sharps management learnings from a pilot project in social housing Page 1 community sharps management toolkit
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1 community sharps management toolkit: learnings from a pilot project in social housing SAVE Bringing greener choices within reach through low or no cost, easy actions. This project has been assisted by the New South Wales Government through its Environmental Trust. Page 1
2 Acknowledgements The Community Sharps Management in Northcott precinct pilot project and the development of this toolkit were part of the SAVE (Sustainable Action Values Everyone) program supported by the NSW Government s Environmental Trust. SAVE was a collaborative partnership between the City of Sydney, Marrickville Council, Randwick City Council, the City of Canterbury and Housing NSW. Over a three year period, to July 2012, this program developed and delivered integrated environmental projects, assessment tools and transferable resources to low income, Aboriginal and Torres Strait Islander and Culturally and Linguistically Diverse (CALD) communities. The Community Sharps pilot project could not have happened without the invaluable support, knowledge and shared experiences of project partners City of Sydney, Housing NSW, NSW Land and Housing Corporation, South Eastern Sydney Local Health District and most importantly, Northcott residents. Special thanks to: Charmaine Jones Residents of Northcott Surry Hills Public Tenants Association Rebecca Martin, City of Sydney Matshepo Molala, City of Sydney Eve Jennings, City of Sydney Dominic Grenot, City of Sydney Niki Carey, City of Sydney Judy McCormick, Housing NSW Susanna Savolainen, NSW Land and Housing Corporation Rodney Apps, South Eastern Sydney Local Health District Amanda Carroll for the development of this toolkit Disclaimer While all care is taken SAVE partners accept no responsibility for the accuracy or completeness of any information contained in this material. Additionally, SAVE partners disclaim all liability to a person in respect of anything, and of the consequences of anything, done or omitted to be done by any such person in reliance, whether wholly or partially, upon any information presented in this material. Page 2
3 Community sharps management at a glance Our Experience Under the SAVE (Sustainable Action Values Everyone) program, City of Sydney, Housing NSW, NSW Land and Housing Corporation and South Eastern Sydney Local Health District worked together with residents on a pilot project to trial sharps waste management in the Northcott social housing community, in inner city Sydney. This toolkit was developed to share the learning gained through the project and to provide tips and suggestions that may assist others in developing community sharps management systems for social housing. Our pilot project cycle Part A Survey Part D Monitor & evaluate Step 7 Measure, review and improve the system Key performance indicators Ongoing data collection Pre and post implementation evaluation Step 6 Training, education and skills development Target groups Promoting the system Ongoing training Step 1 Needs assessment Identify and engage stakeholders Validate location Conduct a situation analysis Collect baseline data Step 5 System development and installation System considerations Location considerations Bin size, design and servicing considerations Selection of contractors Maintenance of sharps bins Part B Plan Step 2 Strategic planning Identify resources, networks and contacts Identify funding support Form partnerships Consult with stakeholders Define goals Step 3 Project planning Develop a project plan Outline approval processes Establish budget and assess costs Identify risks Develop schedule Part C Implement Step 4 Consultation and community engagement Resident information and consultation sessions As with all projects, the activities in the pilot project were not as well defined as this cycle would suggest. Some activities occured simultaneously, others overlapped, and others occured several times (e.g. key performance indicators were developed in Step 2, but for clarity and the purpose of this toolkit this activity was grouped into Step 7). It is suggested that all steps listed here are considered when developing similar projects, but you may wish to change their sequence or add new steps. Page 3
4 Table of contents 1 About the toolkit 5 2 Community sharps management 6 3 Benefits of a community sharps waste system 8 4 The pilot project 9 Part A Survey 11 STEP 1 Needs assessment 12 Part B Plan 15 STEP 2 Strategic planning 16 STEP 3 Project planning 21 Part C Implement 29 STEP 4 Consultation and community engagement 30 STEP 5 System development and installation 33 STEP 6 Training, education and skills development 38 Part D Monitor and evaluate 41 STEP 7 Measure, review and improve the system 42 Where to from here? 45 5 References, resources and useful contacts 46 6 Glossary 48 7 FAQs 49 8 Sample documents 51 9 Appendix 73 1: Community sharps management options 73 2: Sharps waste disposal procedure 76 3: Needlestick injury procedure 77 4: SAVE Community Sharps Management Video 78 Page 4
5 1 About the toolkit The toolkit provides tips and suggestions for establishing a community sharps waste management system for social housing. The toolkit captures the planning principles, resident engagement, capacity building strategies and processes to consider in developing and maintaining a community sharps waste management system. The toolkit outlines seven key steps for building a community sharps system based on the Northcott pilot project cycle. All steps are interlinked and need to be read as a whole. Target audience This toolkit is aimed at public or community housing providers; councils; Local Health Districts; Housing NSW; NSW Land and Housing Corporation; and other organisations interested in supporting the development of a community sharps management system for social housing. Supplementary information Further information is available online at where you can also download copies of this toolkit and view a short video outlining the pilot project experience. Sample project documents are provided online and at the end of this toolkit. They contain more detailed information and examples of approaches used in developing the community sharps management in Northcott precinct pilot project. Supporting documents NSW Health s Community Sharps Management Guidelines for NSW Councils recommend that councils: Provide accessible safe sharps disposal facilities in a variety of disposal locations Deliver public awareness campaigns on safe sharps disposal, the benefits of safe disposal, and the location of disposal facilities Develop sharps waste management partnerships to maximise the opportunities for safe disposal of sharps waste The City of Sydney s Syringe Management Plan is a specialist waste management policy that is informed by these guidelines. It provided a framework for the management of the pilot project. Safety/SyringeManagementPlan2005_2010.pdf Page 5
