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 [email protected] 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

34 Bin size, design and servicing considerations Community sharps waste systems can comprise of one or many bins, and can collect small amounts of single needle syringes or sharps safe containers, depending on the needs identified. Bin sizes and design needs to adequately address the site issues and requirements (see Step 3 for assessing costs). Bin size is determined by the type of sharps waste (single syringes or containers), by expected volume (also implicated in servicing schedule) and by location constraints. Fixed community sharps bins are generally available in four sizes: 1.4 litre: for single needle syringe disposal (often located in public toilets) 23 litre: for single needle syringe or fitpak disposal (often located in public parks) 120 or 240 litre: for sharps safe container disposal (often located on hospital grounds) Tools Bin launch flyer Community sharps bin service protocol Bin repair procedure Refer to sample documents no. 8 & 9 Whilst there are no legislative requirements for the design of outer housings for community sharps bins, there are design criteria that should be considered in order to address work health and safety and duty of care obligations. Community sharps bins should be: Of strong construction that is weather and vandal resistant Designed to accommodate an internal container that conforms to the Australian Standards for sharps containers and can be easily serviced Designed with no sharp edges or surfaces that could cause injury or blockage Securely fastened to the structure that upholds it Designed so the contents of the bin are inaccessible to all except clinical waste contractors Readily distinguishable by means of signage identifying it as only for the purpose of sharps waste disposal Monitored for usage and condition, with a telephone contact number for notification of damage or overfilling It is also recommended that systems for distributing portable sharps safe containers to residents be developed and promoted to assist in the safe collection of sharps and use of the disposal system. For example, at Northcott, the residents have access to free sharps containers through the assistance of the Northcott community centre. Individuals can obtain containers for free from a Needle Syringe Program (NSP) or they can be purchased from most pharmacies or sourced through calling Diabetes Australia on Refer to Table 1 in this step for community sharp disposal bin options. Selection of contractors A clinical waste management service provider with an EPA waste transport licence will need to be selected, and a contract and schedule for servicing put in place that includes an agreement on the communication, monitoring and data collection requirements. The bin cabinets selected for the pilot project were constructed of high-quality stainless steel to ensure hardiness and vandal resistance. Bin cabinet and clinical waste servicing costs will vary, and some waste contractors may not have the expertise in community sharps waste servicing that your site requires, so be sure to search around for the best products and contractors to suit your needs (under clinical waste or sharps waste management ). You may wish to consult with your local hospital and Local Health District about their clinical waste disposal in order to source contractors available in your area, or you may consider having your waste service contractors trained for the collection and transport of community sharps (refer to Step 6 Training, education and skills development). Page 34

35 In the case of the pilot project, the City of Sydney has an existing clinical waste service contract which was extended to include the servicing and collection of waste from the two 240 litre sharps bins on the site. The following factors were considered for contractor servicing, collection and disposal arrangements: Evidence that the contractor holds a current valid Environment Protection Authority (EPA) licence to transport sharps waste (where more than 200kg are being transported) Knowledge of the community sharps management sector Evidence that sharps waste is taken to premises that holds an EPA licence Sharps data collection and reporting requirements Insurance coverage requirements Legislation, regulations and codes of practice relevant to the service Opportunities to coordinate with other community sharps management services Maintenance of the community sharps bins The clinical waste management service provider who maintains the City of Sydney s 240 litre community sharps bins for the Northcott precinct does so in accordance with the following maintenance protocols: Service the community sharps bin on a weekly schedule Assess the integrity and safety of the cabinet and mounting at each service Remove and replace the internal sharps collection bin or container if more than 33% full Safely collect and remove the contents of the community sharps bin Collect sharps related waste from a 10 metre radius around each community sharps bin Transport the sharps waste to a licensed waste disposal facility Clean the inside and outside of the cabinet on a regular basis Undertake repairs to community sharps bin as required Ensure all staff are appropriately trained and equipped in clinical waste services Record and report on the program Refer to sample 9 for an example of the Northcott community sharps bin service protocol. 240 litre community sharps bin, installed at Northcott. Page 35

36 Table 1: Community sharp bin options Sharps disposal bin Purpose Pros Cons 1.4 litre bin 100mm (w) x 195mm (h) Deposit of single sharp. 1.4 litre single sharp wall units are ideal for toilets or other small areas where injecting occurs. Bin may get clogged, leading to increased maintenance and cost for servicing. 23 litre bin 400mm (w) x 700mm (h) x 400mm deep Bins mounted on outside walls of building. Deposit of single syringe and 1.4 litre sharps container or fitpack disposal. Accommodates for containers up to 1.4 litres and fitpaks May get clogged, leading to increased maintenance and cost for servicing. 120 litre bin 600mm (w) x 1500mm (h) x 750mm deep Accommodates from single syringe up to 3.1 litre sharps container. Same design as the 240 litre bin but smaller. Larger bin requires less servicing. Accommodates for sharps safe container disposal up to 3.1 litres. Initial set-up cost. The bin requires space for on-site placement. 240 litre bin 700mm (w) x mm (h) x 820mm deep Container sizes up to 5 litres can be deposited into a 240 litre bin. 5 litre containers are commonly used by people living with diabetes. Allows for a standard 240 litre wheelie bin to be placed inside for ease of collection. Requires less servicing and is a decreased risk for needlestick injury. Initial set-up cost. The bin requires space for on-site placement. Residents may inadvertently use the 240 litre bin as a general waste bin. Accommodates for sharps safe container disposal up to 5 litres. For information on the supply, installation and servicing costs of sharp disposal bins refer to Step 3 Establish budget and assess costs. Page 36

