Re: Height of wall mounted sharps containers / trolley mounted.

[Montague, Cathi (Health)]

Hi this is an old post but just checking and wasn’t sure if I could ask Terry directly off list?

The height of trolley mounted sharps apertures from Terrys advice below is 900mm.

I wanted to give a little leeway in our audit to account for different trolleys.

Is it reasonable (given the variation in AHFG height guides) to require 800-900mm for audit purposes?

(I can see a plethora of requirements to replace all trolleys etc to meet the 900mm height exactly if we ask for this in an audit!)

With thanks,

Best regards,
Cathi

Cathi Montague, RN,(Midwife), ENB998, MClinNsg, FCENA

High quality, compassionate healthcare | Infection Prevention and Control is everyones’ business
Nurse Management Facilitator | Clinical Care Systems Co-ordination
SA Prison Health Service – Corporate Office
Central Adelaide Local Health Network
5 Darley Road (first floor), Paradise SA 5075
Postal address: PO Box 101, 620 Lower North East Road, Campbelltown SA 5074
We would like to acknowledge this land that we meet on today is the traditional lands for Kaurna people and that we respect their spiritual relationship with their country. We also acknowledge the Kaurna people as the custodians of the Adelaide region and that their cultural and heritage beliefs are still as important to the living Kaurna people today.

This email may contain confidential information, which also may be legally privileged. Only the intended recipient(s) may access or use this email. Distribution or Copying must only be with the express consent of the sender. If this email is received in error, please inform the sender by return email and delete the original. If there are doubts about the validity of this message, please contact the sender by telephone. It is the recipient’s responsibility to check the email and any attached files for viruses.

Hi all,
Not sure if my first email (below) was distributed but would like to comment on the great replies coming in…

* Although Australia has no regulations on sharps container (SC) heights, there are national guidelines (AHFG; HB260-2003) and these are picked up in some state recommendations.

* I strongly advise against using the NIOSH 1998 Evaluation, Selection and Use of SC – it’s 52″-56″ recommendation is based on USA white 1970’s population and is dangerously high.

* Close scrutiny of individual rooms in the AHFG guide show heights are inconsistent and range from 800mm-1300mm but….the 900mm is (correctly) for trolleys and 1100mm (correctly) for walls. 1300mm for resusc wall is too high.

* The height should accommodate your shortest staff (or at least 95% of them) and given nurse shortages (forgive the pun), immigrant nurses from Asian countries are commonly 10cm shorter than Caucasian Australian nurses.

* I recommend “70% of shoed 5th percentile height” and this means aperture height for shoed 5th percentile Australian females is 1091mm; and for Vietnamese or Filipino nurses is 1015mm.

So, given ethnic mix among Australian females, an aperture height 1.1 – 1.2m above floor appears reasonable.

Best regards, Terry

Terry Grimmond FASM, BAgrSc, GrDpAdEd
Consultant Microbiologist
Grimmond and Associates
Ph/Fx (NZ): +64 7 856 4042
Mob (NZ): +64 274 365 140
E: tg@gandassoc.com
“This email (including any attachments) is intended only for the use of the individual or entity named above and may contain information that is confidential and privileged. If you are not the intended recipient, you are reminded that any dissemination, distribution or copying of this email or attachments is prohibited. If you have received this email in error, please notify me immediately by return email or telephone and destroy the original message. Thank you.”

Dear Kylie,
There are no national or state regulations stipulating Sharps Container (SC) height in Australia (nor elsewhere that I know of) but there are guidelines. At outset we should agree that it is height of SC aperture in Q. Here are my findings on the matter…
The correct height for SC is one at which staff can safely view down in to the aperture to ensure it is clear and to facilitate safe deposit of sharps and correct activation of tray/door (if present).

The Australasian Health infrastructure Alliance shows the aperture of the wall-mounted SC to be approximately 1.3m off the floor in Acute Patient Bays (http://www.healthfacilityguidelines.com.au/standard_components_lz.aspx), however heights above 1.2m are associated with increased sharps injuries (SI) to HCW (Weltman et al ICHE 1995;16:268-274).
My research indicates that a safe, wall-mounted aperture height is 1.1m – 1.2m above floor level. Epidemiological evidence confirms that staff risk far exceeds child injury risk and at this height I have yet to see a child SI cited.