6 2 Community sharps management What are community sharps? Community sharps are needles, syringes and lancets used for injection and skin penetration outside a clinical or professional environment. There are a number of people in the community who are required or choose to use needles, syringes and lancets to treat or monitor medical conditions, utilise preventative medication, perform cosmetic procedures or to inject illicit drugs. Most needles, syringes and lancets are single use items and not designed to be used more than once. What is a community sharps management system? Community sharps are materials generated from human activity, and options for sharps management are developed to reduce their effect on health and the environment. A community sharps waste management system encompasses educational resources, access to community health services, resident engagement strategies and safe disposal options to sharps users. Safe disposal also involves the collection, transport, processing or disposal, managing and monitoring of sharp waste materials. The primary aims in identifying, developing and assessing available options for a community sharp systems are to: Maximise appropriate sharps disposal Minimise risk of needlestick injury to residents, staff and contractors What are community sharps bins? A community sharps bin is a dedicated, secure bin for the collection of sharps. Some are designed for single sharps disposal. Others are designed to accommodate sharps containers. Single sharps disposal bins are installed in locations where injecting activity is expected to occur, so that the sharp can be disposed immediately. Where the community sharps bin is not located next to the activity, the expectation is that a sharps container be employed to capture the sharps immediately after injection. Sharps containers are robust, puncture proof plastic containers, preferably adhering to Australian Standard AS3081. They are usually designed for a one way disposal system so that once the sharp has been disposed it cannot fall out of the container or be taken from the container. This design feature is to prevent needlestick injury as well as reinforce the fact that sharps should be single use items. Sharps 1.4 litre sharps container 240 litre sharps bin Page 6
7 Why do we need community sharps management? While many sharps are disposed of appropriately at pharmacies, needle and syringe programs or in community sharps bins, a significant amount of sharps are being disposed within the domestic and recycling waste streams, or littered. The provision of community sharps bins results in: A significant reduction in sharps waste in the general and recycling waste streams A reduction in the number of inappropriately discarded community sharps Prevention of needlestick injuries and an increase in safety for residents, staff and waste service contractors What is social housing? Social housing is the collective term for government and community residential properties provided for low-income individuals and families. Social housing residents include people living with a disability and people over 55 who may have medical conditions that are managed at home. Sharps management is an issue for the whole community The City of Sydney has a comprehensive sharps management system for the public domain and council facilities, recognising there are many members of the community who require the use of sharps. Many clinical conditions are no longer being managed in hospitals or at medical centres. As a result, more and more people are using sharps at home to manage medical conditions. Addiction to illicit substances is a health issue and is recognised by the World Health Organisation as a medical condition. In order to prevent poor health outcomes associated with drug use, Australian health policy employs a harm minimisation framework. Harm Minimisation aims to reduce the harmful impacts of drug use, ensuring that the long term health of people can be protected as much as possible while using drugs. Page 7
8 3 Benefits of a community sharps waste system Benefits for all Reduced risk of needlestick injury to staff, contractors, residents and the general public Reduced fear of sharps and increased confidence in safe disposal Improved health, safety and amenity Benefits for social housing residents Access to safe disposal for sharps Increased skills and knowledge in safely disposing of sharps waste Increased understanding of managing sharps use at home Reduced stigma surrounding sharps use Benefits for councils Diversion of community sharps from the general domestic and recycling waste streams Increased safety for street cleaning and waste services staff Employing best practice in sharps waste management Decreased litter and increased amenity Providing best practice sharps waste disposal options for residents Benefits for NSW Land and Housing Corporation, Housing NSW and other social housing providers Increased skills, knowledge and confidence for staff and contractors to safely manage sharps waste Improved environmental management Increased level of safety and cleanliness for residents, staff and contractors Page 8