37 Community sharps system at the Northcott pilot project Sharps bins In the pilot project, two 240 litre capacity community sharps bins were installed into a common waste collection area on the ground floor of the largest building. The bins are comprised of a 1.5m tall stainless steel rectangular cabinet with a levered tray to drop the sharps containers into a clinical waste wheelie bin concealed within. A clinical waste contractor unlocks the front panel and removes the wheelie bin for transportation to the final disposal facility. This system was determined to be appropriate for the site, based on the following considerations: Medical and diabetic health requirements of residents up to: 5 litre containers are commonly used by people living with diabetes and 240 litre bin chute size accommodates for these and most other container sizes Bin size is in proportion to the number of syringes generated and a weekly service frequency Bin allows for large amounts of sharps waste to be deposited at once The one way chute accommodates most publicly available sharps containers Stainless steel bins provide durability, vandal resistance and ease of graffiti removal The bins were purchased by the City of Sydney with a contract established for the supply, installation and maintenance (including content disposal and data reporting). Sharps containers Through the assistance of the Northcott community centre and the South Eastern Sydney Local Health District, residents have access to new sharps containers for safe disposal. Once the sharps containers are three-quarters full residents can dispose the container into the two 240 litre community sharps bins. For further information, refer to sample documents no. 8 & 9. Outputs from Step 5 Community sharps waste system developed and agreed upon Sharps bin size, functionality and location requirements identified Community sharps bins installed Page 37

38 STEP 6 Training, education and skills development Aim: To increase knowledge, awareness and skills in the safe disposal of community sharps. Process: The development of the community sharps waste management system needs to be accompanied by education and training for residents, housing provider staff, service agencies, maintenance contactors and identified stakeholders. This training should focus on harm minimisation, safe disposal, needlestick injury prevention and response from both community health and waste management perspectives. Consult with your Local Health District Needle Syringe Program and Hepatitis NSW for assistance in developing and delivering your training. In the pilot project, training was provided by: Local Health District Needle Syringe Program Coordinator Local Health District Infection Control Specialist Hepatitis NSW City of Sydney Target groups Your primary target audience for training and skills development could include: NSW Land and Housing Corporation staff and contractors with direct site responsibilities Housing NSW Client Service Officers and Community Development Workers Cleaning and waste services contractors Residents Other key stakeholders as identified Pilot project tips Target, consult and promote your education and training to the right people. Don t underestimate how powerful word of mouth is as a communication tool in social housing communities. Use a combination of communication tools to disseminate information as one size doesn t fit all. (i.e. mixture of flyers, posters, letter box drops, word of mouth, key contacts, etc). Be sure to consider the diversity of resident culture and language in developing your information materials, and be sure to include clear visual cues on sharps bin signage. Remember to make residents participation informal, easy and accessible. Engage with your agency media and communication s teams early on especially in relation to co-branding, promotion, communication and education materials i.e. flyers, brochures, signage etc. Keep your branding consistent on all promotional materials for clear communication about the project to residents and stakeholders. Refer to sample documents no. 4, 5, 6, 7 & 8 for examples of promotional and engagement tools Sharps containers, equipment and bins to use during training demonstrations. Page 38

39 Example of an agency training and skills development plan Session objective Learning outcome Train NSW Land and Housing Corporation staff in: response to the identification of sharps hazards practices for the safe collection and disposal of sharps assessment and control of risks Identification and management of sharps waste management issues; skills and knowledge in best practice methods of sharps disposal. Resources Local Health District educator; needle and syringe program (NSP) trainer; Diabetes Australia NSW, Registered Training Organisation and/or training provided by project team members with expertise in sharps management. Training venue. Sharps equipment demonstration kits. PowerPoint training presentation. Duration hours Promoting the community sharps waste management system After the community sharps waste bins are installed, a launch event is an effective way to promote their use. At the Northcott social housing community an event was held with residents, partners and other stakeholders to launch the newly installed bins. It involved community health and waste education sessions to outline safe disposal and the use of the sharps waste management system. Refer to sample document no. 8 for an example of an event flyer. Training in sharps waste management Training needs to be regular and ongoing to ensure system effectiveness. It is recommended that train the trainer courses be held at least annually for council, social housing providers and NSW Land and Housing Corporation staff and contractors. This provides an opportunity to continue the partnership and update staff and contractors on current information in sharps management. Pilot project tips Promote the new community sharps waste system to residents, GPs, community nurses and pharmacists. Hold a community event to launch newly installed sharps bins. Run a yearly awareness workshop with residents, staff and contractors on safe sharps disposal to ensure the ongoing effectiveness of the community sharps waste system. Once key staff are trained they will be able to run sharps safe training and individual consultation with residents, staff and stakeholders to meet their safe disposal needs. Alternatively, TAFE NSW offers a course in the Safe Collection and Disposal of Community Sharps. It is delivered as a 3 hour training session specifically for local government employees whom are potentially exposed to sharps in their work role. The course covers training in the identification of sharps hazards, assessment and control of risks, information about the potential for disease transmission, and procedures and practices for the safe collection and disposal of sharps. For more information go to: and search for TAFE Statement in Safe Collection and Disposal of Community Sharps. An EPA waste transport licence is required for the collection, storage, transport and disposal of clinical sharps waste under the Protection of the Environment Operations Act For councils considering training their own waste service contractors in the collection and transport of community sharps waste, contact the Environment Protection Authority for training and licensing requirements Page 39