Historically, SC were placed at “ergonomic height for staff to safely use” – there was no ‘recommended height from floor’. However, the fear of child access caused SC to be raised to non-ergonomic heights to the point where numerous SI to HCW have been reported because they could not see that:

* a tray/door had activated correctly

* the aperture was clear

* the SC was not overfilled;

* a sharp was not retained in the vestibule (throat) of a tray/door SC;

* or that a sharp was protruding from the aperture
NB. Karen Daley the President of American Nurses Association said she acquired HIV and HCV through an SI because the SC was mounted too high.
I have written to CDC’s NIOSH to inform them their 1998 guideline on Evaluation, Selection and Use of SC (http://www.cdc.gov/niosh/docs/97-111/ ) needs updating as they recommend a height of “52-56 inches” (1.32 – 1.42m). They will discuss this at the next, yet to be scheduled review.
SC height is compounded in countries with short-stature staff and also compounded in developed countries where nurse shortages have been filled with staff emigrating from Asia, Phillipines, Mexico, etc – all short-stature countries.

Finally, sharps containers need be mounted to accommodate an institution’s shortest staff, not their average staff.

I hope this is helpful to you.

Terry Grimmond FASM, BAgrSc, GrDpAdEd
Consultant Microbiologist
Grimmond and Associates
Ph/Fx (NZ): +64 7 856 4042
Mob (NZ): +64 274 365 140
E: tg@gandassoc.com
“This email (including any attachments) is intended only for the use of the individual or entity named above and may contain information that is confidential and privileged. If you are not the intended recipient, you are reminded that any dissemination, distribution or copying of this email or attachments is prohibited. If you have received this email in error, please notify me immediately by return email or telephone and destroy the original message. Thank you.”

UNCLASSIFIED
Good Afternoon,

I was wondering where it is actually written that wall mounted sharps containers should be below eye level and minimum height 1.1m so as out of reach of young children, can anyone advise?

Much appreciated.

Regards,

Kylie Long

Flight Lieutenant
Infection Prevention and Control
Clinical Governance & Projects
Garrison Health Operations Branch
Joint Health Command
Department of Defence

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[Louisa Sasko]

Hi,

Can I ask if it is recommended 1100mm from floor… is that 1100mm to the top of the sharp bin or the bottom of the sharps bin (meaning depending on the size of the sharps bin the opening could be higher than others)??

I was asked something along these lines not long ago.

Kind Regards

Louisa Sasko

Clinical Nurse Consultant | Infection Prevention & Control Service – IPACS
Blacktown and Mt Druitt hospitals
Blacktown Hospital
Louisa.Sasko@health.nsw.gov.au

Conjoint Associate Lecturer
School of Medicine
Blacktown Hospital
UWS

Hi this is an old post but just checking and wasn’t sure if I could ask Terry directly off list?

The height of trolley mounted sharps apertures from Terrys advice below is 900mm.

I wanted to give a little leeway in our audit to account for different trolleys.

Is it reasonable (given the variation in AHFG height guides) to require 800-900mm for audit purposes?

(I can see a plethora of requirements to replace all trolleys etc to meet the 900mm height exactly if we ask for this in an audit!)

With thanks,

Best regards,
Cathi

Cathi Montague, RN,(Midwife), ENB998, MClinNsg, FCENA

High quality, compassionate healthcare | Infection Prevention and Control is everyones’ business
Nurse Management Facilitator | Clinical Care Systems Co-ordination
SA Prison Health Service – Corporate Office
Central Adelaide Local Health Network
5 Darley Road (first floor), Paradise SA 5075
Postal address: PO Box 101, 620 Lower North East Road, Campbelltown SA 5074
We would like to acknowledge this land that we meet on today is the traditional lands for Kaurna people and that we respect their spiritual relationship with their country. We also acknowledge the Kaurna people as the custodians of the Adelaide region and that their cultural and heritage beliefs are still as important to the living Kaurna people today.

This email may contain confidential information, which also may be legally privileged. Only the intended recipient(s) may access or use this email. Distribution or Copying must only be with the express consent of the sender. If this email is received in error, please inform the sender by return email and delete the original. If there are doubts about the validity of this message, please contact the sender by telephone. It is the recipient’s responsibility to check the email and any attached files for viruses.

Hi all,
Not sure if my first email (below) was distributed but would like to comment on the great replies coming in…

* Although Australia has no regulations on sharps container (SC) heights, there are national guidelines (AHFG; HB260-2003) and these are picked up in some state recommendations.

* I strongly advise against using the NIOSH 1998 Evaluation, Selection and Use of SC – it’s 52″-56″ recommendation is based on USA white 1970’s population and is dangerously high.

* Close scrutiny of individual rooms in the AHFG guide show heights are inconsistent and range from 800mm-1300mm but….the 900mm is (correctly) for trolleys and 1100mm (correctly) for walls. 1300mm for resusc wall is too high.