9 4 The pilot project Under the SAVE program, the City of Sydney partnered with Housing NSW, NSW Land and Housing Corporation, South Eastern Sydney Local Health District and Northcott residents to deliver a pilot project for managing community sharps waste in a high-rise social housing precinct. The Northcott precinct was selected for the pilot project for two primary reasons: ongoing reports of discarded sharps in common areas of the precinct successful introduction and implementation of a new recycling system a year earlier The pilot project partners recognised safe sharps disposal as both a health issue and waste management issue. For these reasons, the project was delivered within a health promotion and waste education framework to the Northcott residents, staff and contractors. This approach recognised that community sharps are generated as a by-product of resident health management. Implementation and success of the project pilot relied upon the residents support and sense of ownership of the new system. Project partners achieved this support by holding information, education and consultation sessions with residents, staff, contractors and service providers. Residents were required to make an informed decision as to whether the project should proceed. The consultation sessions covered a range of issues, including: Harm minimisation and the NSW Needle and Syringe Program Safe collection and disposal of community sharps Understanding the risks associated with community sharps The consultation sessions focussed on discussing the health and safe disposal issues of sharps waste and the proposed community sharps waste system. The consultation and engagement sessions with residents revealed that the preferred waste system was sharps collection bins to accommodate portable sharps containers. The planning and consultation process resulted in the installation of two 240 litre community sharps collection bins with regular council servicing arrangements. Effective utilisation was ensured through the provision of resident resources, education and promotion. Housing NSW staff and contractors were given safe disposal training and invited to participate in monitoring any impacts of the new sharps management system proposed for the precinct. The sharps bins were monitored for a 12 month trial period from July 2011 to June 2012, and the evaluation indicates that residents are effectively using the sharps bins. 9,685 sharps have been collected in the sharps bins in the year since they were installed, diverting them from the general domestic waste stream. The sharps bins are now being incorporated into the Northcott s ongoing waste management system. Consultation session held with Northcott residents to discuss sharps management options. Page 9
10 Pilot project Snapshot Goals To reduce the number of sharps inappropriately disposed of in general waste and recycling and in public spaces. To provide bins and a maintenance service for a dedicated community sharps waste stream. Engage residents, maintenance contractors and Housing NSW staff in the management of community sharps. Provide education and health promotion activities and resources. Break down the stigma associated with sharps use. Outputs Introduction of a dedicated waste stream for sharps disposal, including the installation of two 240 litre capacity community sharps bins. Delivery of information, consultation, and training sessions on sharps management for residents, project staff and contractors. Impact evaluation showing high rates of utilisation and positive resident response. Partners Northcott residents SAVE program City of Sydney South Eastern Sydney Local Health District Housing NSW NSW Land and Housing Corporation Budget Project budget of $10,000 and in-kind support Bins and servicing provided by the City of Sydney Page 10
11 Part A Survey Step 1 Needs assessment Identify and engage stakeholders Validate location Conduct a situation analysis Collect baseline data Page 11
12 Part A Survey Step 1 Needs assessment Aim: To determine the needs and resources of residents and the local area in regards to community sharps management. Process: Engage stakeholders Select a site Conduct a situation analysis, including assessing need, safety and risk Collect baseline data Tools Survey sheets Site map to identify hot spots Baseline data collection sheets Refer to sample documents no. 1 & 11 Identify and engage stakeholders Dialogue with the following stakeholders will help in identifying needs, site issues, and generate local knowledge and support for the implementation of a community sharps waste system: NSW Land and Housing Corporation office or property owner Local Health District Needle Syringe Program Local Hospital Infection Control staff NSW Needle Clean Up Hotline (NSW Health) Council waste service, community safety and community development units Housing NSW office or social housing provider Community health services such as nurses, general practitioners (GPs), pharmacies, and drug and alcohol services Social housing residents Validate location The selection of a social housing precinct may be self-evident due to ongoing issues with community sharps disposal or the need for sharps waste facilities. However, to provide a level of reassurance that a nominated precinct is suitable for a community sharps project, the following factors should be considered: Ongoing issues with unsafe disposal or discarding of community sharps in public areas No existing facilities or options for the safe disposal of sharps except in general domestic or public waste bins Features of the built environment that enable appropriate installation of sharps waste facilities Previous success with community health and waste education initiatives A supportive resident community A supportive landlord (property owner) An established resident group Supportive local health service providers, housing provider, and council NOTE: Although a social housing precinct may be selected to trial a community sharps waste management system, it needs to be supported by the landlord (property owners) and by the social housing residents prior to implementation. Resident support is addressed in Step 4 of this toolkit. Page 12