40 For further information, refer to sample documents no. 4, 5, 6, 7 & 8. Outputs from Step 6 Development of training resources for target groups Delivery of education and training in community sharps management to key stakeholders, frontline staff and maintenance contractors Launch and promotion of the community sharps system and bins Demonstration on safe disposal of community sharps. Page 40

41 Part D Monitor and evaluate Step 7 Measure, review and improve the system Key performance indicators Ongoing data collection Pre and post implementation evaluation Page 41

42 Part D Monitor and evaluate Step 7 Measure, review and improve the system Aim: To measure, review and improve the community sharps waste system performance. Process Requirements for monitoring and evaluating a community sharps project should consider key questions, such as: What data is required pre-implementation and post-implementation to measure results? What are the goals and anticipated outcomes? What key performance indicators will be used to measure the effectiveness of the system? How will we know the community sharps waste management system is a success? How can we consult and receive ongoing feedback to further improve the system? Effective evaluation needs to occur over the entire period of development and implementation. In the pilot project, evaluation by independent evaluators was ongoing over the entire project and measured against the established key performance indicators below. Key performance indicators Quantitative KPIs to assess the community sharps waste system performance include: Resources for monitoring Data collection tools Collection procedures Waste service contractors and monitoring staff Team member to collate and analyse sharps waste collection data and report on outcomes Data collection tools Maps and data collection sheet to document sharps disposal hot spots Community sharps bin collection data (contents and quantity) Inappropriate sharps waste disposal data Issues register Resident surveys Note: Refer to sample documents no. 1, 10 & 11 for examples of data collection tools Number of sharps deposited in community sharp bins Number of sharps collected from public areas and internal areas Estimated diversion of sharps from the general waste stream Number of residents attending consultation sessions and their feedback Number of residents made aware of safe sharps disposal Number of community sharps management events Qualitative KPIs to assess the program include: Evaluation and feedback from project partners, stakeholders and the local public Residents have increased access to safe sharps disposal information and resources Residents have increased capacity, skills and motivation to dispose of sharps safely Project partners have developed and implemented cohesive and coordinated sharps management processes Page 42

43 Ongoing data collection Data will need to be continuously collected and analysed in order to measure system effectiveness. As an example, below is an account of the data that continues to be collected from Northcott. Data Source Data Type Data collection timing Total number and/or volume of sharps collected in community sharps bins Location of litter hot spots for sharps disposal (pre-trial to post-trial) Diversion of sharps from the general waste stream Total number of external sharps collected Measure of bin content - audit by City of Sydney waste collection service contractor on number and/ or volume of sharps Data gathered by NSW Land & Housing Corporation contractors, including cleaners, garden and groundskeeper staff on any hot spots in internal buildings, common areas, laundries, stairwells and grounds Resident feedback on sharps litter hot spots to Housing NSW local Client Service Officer and NSW Clean Up Hotline Waste audit by City of Sydney clinical waste contractor on sharps bin data NSW Needle Clean Up Hotline data on discarded syringes retrieved on Northcott grounds Weekly (& tallied for monthly trends) Pre-implementation, post-implementation (on-going) Pre-implementation, post-implementation (on-going) Annual (& as required) Continual Pre and post implementation evaluation Comparing baseline data with data collected after implementation will assist in identifying the impact that the community sharps waste management system has had. It is important to also include in this the qualitative information that was received in consultations with residents and other stakeholders, for example the data collected below from the pilot project. Data Source Data Type Data collection timing Interviews with residents at information and consultation sessions Interviews with residents Baseline data collected including sharps disposal issues, knowledge of sharp disposal safety and facilities for this, hot spot locations, etc Discussions regarding the value, benefits and issues of managing community sharps and of the system implemented Pre-implementation Pre-implementation Page 43

44 Findings from the pilot project evaluation The pilot project evaluation showed an increase in knowledge and skills in safe sharps disposal among the residents, staff and contractors, as well as increased environmental safety and amenity. 9,685 sharps having been collected in the sharps bins in the year since they were installed. Pilot project tips Have data collection systems in place to monitor the system Determine the type of data required early in the project Review data every 6 months after implementation for effective ongoing operations Project highlights The highlight for me is participating in the project and meeting people from the community. Needle Clean Up Coordinator The highlights of the project have been the collaboration taken place amongst the partners, local residents and various agencies coming together. The project did take a while, but all good things take time. Northcott resident Rodney, South Eastern Sydney Local Health District, Needle Clean Up Coordinator. Outputs from Step 7 Evaluation of the issues, benefits and risks pre and post system implementation Development of data collection tools and processes to monitor ongoing system performance Page 44

