Selection, evaluation and use of sharps box (Serialization 4)

II-Sharp Box
A. Performance standards
Target group research shows that there are four main standards for the safety performance of sharps handling devices: functionality, accessibility, visibility, and adjustability. These four standards are described in more detail as follows:
 Functionality: The containers should maintain their functionality throughout their service life (for example, these containers should always be durable and closed, have leak-proof and perforated effects on the bottom and sides, and can last until the final disposal). The number of sharps boxes should be sufficient. A single container should have sufficient volume and remain safe until the beginning of the treatment.
 Accessibility: The container should be accessible to workers who use, hold or handle sharp equipment. The container should be placed in a convenient place and portable in the work space if necessary.
 Visibility: The staff using the container should be clearly visible to the container. Workers should see the full scale of the container, appropriate warning labels and color coding.
 Compatibility: The container should be adjustable to facilitate users and supporting equipment. The container should be environmentally friendly (for example, no heavy metals and composed of recyclable materials). Adjustability also includes easy storage and assembly of the container and simple use.

1. Functional criteria
Under normal use and storage, handheld, installation, use, closing and transportation, the container for handling sharps should be designed to be thick enough and durable, leak-proof and perforated. Therefore, user and equipment requirements can be met before final treatment. Appropriate temperature changes during use or storage of the container cannot affect its durability and perforation resistance. The fixing and support equipment used for installation should also be durable.

Barrier material performance. The sharps box should prevent chemical or liquid penetration or degradation, perforation, cracking and abrasion.

Closed mechanism. The closing mechanism should be designed so that the user can touch the contents of the container and touch the wounds on his hands as little as possible before the final treatment. Once the final closing mechanism of a container for handling sharps is opened, the container cannot be opened artificially.
stability. When the container is placed on a horizontal surface and used for the activities described in the product label, the container (including wheeled and non-wheeled) should remain stable. Some manufacturers provide pallets, supports, and shells to keep their containers stable in certain applications. The use of these items should be specified in the label.
Size and shape. Where staff use sharps and equipment, there should be a sufficient number of sharps boxes of appropriate size and shape. The size of the sharps box should be large enough to accommodate the largest sharps used in the work area where it is placed. The container should also contain special shaped sharp tools that need to be processed. The minimum standard is to provide at least one sharps box where every sharp weapon may be produced or distributed.

The sharps box should also be large enough to contain the sharps generated during maintenance activities. Providing a sharp container of sufficient size will minimize the possibility of overfilling the container, which will ensure safe production.

Fixing frame. The holder of the sharps box should be solid and reliable and easy to clean and repair.

2. Accessibility guidelines
Processing switch or admission mechanism. The design of the sharps box should ensure the safe handling of sharps. The sharps box should be simple and easy to use. When the user expects the use in the vertical direction, the closing, sealing and transportation of the sharps box, the disposal switch should prevent the leakage of the contents (solid or liquid) until the final disposal. The design of the sharps box should minimize the possibility of the inserter being held and stabbed or the sharps placed disorderly when the sharps are placed in the box. For the user, the handling switch should be identifiable, barrier-free and conducive to one-handed handling.

In some areas where sharps box equipment is used, safety is an issue. For example, in order to prevent children and other people from putting their hands in the sharps box, one should choose a sharps box with a device that prevents hands or fingers from reaching into the box. The device that restricts children's touch must not prevent the staff from opening the sharps box's sight. Harm to visitors is also a problem. The equipment should choose a sharps box that solves these problems.

handle. For some designs, the handle should facilitate safe manipulation of the sharps box. If there is a handle, the handle should be strong enough to prevent the sharps box from breaking during use and transport before final disposal. The handle should be placed higher than the container is full, and when using the handle, the user's hand should not be too close to the disposal switch.

The location of the sharps box. The reasonable placement of the sharps box should ensure that the user can see and easily get the sharps box on a horizontal surface. The location of the sharps box should comply with existing state or local regulations or specific permits or certification standards. When the container is fixed on a wall or other permanent point, its vertical height should allow the user to see the opening of the container and use the container.

The sharps box should be placed where there is no obstacle or furniture between the point of use and the container. Accidents are easily released when the sharps box is placed in an inconvenient or unsafe place. These unsafe placement positions may cause users to make unnecessary movements when holding sharp tools and opening the sharps box. Placing the sharps box outside the ward also increases the risk of accidents. Examples of inappropriate placement include placing it in the corner of the room, behind the door of the room, under the cupboard, inside the cupboard door, and under the washbasin, where people may sit or lie down. Places under containers, near light switches, indoor environmental controls, or on the way to public equipment systems, near mailboxes, or places where the container will obstruct the function and movement of pedestrian passages, mobile equipment, gurneys, wheelchairs or moving doors. A standard use process should be established to ensure that users can dispose of the equipment as quickly as possible after use-the best thing is that there is no need to put down the equipment and pick it up again.