13 Conduct a situation analysis Community sharps issues can be identified through: On-site safety and risk audits NSW Needle Clean Up Hotline reports Resident surveys Complaints regarding sharps waste reported to the social housing provider, council, NSW Health or NSW Land and Housing Corporation Information from waste service collectors or cleaning contractors servicing the property Information from the Diabetes Council of Australia about diabetes prevalence in the area Issues that will inform the need for a community sharps waste management system include: Health and safety concerns of residents regarding sharps waste in the precinct Risks to the safe work environment for staff, maintenance contractors, and waste contractors No dedicated community sharps bins, and limited or no on-site options for the safe disposal of sharps for residents Collect baseline data To inform the needs assessment process and site issues, gathering quantitative and qualitative data on sharps use and disposal is recommended. Pilot project tips Collect at least 3 months worth of baseline data. Consider including social housing precincts with high risk in sharps issues in council household waste audits or surveys. Identify precinct issues using information from multiple sources and stakeholders. Identify and engage all key stakeholders early on, consult with residents, and obtain local information by speaking with community health nurses, GPs and pharmacists who have existing relationships with sharps users in social housing. Baseline data can be used to provide a comparison for assessing the impact of implementing a community sharps management system and for evaluating the improvements achieved in health, safety and amenity. Hot spots are areas where discarded needles are frequently found, such as public toilets, park or garden areas, common areas in the built environment such as laundries and stairwells, or in waste collection areas. Collecting baseline data on hot spots will assist in development of the community sharps system and to identify potential location for sharps bins. Other data that will assist in the needs assessment process includes: Knowledge of sharps use by residents Knowledge of site history as a location for discarded sharps The average number of sharps collected per week from the location in a defined period Resident population and density of the built environment Repeated resident or community requests for sharps bin installation Repeated resident reports of discarded sharps to Housing NSW staff, council or the NSW Needle Clean Up Hotline Location and proximity of existing community sharp disposal bins to the social housing precinct Page 13
14 Type of data Hot spot data including the frequency, amounts and locations of discarded community sharps Total number of sharps collected in surrounding public spaces Total number of sharps collected within the site property Waste audits or surveys of community sharps in the general domestic and recycling streams Who to source the data from NSW Land & Housing Corporation cleaners, grounds staff and other maintenance workers Resident feedback on sharps disposal from the Housing NSW Client Service Officer or community housing provider NSW Needle Clean Up Hotline Council waste services team and contractors NSW Health Needle Clean Up Hotline Council s waste service contractors NSW Land & Housing Corporation maintenance contractors Council household waste audits or surveys of social housing properties could be included as part of the Waste and Sustainability Improvement Payment (WaSIP) requirements Refer to sample documents no. 1 and 11 for baseline tools. Outputs from Step 1 Community sharps waste management needs assessed Identification of site issues associated with sharps disposal Baseline data obtained Page 14
15 Part B Plan Step 2 Strategic planning Identify resources, networks and contacts Identify funding support Form partnerships Consult with stakeholders Define goals Step 3 Project planning Develop a project plan Outline approval processes Establish budget and assess costs Identify risks Develop schedule Identify sharp options Page 15
16 Part B Plan Step 2 Strategic planning Aim: To identify potential partners and resources. Process: Identify sharps management resources, networks and contacts Consult with stakeholders Identify funding support Form partnerships Define project goals Identify resources, networks and contacts Resources, networks and useful contacts in addressing sharps issues need to be identified and consulted. Information from existing networks may be helpful in forming partnerships to effectively address and manage the specific community sharps issues in the selected social housing property. The following resources and contacts were useful in the Northcott pilot project: Organisation/Service NSW Needle Clean Up Hotline NSW Health Local Health District Needle and Syringe Programs Ways they can assist Advice, information and data on sharps discarded in public places. Community sharps management resources, funding, advice and support. Local information, sharps disposal advice, resources, education and training support. Sharps users can access new sharps equipment and containers. For a list of Local Health Districts and their contact details please go to or contact NSW Health. For a directory of NSP outlets across NSW go to the NSW Users and AIDS Association (NUAA) Services Directory located under Local Government and Shires Association of NSW (LGSA) Medical Industry Association of Australia Pharmacy Guild of NSW Information, policies and case studies. Access to information, case studies and resources via Access to information on existing options for community sharps disposal through pharmacies. Page 16
17 Organisation Diabetes Australia NSW Riverina Eastern Regional Organisation of Councils (REROC) NSW Users and AIDS Association (NUAA) Hepatitis NSW Alcohol & Drug Information Service (ADIS) Ways they can assist Charity organisation that runs the National Services Scheme in NSW. The service provides access to phone diabetes educators, support and advice. To find sharps disposal locations in your area go to: Advice and outreach services in addressing the harm minimisation needs of illicit drug users. Peak community-based organisation in NSW for providing advice, education, training and resources in hepatitis. Helpline number is NSW telephone service providing information, referral, crisis counselling and advice related to medical, illicit drug use and sharps management. ADIS has a state wide list of chemists that provide fitpaks. ADIS operates 24 hours, 7 days a week - phone (02) or (for callers outside Sydney) or drugaction@ doh.health.nsw.gov.au WorkCover NSW NSW Environment Protection Authority (EPA) Ethnic Communities Council of Australia Information, advice and resources on Work, Health and Safety (WHS) for staff and contractors. Advisory phone-line service on and resources available at Advice and information on community sharps waste management and licensing requirements for the collection, transport and disposal of sharps hazardous waste as defined under the Protection of the Environment Operations Act or info@environment.nsw.gov.au The Ethnic Communities Council of Australia (ECC) is the peak body for all culturally and linguistically diverse communities. ECC can assist with access to bi-lingual educators, translators and facilitators for effective engagement with culturally and linguistically diverse communities. Phone (02) or go to Refer to Section 5 on references, resources and useful contacts for further information. Page 17