45 Where to from here? The City of Sydney and Housing NSW have committed to service and maintain the two community sharps bins at Northcott. They will also support the associated education activities and monitoring to ensure that the system continues to function effectively. The existing Memorandum of Understanding (MOU) between Housing NSW and the City of Sydney will ensure an ongoing commitment to effective community sharps management at the Northcott precinct. Northcott precinct Page 45

46 5 References, resources and useful contacts References Australian Standard 4031(1992): Non-reusable containers for the collection of sharp medical items used in health care areas. Australian Government Department of Health and Ageing (2002). Return on investment in needle & syringe programs in Australia. Australian and New Zealand Clinical Waste Management Industry Group (2007). Industry Code of Practice of the management of clinical and related wastes. (5th ed.). City of Sydney (2005). Syringe Management Plan SyringeManagementPlan2005_2010.pdf Housing NSW (2011). Tenant Engagement Framework. Tenant+Engagement+Framework.htm Local Government Association of Queensland (2003). Building Safer Communities: Community Sharps Management - A Handbook for Local Government in Queensland. FE-5630.pdf NSW Health (2004). Community Sharps Management Guidelines for NSW Councils. Page 46

47 Useful contacts Organisation Phone number & website Alcohol & Drug Information Service (ADIS) (02) City of Sydney Safe City Program (02) Diabetes Australia-NSW (DA-NSW) (02) Hepatitis NSW (02) Pharmacy Guild of Australia (NSW) Medical Industry Association of Australia (02) Needle Clean Up Hotline NSW Health (02) NSW Users & Aids Association (NUAA) NSW Environment Protection Authority (EPA) (02) (02) WorkCover NSW (02) For a list of Local Health Districts and their contact details please go to or contact NSW Health. Page 47

48 6 Glossary Community sharps Sharps generated by non-clinical activities including needles, syringes and lancets used by people living with diabetes and other medical conditions requiring self-injection in the home, and syringes used by injecting drug users in the home or in public places, (as defined in the NSW Health Community Sharps Guidelines for NSW Councils). Hot spots Areas where discarded needles are littered and frequently found, such as public toilets, parks, common areas in the built environment such as laundries and stairwells, or in waste collection areas. Lancets Small solid-bore needles used to prick the skin to monitor blood glucose levels. Community sharps bin A stainless steel cabinet which contains either a 1.4 litre, 23 litre, 120 litre or 240 litre internal sharps collection bin or container. Community sharps container After use, sharps need to be placed into a sharps container before disposing the container into a sharps bin. Sharps containers are generally bright yellow hard plastic containers or smaller black fitpack containers conforming to Australian Standard AS4031 for the disposal of sharps. The sharps container must be rigid, puncture resistant, unbreakable, leak resistant with a tightly sealed lid and labeled Sharps Waste or with the International Biohazard label. Licensed Waste Contractor Waste contractor with licence issued by the Environment Protection Authority (EPA) to transport clinical waste. Needlestick Injury (NSI) A wound caused by accidental penetration of the skin by a needle. Clinical Waste Service Provider Company contracted by a council or organization to service the community sharps bins. Servicing community sharps bins The servicing of community sharps bins includes the collection, transport and disposal of sharps waste. Social housing The collective term for government and community residential properties provided for low-income individuals and families. Examples of Australian Standard sharps containers in various sizes, including 10 litre, 2.8 litre, 1.5 litre and smaller sharps containers. Fitpak Black plastic personal sharps container. The fitpak includes new syringes and a compartment for placement of used syringes. Fitpaks are available at NSP outlets and Fitpak Scheme pharmacies, or purchased from vending machines. Sharps Includes both community sharps and sharps related waste. Sharps are an object or device having sharp points, protuberances or cutting edges that are capable of causing a penetrating injury to humans, for example needles, syringes, scalpels or blades, lancets, edged instruments, broken glass, bone fragments or any other item that might penetrate the skin. Sharps related waste Includes other equipment used in injecting such as water vials, cotton wool, alcohol swabs, balloons, plastic satchel bags, spoons, fitpaks, cut cans, tablet blister packs, syringe caps, syringe wrappers and tourniquets. Example of a fitpak showing a cross-section of the sharps container compartments and lid to seal the container prior to disposal into a sharps bin. Page 48

