work related psycho-social

factors and the influence of factors related to the

working environment;

(ii) providing the necessary training;

(iii) conducting health surveillance procedures, as

provided by the Protection of Workers from

Risks related to Exposure to Biological Agents

at Work Regulations; and

(f)

the use of personal protective equipment.

(1) If the assessment referred to in regulation 8 reveals that

there is a risk to the safety and health of workers due to their

exposure to biological agents for which effective vaccines exist,

then it shall be the duty of the employer to offer vaccination to the

workers.

AND HEALTH CARE ESTABLISHMENTS

(2) Vaccination and, if necessary, re-vaccination shall be carried

out in accordance with the schedules and recommendations

established by the Superintendent of Public Health

Provided that workers shall be informed of the benefits and

drawbacks of both vaccination and non-vaccination and that the

vaccination is offered free of charge to all workers.

As regards sharps it shall be the duty of the employer,

without prejudice to any other obligation under any other law, to

take the appropriate measures to

(a) highlight the different risks;

(b) give guidance on existing legislation;

(c) promote good practices regarding the prevention and

recording of incidents and, or accidents;

(d) raise awareness by developing activities and

promotional

materials

in

partnership

with

representative trade unions and, or workers’

representatives;

(e) provide information on support programmes available.

(1) In addition to those measures established under the

Occupational Health and Safety Authority Act and its subsidiary

legislation, employers shall provide the necessary training on a

regular basis taking into account results of monitoring,

modernisation and improvements including

(a) the correct use of medical devices incorporating sharps

protection mechanisms;

(b) induction programmes for all new and temporary staff;

(c) the risk associated with blood and body fluid

exposures;

(d) preventive measures including standard precautions,

safe systems of work, the correct use and disposal

procedures, the importance of immunisation,

according to the procedures at the workplace;

(e) the reporting, response and monitoring procedures and

their importance; and

(f)

measures to be taken in case of injuries.

(2) Employers shall ensure that workers are released in order to

attend the training provided.

(1) The employer shall set up a procedure whereby all

sharp injuries can be reported. This shall be done in consultation

with the workers’ health and safety representatives.

(2) It shall be the responsibility of workers to immediately

report any accident or incident involving sharps to the employer or

to any other person so delegated by him.

AND HEALTH CARE ESTABLISHMENTS

Upon receipt of a report of an injury, the employer shall

(a) immediately take the necessary steps for the care of

the injured worker, including the provision of post-

exposure prophylaxis and the necessary medical tests

where indicated for medical reasons, and the

appropriate health surveillance in accordance with the

Protection of Workers from Risks related to Exposure

to Biological Agents at Work Regulations;

(b) investigate the causes and circumstances leading to the

injury and record the accident or incident, taking,

where appropriate, the necessary action; workers shall

provide the relevant information at the appropriate

time to complete the details of the accident or incident;

(c) consider the need for counselling of workers, where

appropriate, and guarantee medical treatment;

(d) maintain the confidentiality of the injured worker and

the diagnosis and treatment resulting from the injury.

It shall be the duty of all employers to ensure compliance

with the provisions of this Order.

Without prejudice to the provisions of any other law, any

breach of these regulations shall be deemed to be a breach of the

Public Health Act and shall be subject to the penalties contained in

the said Act.