18 Consult with stakeholders In addition, project partners may canvass local stakeholders to strengthen opportunities and obtain resources, funding, local information and feedback on effective resident engagement: Local Health District Community Health Centres NSW Police Local Area Command Council and housing provider waste services To develop effective methods of community engagement with residents, the project team should consult with these stakeholders if they exist in your local area: Social Housing Resident Groups Neighbourhood Advisory Board Safety Working Groups Funding support Depending on your organisation, you may be able to access funds and resources through the following sources. Social housing providers may access funding in partnership with single or combined councils. Pilot project tips Establish clear roles and responsibilities. Engage with partners, stakeholders and residents in the early stages of planning. Team members need to take responsibility for following their organisation s internal processes to avoid project delays. Risk management implications need to be identified upfront. NSW Health s Community Sharps Management Grants Program: National Diabetes Services Scheme (NDSS): Diabetes Australia: NSW Government Waste and Sustainability Improvement Payments: NSW Government Community Builders: Australian Government GrantsLINK: NSW Attorney General & Justice Crime Prevention Grants NSW Health s Community Sharps Management Grants Program provides funds for: The purchase and installation of community sharps disposal infrastructure (sharps bins) Development and production of resources promoting safe disposal practice (i.e. brochures, posters and stickers) Training for council and partnership employees and contractors in the safe collection and disposal of community sharps (conditions apply) Approximately $60,000 for a group of adjoining councils and $10,000 for a single council can be accessed. Up to $10,000 for a group of adjoining councils and $2000 for a single council can be used to deliver training in the safe handling and disposal of community sharps staff and contractors. For more information refer to In the Northcott pilot project part funding was sourced from the NSW Environmental Trust which covered the cost of community and waste education resources. Refer to Step 3 for an indication of budget and costs. Page 18
19 Form partnerships Partnerships have the benefit of sharing agency resources, applying for combined funding, and using the particular expertise of partners in community sharps management, health promotion, waste management, social housing projects and engaging with residents. They can be formalised through: Partnership agreements Terms of references Memorandums of Understanding (MOUs) A lead agency is required to manage and administer the project on behalf of the project partners. The following table outlines some of the roles and responsibilities of the pilot project partners in delivering a community sharps waste management system for the Northcott precinct. Partner SAVE program (funded by NSW Environmental Trust) Roles and responsibilities Overall project management Partner coordination Coordinate development and implementation of the project plan and the resident information and consultation plan Engagement strategy development Evaluation liaison Promotional material development Coordination and delivery of consultation sessions, health promotion and waste education seminars City of Sydney Sharps bin infrastructure, installation and servicing Funding for the project trial infrastructure Training provision to residents and Housing NSW staff and contractors Community sharps bin data collection by clinical waste contractors Housing NSW Communication with residents Coordinate approvals Strategic planning advice Engagement strategy development Facilitation and delivery of some of the consultation sessions NSW Land and Housing Corporation (property owner) Approval of the project prior to implementation Site and bin location approval Asset management and property maintenance Data collection by maintenance contractors South Eastern Sydney Local Health District Training and education resources Needle Clean Up Hotline services Page 19
20 Project partner representatives from NSW Health, City of Sydney, Housing NSW, NSW Police and the community at the launch of the Northcott Sharps bins. What have you learnt about working in partnerships through this project? Don t give up straightaway... don t do it by yourself, consult and get as many people from the community to dig in and all do it together Needle Clean Up Coordinator South East Sydney Local Health District Define goals Goals are the broader outcomes that the project sets out to achieve, giving an overall direction and purpose. Project goals Goals developed for the pilot program included: Provide facilities for a dedicated community sharps waste stream Reduce the amount of sharps in general waste and recycling streams Raise the awareness and confidence of residents, contractors and service staff in safely managing community sharps Outputs from Step 2 Identification of resources, networks and contacts Formation of partnership between agencies and stakeholders Stakeholder consultation Agreement between partners and stakeholders about the goals Page 20