49 7 FAQ s Frequently asked questions (FAQ s) What are community sharps? NSW Health defines Community Sharps as: needles, syringes and lancets used by people living with diabetes and other medical conditions requiring self injection in the home, and syringes used by injecting drug users in the home or in public places (source: Community Sharps Guidelines for NSW Councils, 2005). What is community sharps management? Community sharps management comprises of fixed sharps bins for the appropriate collection and disposal of sharps or sharps safe containers; education resources and training; waste service providers to maintain the system; and residents and project staff to promote and monitor. Why create a community sharps system? Used sharps and injecting equipment are contaminated by blood, and blood may contain viruses and transmit infection. Where there is no sharps waste system, it is more likely that sharps will be disposed of in general waste or recycling, or discarded in public areas. Safe disposal through a sharps waste system minimises health and injury risks to self and others. How many people have contracted HIV from a discarded sharp? None. Globally there has been no report of a person contracting HIV from a community sharps needlestick injury. Staff in a clinical healthcare environment are at higher risk of contracting a blood borne virus as a result of needlestick injury, however rates of infection are very low. What is social housing? Social housing is the collective term for government and community residential properties provided for low-income individuals and families. Who needs to be involved? For social housing properties it is important to involve NSW Health, local councils, property owners, tenancy agents, residents and other local service providers. Can sharps be disposed in the garbage or recycling bin? No. Community sharps should always be kept secure and separate from other waste streams. Due to the risk of injury to workers, they should never be placed in a garbage or recycling bins. Page 49

50 How should sharps be collected and disposed? After use, sharps need to be placed into a sharps safe container. These are generally bright yellow hard plastic containers, or smaller black fitpack containers, and are available from pharmacists and others services that provide the sharps. Once the container is about two-thirds full the lid needs to be fastened and the container taken to a sharps disposal service or community sharps bin. The sharps bin is emptied by council s licensed waste contractors or council s waste service contractors (trained in sharps management) who then transport the contents to an Environment Protection Authority licenced facility which destroys sharps waste either by high temperature incineration or autoclaving, shredding and depositing as landfill. After the community sharps bins are installed, who maintains them? Maintenance of the bins may differ for each social housing community. For example, at Northcott, the City of Sydney manages the ongoing servicing and maintenance of the community sharps bins with council s clinical waste contractor. NSW Land and Housing Corporation s maintenance contractors are responsible for the upkeep and cleanliness of the social housing property and common grounds. Page 50

51 8 Sample documents The following documents were developed for the pilot project. They are organised for ease of access under each the four separate sections of the project cycle. Project stage Step no. Sample docs Sample No. Part A Survey Step 1 Data collection sheet (map and survey) Sample no. 1 Part B Plan Step 2 & 3 Step 3 Part C Implement Step 4 Step 5 Sharps management action plan Project plan table of contents Flyer - Engagement workshops Voting form Map of Northcott indicating hot spot areas for discarded sharps Fact sheet Northcott sharps management project Flyers to launch the sharps bins Sharps bin repair procedure Sample no. 2 Sample no. 3 Sample no. 4 Sample no. 5 Sample no. 6 Sample no. 7 Sample no. 8 Sample no. 9 Part D Monitor and evaluate Step 7 Survey evaluation templates Data collection sheet, statistics and graphs Sample no. 10 Sample no. 11 Other Community sharps management options Appendix 1 Sharps waste disposal procedure Appendix 2 Needlestick injury procedure Appendix 3 SAVE Community Sharps Management Video Appendix 4 Page 51

52 Sample 1: Data collection sheet (map and survey) Copyright 2011 City of Sydney Council, All Rights Reserved. Copyright 2011 Land and Property Information, All Rights Reserved. Copyright 2011 Sinclair Knight Merz, All Rights Reserved. Copyright 2011 Ausway, All Rights Reserved. This map has been compiled from various sources and the publisher and/or contributors accept no responsibility for any injury, loss or damage arising from the use, error or omissions therein. While all care is taken to ensure a high degree of accuracy, users are invited to notify Council?s GIS Group on of any map discrepancies. No part of this map may be reproduced without written permission. NORTHCOTT PRECINCT Sharps Data Collection 2011 Scale is 1:571 at A3 Document Produced: 20/05/2011 User: ejennings Page 52

53 Sample 1: Data collection sheet (map and survey) Page 2 DATE FECHA WHERE? DONDE? HOW MANY? CUANTAS? ANY OTHER INFORMATION MÁS INFORMACIÓN Page 53

54 Sample 2: Sharps management action plan Northcott Sharps Project SAMPLE of a SHARPS MANAGEMENT ACTION PLAN Action Responsibility Date Required resources Comments Finalise the Project Plan and submit to Area Director Housing NSW; Council <insert your date> <insert your required resources> Awaiting comments from all on revised components. Site confirmation meeting Project Team members Staff and contractors Meeting held. Data Collection Council project team member and Housing NSW Community Development Worker to coordinate pre trial data collection; HNSW contractor; NSW Needle Clean-Up Coordinator; Waste service contractors Ongoing Data collection tool Important for ongoing monitoring of potential new hotspots as well as evaluation of trial. Need to create processes that are timely and helpful. Draft 1 info fact sheet; to be distributed to community same week bins are installed at Project Team members <insert your date> 2 x 240 lire bins ordered Council <insert your Training to be delivered to HNSW staff, contractors and community leaders 1. workshop with residents / BBQ - same week bins are installed / launch 2. HNSW staff and 7 Contractor staff Installation of 2 bins at Northcott in selected locations Sharps waste contractors resume collection following the installation of the 2 bins Project team to discuss with project control group at next meeting date> <insert your date> Project team members <insert your date> Project team to advise at next project control group meeting <insert your date> Evaluation needs Project control group to finalise <insert your date> Engage SHPTA Timing of flyer distribution important. Builds on work with community to date re. this project. Also available at Community Centre, HNSW office Training materials developed; venue; dates; staff and contractors Flyer; mobile BBQ; catering items; waste services guides; recycling bags Collection procedure Data collection and relevant service providers. In stock. Focus on education re. harm minimisation, safe disposal, needlestick injury prevention and response. Currently Waste and Recycling is going well in Northcott, (source Waste Service) Project team members to co-ordinate timing. Access / timing issues. Define frequency of collection. Data collection Review and comments required from all based on revised evaluation plan. Page 54