* The height should accommodate your shortest staff (or at least 95% of them) and given nurse shortages (forgive the pun), immigrant nurses from Asian countries are commonly 10cm shorter than Caucasian Australian nurses.

* I recommend “70% of shoed 5th percentile height” and this means aperture height for shoed 5th percentile Australian females is 1091mm; and for Vietnamese or Filipino nurses is 1015mm.

So, given ethnic mix among Australian females, an aperture height 1.1 – 1.2m above floor appears reasonable.

Best regards, Terry

Terry Grimmond FASM, BAgrSc, GrDpAdEd
Consultant Microbiologist
Grimmond and Associates
Ph/Fx (NZ): +64 7 856 4042
Mob (NZ): +64 274 365 140
E: tg@gandassoc.com
“This email (including any attachments) is intended only for the use of the individual or entity named above and may contain information that is confidential and privileged. If you are not the intended recipient, you are reminded that any dissemination, distribution or copying of this email or attachments is prohibited. If you have received this email in error, please notify me immediately by return email or telephone and destroy the original message. Thank you.”

Dear Kylie,
There are no national or state regulations stipulating Sharps Container (SC) height in Australia (nor elsewhere that I know of) but there are guidelines. At outset we should agree that it is height of SC aperture in Q. Here are my findings on the matter…
The correct height for SC is one at which staff can safely view down in to the aperture to ensure it is clear and to facilitate safe deposit of sharps and correct activation of tray/door (if present).

The Australasian Health infrastructure Alliance shows the aperture of the wall-mounted SC to be approximately 1.3m off the floor in Acute Patient Bays (http://www.healthfacilityguidelines.com.au/standard_components_lz.aspx), however heights above 1.2m are associated with increased sharps injuries (SI) to HCW (Weltman et al ICHE 1995;16:268-274).
My research indicates that a safe, wall-mounted aperture height is 1.1m – 1.2m above floor level. Epidemiological evidence confirms that staff risk far exceeds child injury risk and at this height I have yet to see a child SI cited.

Historically, SC were placed at “ergonomic height for staff to safely use” – there was no ‘recommended height from floor’. However, the fear of child access caused SC to be raised to non-ergonomic heights to the point where numerous SI to HCW have been reported because they could not see that:

* a tray/door had activated correctly

* the aperture was clear

* the SC was not overfilled;

* a sharp was not retained in the vestibule (throat) of a tray/door SC;

* or that a sharp was protruding from the aperture
NB. Karen Daley the President of American Nurses Association said she acquired HIV and HCV through an SI because the SC was mounted too high.
I have written to CDC’s NIOSH to inform them their 1998 guideline on Evaluation, Selection and Use of SC (http://www.cdc.gov/niosh/docs/97-111/ ) needs updating as they recommend a height of “52-56 inches” (1.32 – 1.42m). They will discuss this at the next, yet to be scheduled review.
SC height is compounded in countries with short-stature staff and also compounded in developed countries where nurse shortages have been filled with staff emigrating from Asia, Phillipines, Mexico, etc – all short-stature countries.

Finally, sharps containers need be mounted to accommodate an institution’s shortest staff, not their average staff.

I hope this is helpful to you.

Terry Grimmond FASM, BAgrSc, GrDpAdEd
Consultant Microbiologist
Grimmond and Associates
Ph/Fx (NZ): +64 7 856 4042
Mob (NZ): +64 274 365 140
E: tg@gandassoc.com
“This email (including any attachments) is intended only for the use of the individual or entity named above and may contain information that is confidential and privileged. If you are not the intended recipient, you are reminded that any dissemination, distribution or copying of this email or attachments is prohibited. If you have received this email in error, please notify me immediately by return email or telephone and destroy the original message. Thank you.”

UNCLASSIFIED
Good Afternoon,

I was wondering where it is actually written that wall mounted sharps containers should be below eye level and minimum height 1.1m so as out of reach of young children, can anyone advise?

Much appreciated.

Regards,

Kylie Long

Flight Lieutenant
Infection Prevention and Control
Clinical Governance & Projects
Garrison Health Operations Branch
Joint Health Command
Department of Defence

Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

To send a message to the list administrator send an email to aicalist-request@aicalist.org.au.

You can unsubscribe from this list be sending ‘signoff aicalist’ (without the quotes) to listserv@aicalist.org.au
Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

To send a message to the list administrator send an email to aicalist-request@aicalist.org.au.

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The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

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MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.

Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au

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