21 Step 3 Project planning Aim: To define the goals for community sharps management in the selected social housing precinct, and create a plan to meet these. Process: To provide navigation and guidance in implementing a project it is recommended that a project plan is developed. Your plan can assist the project team to document clear objectives, roles and responsibilities for effective delivery. It needs to include the following: Tools Project plan Sharps action plan Project schedule Refer to sample documents no. 2, 3 and appendix 1 Outline approvals processes Establish budget and assess costs Identify risks Develop schedule Develop project plan A project plan will assist in developing a community sharps waste management system. It includes: Partner roles and responsibilities Budget Schedule Risk assessment Options for an appropriate community sharps waste system Resident information and consultation plan Data collection and evaluation Performance indicators Involve partners, stakeholders and residents during the planning stage, and focus on the long term solutions and benefits. Examples of components to include in a project plan are outlined in sample document no. 3. Outline approvals processes Critical issues requiring resolution, decision making and approval are important to document in your plan. Be sure to consider who should be involved, the timeframes needed, and the order in which activities should be undertaken. Approvals required Area Director, Housing NSW and NSW Land and Housing Corporation: Approval of the resident information and consultation plan Approval of the project plan and budget Director City Culture and Community, City of Sydney Approval of the project plan and budget Page 21
22 Establish budget and assess costs A budget needs to be determined and approved by the partners for the development and implementation of the community sharps management system, as well as for ongoing servicing costs. The table below outlines an example of the estimated project budget based on the pilot project experience. Expense item Item cost and notes Community engagement and consultation Catering Resource printing (brochures, posters, invitation letters) Venue Community engagement resident strategies Health education workshops Interpreters & bilingual educators $400 to $500 to cover for three resident consultation sessions and one follow-up session. Approximate costs can also be determined on $5 to $10 /person for refreshments or $15 to $30 /person for meals. $600 to cover the cost of resources promoting safe disposal practice (i.e. printing brochures, posters, invitation letters during the resident consultation phase). A free venue at a local community centre, workshop or meeting room is likely to be available from the social housing provider or council. The social housing provider can assist to develop community engagement resident strategies specific to the social housing precinct. Education workshops in safe sharps disposal practice may be conducted in-kind by Local Health District Needle and Syringe Program (NSP) outlet, Diabetes Australia NSW and council staff with expertise in sharps management. $50 to $100 per hour per translator (depending on the number of languages). Infrastructure 240 litre sharps bin cabinets (supply & install) Sharps bin servicing, cleansing, repair NSW Needle Clean Up Hotline discarded community sharps retrieval $2,500 to $3,400 each (depending if the bin is powder-coated zinc or stainless steel). $2,600 to $2,900 per annum (based on weekly servicing). In-kind service provided by NSW Health. Page 22
23 Expense item Item cost and notes Training and education Safe sharps disposal training to staff and contractors Training workshops in the safe handling and disposal of sharps can sometimes be provided as an in-kind contribution by Local Health District Needle and Syringe Program (NSP), Diabetes Australia NSW, and council staff with expertise in sharps management. Alternatively, funds of up to $2,000 for a single council and $10,000 for a group of councils are available under the NSW Health Community Sharps Management Grants. The indicative costs for the set-up and servicing of sharps bins in the Sydney metropolitan area are listed below. Bin size Supply and install Weekly servicing (one bin) Yearly servicing (one bin, based on weekly collection) 240 litre $2,500 to $3,400 $50 to $65 $2,600 to $2, litre $2,000 to $3,200 $50 to $65 $2,400 to $2, litre $1,500 $30 to $40 $1,560 to $1, litre $150 $15 to $25 $780 to $900 Note: These are estimated costs for the Sydney metropolitan area only. Annual servicing costs vary based on frequency of collection and vary between clinical waste service providers. Page 23
24 Identify risks Undertaking a proactive approach in identifying and managing project risks is critical to the effective delivery of the community sharps management system. Below are possible risks to consider identified from the Northcott pilot project. Risks in proceeding Potential perception that the community sharps waste management program is the cause of injecting drug use activity, sharps waste, and related safety issues Perception that community sharps waste management is unjustly prioritised over more pressing needs Duplication or poor coordination between waste service contractors Lack of clear information about how to report damage or servicing needs Risks in not proceeding Ongoing safety issues arising from unmanaged community sharps waste Potential litigation and health impacts arising from a needlestick injury to staff or residents Lack of response to a known public health and safety issue Managing community and stakeholder disappointment and dissatisfaction if the project did not continue Identify available options for a community sharps system Development of options for community sharps systems depend upon a number of key factors including; Outcomes from the resident needs assessment and consultation sessions Available budget and funding Demographic, resident population and resident health requirements The level of risks assessed on the site, including needlestick injury risks Available access to existing resources and services Proximity to sharps disposal facilities including hospitals, community health centres, needle and syringe program (NSP) outlets and pharmacies Proximity to services that supply the replacement of personal sharps containers Refer to Safe Sharps website to search for sharps disposal locations Page 24