55 Sample 3: Project plan table of contents Sample outline of the key components included into the Northcott Project Plan Table of Contents 1. Background 2. Problem or Issue Statement 3. Project Objectives 4. Options Analysis 5. Project Deliverables 6. Estimated Project Budget 7. Major Risks 8. Benefits 8.1 Tangible Benefits 8.2 Intangible Benefits 9. Alignment to Corporate Plan 10. Attachment 1: Project Scope 11. Attachment 2: Project Implementation 12. Attachment 3: Community Engagement and Training and Skills Development 13. Attachment 4: Key Performance Indicators 14. Attachment 5: Evaluation Data Page 55

56 Sample 4: Flyer Engagement workshops Northcott residents, get involved Make a decision about managing sharps Housing NSW (Central Sydney Region) and the City of Sydney want to know how to work with you to manage community sharps (needles, syringes and lancets). Unsafe disposal of sharps can be a risk to everyone. Come to an information/consultation session at Northcott Community Centre and: learn more about community sharps hear how they can be managed safely ask questions and get more info Nor get Make Housing NS how to wor lancets). Unsafe di Come to an le he as Monday 25 October pm Tuesday 26 October 12 2pm Monday 1 November pm Lunch & Afternoon Tea provided at all sessions Community Feedback session: Wednesday 17 November 1 3pm BBQ lunch provided For more information contact: Project officer details have been removed for the purpose of this toolkit. Monday 25 Tuesday 2 Monday 1 Lunch & A Communi BBQ lunc For more in Catherine C E. Catherine Dominic Gre E. dgrenot@ Page 56

57 Sample 5: Flyer Voting form Community Consultation Sharps Management in Northcott Project VOTING PAPER Please put a circle around the symbol to indicate your preference YES I WANT the Project in Northcott OR NO I DON T WANT the project in Northcott Thank you. 2 Page 57

58 Sample 6: Map of Northcott indicating hot spot areas for discarded sharps Page 58

59 Sample 7: Fact sheet Northcott sharps management project Sharps Management in Northcott Project What did you tell us? 55 Northcott tenants came to our workshops and 53 tenants voted YES to a Sharps Management Project. Will Northcott have a Sharps Management Project? The SAVE Project has started work straight away with the help of local health services. Right now this means Northcott is seeing a whole lot more of Rodney, the Needle Clean Up Coordinator from South Eastern Sydney Illawarra Health Services. You can report discarded sharps to the Needle Clean Up Hotline and Rodney will come to collect them NEEDLE When will the Project start? We have started work already! The project team are working with local pharmacies, GPs and community nurses so that we can make sure there is access to community sharps containers and bins for disposal. What will it look like? We will make sure there are more local sharps disposal options. We will trial bins in different locations and see what works. Where can I get sharps containers? Call Bek Martin at the City of Sydney Council and she can talk with you about the different options for getting containers. City of Sydney Page 59

60 Sample 7: Fact sheet Northcott sharps management project Page 2 Where do I put my sharps now? Place all sharps in a sharps container or a plastic puncture proof container like a drink bottle or takeaway container. A large container is currently kept at the Community Centre. Call the needle clean up hotline and tell them you have left your container at the Community Centre. Rodney will come to the Community Centre to collect full containers and leave new ones behind. What about the laundries? Residents told us there are real concerns about safety in the laundries in the main Northcott buildings. The Project Team are working on how to make the laundries safer. Any changes to laundries will be subject to further consultation with tenants and Housing NSW. In the meantime, take extra care by making sure you don t put your hands and fingers in a spot where you can t see. How do I report needles in public places? Call the Needle Clean Up Hotline How do I report needles inside Northcott Buildings? Call Housing NSW Call Centre Who can I talk to about the project? Project officer contact details have been removed for the purpose of this toolkit. Page 60