In special circumstances, innovative sharps box placement methods and safety measures may be required. Examples of these special circumstances include children, elderly and mental wards or corrective equipment. If necessary, in places with many patients and visitors, the sharps box should be placed in a lockable fixture. In the emergency room, the sharps box may need to be placed on wheels to help the gurney move and monitor equipment. In some cases, in order to assist the use of the gurney, it is also appropriate to place the sharps box directly on the gurney. Although some pediatric equipment places the sharps box high on the wall to prevent them from being touched by children, it should not be placed too high because it will hinder the safe access of the staff.

Installation height. Mounting the container at a suitable height will reduce the user's injuries related to sharp weapons. The sharps box should be placed below the line of sight of the point of use, one arm away. For a permanent fixed, wall-mounted container, an ergonomically acceptable installation height range can be obtained from Schedule B
Is calculated. A standard anthropometric table can be used to measure the range of normal human movement. The fixed height is usually sufficient for 95% of adults. The following criteria can be used to determine the ideal range of the fixed installation height: (1) The user’s view of the container opening is clear and unobstructed (2) The container should be located where the arm can reach (3) The fixed height should be lower than The sight of 95% of adult female staff. These three requirements specify a feasible installation range of 52-56 feet in a standing work site and 38-42 feet in a sitting work site. The upper and lower ranges of the installation height are calculated based on the reach of the user. Attached Table B is a complete explanation on calculating feasible installation heights.

Other ergonomic alternatives include: (1) On the sitting workbench, for a fixed-height sharps box device, use a telescopic arm to bring the sharps box closer to the work surface. (2) Provide a height-adjustable chair to allow the staff to see the entire surface from a sitting workbench. (3) Use brackets so that users can adjust the container (attachment B).

3. Visual criteria
In order to reduce the probability of skin damage, the sharps box should be visible and identifiable. Safe handling of sharps requires a clear view of sharps and containers. Before the sharp object is placed in the container, the user should see the handling switch or access mechanism and the current capacity.

The sharps box should have a risk warning label. The color of this label and instrument indicates danger and is visible to the user. The purpose is to alert the user of the potential risks before the sharp tool is put in. Before the sharp tool is put in, the user can easily observe the current capacity. Sufficient instructions are needed on the container to determine whether there are sharp objects protruding from the container or whether the opening mechanism and holding points of the container are severely soiled. Under the light of the installation location, the current capacity of the container should be observed. The safety features, protective measures, and aesthetics of the container should not hinder the identification of the container, the current capacity of the container, warning signs, or processing entrance.

The Occupational Safety and Health Administration’s blood-borne pathogen standard [29 CFR 1910.1030, section(g)(1)(I)(C)] includes special requirements for the labeling of contaminated sharps. These labels should be fluorescent orange or fluorescent orange or mainly such, and use contrasting colors for letters or logos. This standard also requires the placement of biohazard signs and the word Biohazard; however, note that the red bags and containers in section (g)(1)(I)(E) may be replaced by labels.

4. Acceptability criteria
The sharps box should be adjusted according to the user, equipment and environment. Compatibility is a measure of ease of storage and assembly, minimum worker training requirements, simple operation and adjustable design. The container design should improve one-handed operation. The design and finished product should minimize the surface of sharp objects and cross-infection. Special aesthetic, functional and safety features should not hide or hinder contact with the container and the opening and closing process of the container. The user should be able to assemble the container easily, and if necessary, the bracket should be safe, durable, reliable, clean and locked. Putting the sharps box into the holder and taking it out of the holder should be simple and feasible, and safety should not be lost due to this. In order to ensure the stability and function of the bracket, the bracket should only be used by the matching sharps box. It is an unsafe and ineffective attempt to adjust the bracket to accommodate the mismatched sharps box.

The container should be designed to be simple and usable. The manufacturer of the sharps box should provide users with recommended training content, which may include the following:
 1. Assembly instructions
 2. Safety precautions
 3. Maintenance standards for non-disposable containers
 4. Optimal storage conditions
 5. Warranty Information
 6. Cleaning recommendations (for non-disposable containers and their holders)
 7. Container scrap conditions (for non-disposable containers and their holders)
 8. Where do you need two or more materials
 9. Precautions for handling sharps box
 10. If necessary, retrain information regularly