25 Due to the hazards that unsafe disposal practices present to residents, staff and contractors many councils are choosing to offer safe, convenient disposal options to sharps users. In understanding and developing options for a community sharps management system, the below diagram outlines the typical components of a sharps waste management system required over the cycle of a resident s sharps use including; source of supply of personal use sharp containers for residents education, training and supporting programs disposal facilities for the collection, service & treatment of resident sharps Walk in the shoes of someone that uses sharps Personal sharps needs Information & support programs A Safe sharps disposal & collection C Sharps container supply B Part B Survey In understanding and developing options for a community sharps management system, the above diagram and following flow chart outlines the typical components required by a community sharps user: A Education, training and support programs B Facilities that supply sharp containers C Access to sharp disposal facilities Page 25
26 Community sharps management system options Key objectives of community sharps options are to maximise appropriate community sharps disposal, minimise needlestick injury and monitor for effective performance. Community sharps service options need to consider: Facilities where sharps can be safely disposed Facilities that supply new sharp containers Access to advice, education and support on safe sharps management A B C Information & support programs Supply of new personal sharps containers Sharps disposal, collection & servicing What education and support programs are available? Sharps management education & awareness seminars conducted by: Council staff with sharps expertise NSW Health, Local Area Health District Needle & Syringe program (NSP) Diabetes Australia NSW NSW Users and AIDS Association (NUAA) What training options are available in sharps management? Training in sharps management conducted for staff and contractors by: TAFE NSW NSW Health Registered Training Organisations Where can new sharps containers be accessed from? Access to the supply of new personal containers at: Community health centres Needle & Syringe program (NSP) outlets Participating Fitpak Scheme pharmacies Diabetes Australia-NSW Still no service available? For further advice and support on options for the supply of new personal sharps containers & disposal options, refer to the useful contacts section of this toolkit. Where can sharps be disposed of? Disposal of containers options at: Public hospitals (24 hr/7 days) Community health centres Needle & Syringe program (NSP) outlets Public sharps disposal bins Still no service available? Councils, with support from the social housing provider and residents, may consider a designated on-site community sharps bin. System includes collection & servicing. Refer to Step 6 for training, education and skills development options. Refer to Step 4 for consultation of sharps management options. Refer to Step 5 for development of an on-site system. Refer to appendix 1 for further information on the pros and cons of sharps management options. Refer to sample document no. 2 for an example of an action plan for implementing a selected sharps management option. Page 26
27 Develop project schedule Key milestones, tasks and anticipated timeframes for delivering a community sharps waste management system can be mapped using a project schedule. An example of the pilot project schedule is provided below, outlining the indicative timeframe and tasks considered in delivery of a community sharps waste management system. Indicative project schedule Phase Month Item Survey Identify project issues & purpose Identify stakeholders Baseline data collection Plan Briefing sessions to stakeholders (staff, contractors) Formation of project partnership team Develop project plan Implement Consultation and community engagement sessions Training and skills development seminars System development & installation (e.g. bins etc) Monitor and Evaluate Sharps bin data collection & monitoring (on-going) Pre-trial evaluation Post-trial evaluation Six monthly evaluation (ongoing) Page 27
28 Indicative project Phase Activities Survey Identify project issues & purpose Identify stakeholders Baseline data collection Three on-site visits Consultation session with key stakeholders Weekly/fortnightly contractor data over 2 to 3 months Plan Briefing sessions to stakeholders (staff, contractors) Formation of project partnership team Develop project plan Minimum of two briefing sessions Four to six meetings Develop project plan Implement Consultation and community engagement sessions Training and skills development seminars System development & installation (e.g. bins etc) Three consultation and one resident feedback session Two training seminars Bin installation & launch event Monitor and Evaluate Sharps bin data collection & monitoring (ongoing) Pre-trial evaluation Post-trial evaluation Six monthly evaluation (ongoing) Weekly waste service contractor collection of data and monthly trend reporting Pre-trial qualitative surveys with residents and key stakeholders Post-trial qualitative surveys with residents and key stakeholders Review meeting with project team, waste service contractors and residents For further information, refer to sample documents no. 2, 3 and appendix 1. Outputs from Step 3 Approval from project sponsor Approved project plan (including budget, team roles, risks and schedule) Approved resident information and consultation plan Formation of a project team Required resources committed Sharps management action plan (to guide the team with implementation) Page 28
29 Part C Implement Step 4 Consultation and community engagement Resident information and consultation sessions Step 5 System development and installation System considerations Location considerations Bin size, design and servicing considerations Selection of contractors Maintenance of the community sharps bins Step 6 Training, education and skills development Target groups Promoting the system Ongoing training Page 29