61 Sustainable Action Sample 8: Flyers to launch the sharps bins Northcott Precinct Community sharps bins Two community sharps bins will soon be available next to the recycling bays at Northcott. Collect your needles, syringes and lancets into a sharps container at home, and place this container in the community sharps bin. You can get sharps containers at the Northcott Community Centre or by calling the Needle Clean Up Hotline. This project is supported by the New South Wales Government through its Environment Trust Launch of the Northcott Precinct Community Sharps Bins You re invited! Join us for a free lunch to celebrate the launch of two community sharps bins for the Northcott local neighbourhood: Thursday 28 July, 12pm to 2pm Northcott Community Centre Community sharps are needles, syringes and lancets, which are used by many people including those who have medical conditions, such as diabetes. Community sharps can cause injury if not managed properly through a clinical waste system. Fifty-five Northcott Precinct tenants were consulted about ways to manage community sharps, and of these 53 voted YES to a community sharps bin. Values Everyone This project is supported by the New South Wales Government through its Environment Trust Values Everyone Sustainable Action Page 61

62 Sample 9: Sharps bin repair procedure Northcott Community sharps bin Sustainable Action Values Everyone Sharps Waste Disposal Procedure Collect your used needles, syringes and lancets in a sharps container, and put it in this bin. If you find discarded sharps waste: - Call the Needle Clean Up Hotline on If the sharps waste is inside Housing NSW property, call the Housing Contact Centre on If this bin is broken, full or damaged please contact us on so that we can fix the problem as soon as possible. This project is supported by the New South Wales Government through its Environment Trust Page 62

63 Sample 10: Survey evaluation templates Round 1 SAVE projects - baseline survey (1) Question 1 Project name: Yarra House Kooloora Community Garden Russian Bilingual Educator Waterloo Kerbside Service Education Northcott Sustainability on a Shoestring Ngadu Hostel Garden Jubilee Reserve Community Garden Project A Project B Project C Question 2 Participant Name: Question 3 How did you hear about this activity? (garden, workshop, water tank) Face to face Letter Flyer Other Question 4 What made you decide to join the activity / register your participation? Question 5 - Rating Scale How important would you say the environment (living in an environmentally friendly way) is to you? Not at all Not much Neutral A bit A lot Question 6 - Rating Scale How much would you say that you know about the environment now? Not much at all Not much Neutral A bit A lot Page 63

64 Sample 10: Survey evaluation templates Page 2 Question 7 Are there things that you do in your daily life that are environmentally friendly? E.g. Recycle plastics, glass Garden Use public transport often Walk for short trips Turn off lights and heaters Reduce water use Other, please specify Question 8 Where do you find out about environmental issues (environmentally friendly) ways of living? Family Friends/ Neighbours TV, Radio Magazines Council Other service Internet Other, please specify Question 9 Have you ever done any other environmental activities like a workshop? Yes No Question 10 If yes, what was the workshop, project, activity? Question 11 This activity has a focus on (energy saving, water saving, community gardening etc) - what sorts of things are you hoping to learn about from the activity? Page 64

65 Sample 10: Survey evaluation templates Page 3 Question 12 Are you doing anything to look after the environment at the moment (around your home)? Switch off lights when not in use Switch off appliances when not in use Use draft stoppers Switch off the hot water cylinder when not in use Reduce length of showers Other Heading Community wellbeing indicators - Baseline Question 13 Where do you live at the moment? Type of dwelling? (Suburb and unit/house/ etc) Question 14 How long have you lived here? 0 to 6 months 7 months to 1 year 1 to 5 years 6 to 10 years Over 10 years Question 15 Do you like living here? Yes No Question 16 Why or why not? Page 65

66 Sample 10: Survey evaluation templates Page 4 Question 17 Do you feel that your suburb is a safe place to live? Yes No Question 18 Why or why not? Question 19 In the past 3 years have you taken part in a community activity - social group, volunteering, and events at your local community centre? If no, go to question 21. Yes No Question 20 If yes, what were you doing? Question 21 When you are in a group, and you disagree with what other people are saying, do you feel free to speak out? Yes, a lot Yes, a little No Question 22 Do you agree that most people can be trusted? Not much at all Not much Neutral A bit A lot Question 23 Are you able to ask your neighbours for help if you need it? Yes No Additional Comment Page 66

67 Sample 10: Survey evaluation templates Page 5 Round 1 SAVE Sharps at Northcott: Follow up Question 1 Participant name: Question 2 Participant age 15 to to to to to and over Question 3 Gender Male Female Page 1 - Question 4 - Yes or No Did you come to any of the earlier meetings about the Sharps project? Yes No Additional Comment Question 5 Are you pleased that the Sharps bins have been installed? Yes No Additional Comment Question 6 How did you hear about today's launch? Flyer Poster From a friend From a neighbour Just walking past Other, please specify Page 67

68 Sample 10: Survey evaluation templates Page 6 Question 7 Have you learnt more about the following from the Sharps project? Not at all Not much Neutral A bit A lot safe Sharps disposal Sharps and general health waste reduction other environmental issues Question 8 Is there anything else you have learnt from the Program? Yes No If yes, what have you learnt? Question 9 Are there other things about the Project that are important to you? getting out for a social event seeing my friends enjoying the company of others making our community safer Other, please specify Question 10 Have you told anyone else about what you learnt at the Sharps meetings? Yes No If yes, who have you told (eg. family, friend, neighbour...)? Question 11 If yes, do you think they do anything different because of what you have told them? Yes No If yes, please describe what they are doing differently: Question 12 Are there any other things that you would like to see happen at Northcott as a result of the Sharps project? Page 1 - Question 13 - Open Ended - Comments Box General comments: Page 68