30 Part C Implement Step 4 Consultation and community engagement Aim: To raise awareness of community sharps management issues and responses among social housing residents of the selected precinct, to listen to their concerns and ideas, and to seek their support and approval before implementing the scheme. Process: Your approach for social housing consultation and engagement can be guided by: the resident information and consultation plan developed in the project planning phase (Step 3) International Association for Public Participation (IAP2) tools and resources: Resources Resources you might make use of during consultation include: Resident information and consultation plan Community Development Worker (Housing NSW) Bilingual educators e.g. from the Ethnic Communities Council (ECC) Staff members from partner organisations Sharps containers and injecting equipment from your local Needle Syringe Program, for demonstration purposes Site maps to mark sharps litter hot spots Refer to step 2 and section 5 for references, resources and useful contacts Promotion tools The tools used to promote the pilot project resident information and consultation sessions included: Housing NSW tenant newsletters Multilingual flyers (dropped in letterboxes) and posters (displayed in common areas) Promotion at the Surry Hills Social Housing Resident Association meetings Word of mouth to residents by the Housing NSW Community Development Worker Self-nominated resident volunteers to promote the project to other residents Refer to sample documents no. 4, 5, 6, & 7 for examples of the promotional tools Consultation sessions on community health and safe sharps management provided to residents. Page 30
31 Community engagement for the pilot project Method Community engagement with Northcott residents was informed by the International Association of Public Participation methods of inform and consult. Information and consultation sessions Three separate resident information and consultation sessions were conducted at the Northcott Community Centre in partnership with City of Sydney, NSW Land and Housing Corporation and South Eastern Sydney Local Health District. Sessions covered the following topics: Use of sharps Infection control Community sharps management and safe disposal systems Successful introduction of the recycling system in the Northcott precinct Available networks, contacts and resources The sessions highlighted a number of issues, opportunities and questions including: How to access needle and syringe programs Location of on-site sharps waste hot spots Options and locations for community sharps bins Who was responsible for delivery of the pilot project Ease of access for all residents to the community sharps waste facilities and resources Involvement of local pharmacies, general practitioners (GPs) and community nurses Activities During each of the sessions, residents were encouraged to participate in two activities: Marking sharps litter hot spots on maps of the Northcott estate Voting either yes or no in favour or against the pilot project on an anonymous voting slip Refer to Appendix 4 for an example of hot spot map and voting card used. Feedback A feedback session was held a week after the final consultation, addressing: the voting results, indicating support for the trial questions and concerns raised by residents the next steps in implementing the trial project Page 31
32 For further information, refer to sample documents no. 4, 5, 6 & 7, and Step 2 and Section 5 for references, resources and useful contacts. Outputs from Step 4 Implementation of the Resident Information and Consultation Plan Identification of resident needs, issues, concerns and support Identification of information and education resources required Resident approval and input into project plan Identification of individuals interested in promotion and participation Consultation session on community sharps management held with Northcott residents. Sharps containers, educational flyers and information on available community sharps networks were provided at the Northcott resident consultation sessions. Page 32
33 Step 5 System development and installation Aim: To develop a dedicated waste stream for community sharps disposal, and choose and complete installation of sharp bins. Process To devise an appropriate system for community sharps disposal at the site To provide resources and infrastructure for the community sharps waste management system System considerations To effectively manage the collection and disposal of sharps, a broad range of community sharps options are scoped and identified during the project planning and the community engagement consultation phase. If an on-site community sharps systems and provision of sharps bins are deemed appropriate for the site, then a number of factors, including sharps bin positioning, bin size and servicing requirements need to be considered. Take the container to the sharps, and not the sharps to the container Rebecca Martin, City of Sydney Location considerations Providing community sharps bins in appropriate and accessible locations significantly reduces sharps waste in the domestic waste and recycling streams. Research demonstrates that people who inject in public spaces will discard the sharps waste close to the injecting location. To determine the location and appropriate bin size, site data collected from staff and contractors during the site analysis (Step 1) and from residents during the consultation phase (Step 4) will be vital. Assets staff from the landlord or property maager will also be involved in approving the location. Location considerations include: Proximity to any public injecting activity hot spots, if this is an issue on the site Placement of sharps bin in an internal area accessible only to residents or an external area also accessible by the public Ease of accessibility for all residents, servicing staff and the public (if appropriate) Lighting levels and general safety and security of the site A risk analysis will assist in determining if the site will meet the sharps disposal requirements of the target population as well as assess the potential for damage to the bins or other proximate assets. Page 33
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