69 Sample 10: Survey evaluation templates Page 7 Final SAVE Project Feedback Gender M/F Question 1 Name (for our purposes only) Question 2 Has you knowledge about the environment changed since you have been involved with the SAVE project [insert name]? Yes No Its about the same Question 3 How much more would you say that you know about the environment now? nothing more (go to Q5) a little a reasonable amount a lot a very great deal Question 4 If you said that you know more about the environment (e.g. a little a lot, a great deal etc), could you briefly explain below what it is you have learned? Question 5 Could you please say whether or not you are doing the following environmentally friendly things any more or less as a result of the SAVE project [insert project name]? Less about the same more a lot more Recycling plastics, glass Safe Sharps disposal Using public transport Walking (for short trips) Turning off lights and heaters Using less water anything else - if so please specify here Question 6 Have you met any new friends through your involvement with the SAVE project [insert project name]? Page 69

70 Sample 10: Survey evaluation templates Page 8 Yes No Question 7 Do you this that the SAVE project [insert project name] has made a difference to how you feel about your neighbourhood or where you live? Yes No Question 8 Please tell us why you answered yes or no to the question above? Question 9 Has your experience with the SAVE project [insert project name] influenced you to become more involved in other community activities? Yes No (please go to question 8) Question 10 If you answered yes could you please explain below what other community activities you are involved in e.g. help as a volunteer, taken more workshops to learn more about the environment, other examples...? Question 11 When you think about the SAVE project [insert project name] what are the things that you have enjoyed most about the process? Question 12 If the SAVE project [insert project name] was just getting going now and knowing what you know now would you have any suggestions or improvements for those organising and delivering the project? YES go to Q10 No (finish with this question) Question 13 Please explain your suggestions or improvements below and why you think they would be helpful Page 70

71 Sample 11: Data collection sheet, statistics and graphs NORTHCOTT COMMUNITY SHARPS PROJECT. Sharps collection statistics 5 August June 2012 Date of Service Sharps in Bin (West) Sharps in Bin (East) Total Sharps 05 August August August August September September September September September October October October October November November November November December December December December December January January January January February February February February March March March March March April April April April May May May May June June June June June Totals to date Northcott Sharps Bin Collection Statisitics - June 2012.doc Eve Jennings, Project Coordinator Safe City City of Sydney Given the public access to the bins, it is assumed that the broader community may also be using them. Page 71

72 Sample 11: Data collection sheet, statistics and graphs Page 2 NORTHCOTT COMMUNITY SHARPS PROJECT. Sharps collection statistics 5 August June 2012 Northcott Sharps Project TOTAL SHARPS COLLECTED FOR EACH MONTH SINCE INSTALLATION Sharps Collected August September October November December January February March April May June Month Northcott Sharps Bin Collection Statisitics - June 2012.doc Eve Jennings, Project Coordinator Safe City City of Sydney Page 72

73 9 Appendix Appendix 1: Community sharps management options Options Pros Cons System: Supply of personal use sharp containers Needle and Syringe programs (NSP) A network of outlets that supply sharps containers. NSW Users and AIDS Association (NUAA) Advice and outreach service. Pharmacy Fitpak Scheme A program run by 400 pharmacies in NSW, which makes new equipment and sharps containers available to injecting drug users. Local community health centres Some Local Health Districts may provide local community sharps containers and disposal collection facilities at local community health centres. Majority of NSP outlets provide free sharps containers and kits. Anonymity provided to any member of the public to dispose of their personal sharp containers and collect new sharp containers. Free portable sharps containers, kits and equipment can be accessed anonymously by any member of the public. New syringes and personal use sharps containers are provided free to clients who return used injecting equipment to participating pharmacies. Ease of access and convenience for residents to dispose of their personal sharp containers and collect new sharp containers. Reduce the incidence of residents stockpiling containers of sharps at home. Not all NSP outlets may supply replacement sharps containers. Not all NSP outlets are accessible 24 hours a day, 7 days a week. Sydney-based only. Not accessible 24 hours a day, 7 days a week. Access limited to operating business hours. Not all residents may want to be members in order to participate in the Pharmacy Fitpack Scheme. Not accessible 24 hours a day, 7 days a week. Access limited to operating business hours. Not all local community health centres supply free sharps containers. Not accessible 24 hours, 7 days a week. Note: Refer to Step 2 and Section 5 of this toolkit for information on resources, networks and useful contacts who can provide education, training and support programs for residents. Page 73

74 Options Pros Cons System: Education, training and supporting programs Education and training in sharps waste management To residents, staff and maintenance contractors by a Registered Training Organisation or agency with expertise in safe sharps disposal (i.e. NSW Health, Workcover NSW, TAFE NSW). Low cost option. Training can be conducted as in-kind contribution by Local Health District Needle and Syringe Program (NSP), Diabetes Australia NSW, NSW Users and AIDS Association (NUAA) and council staff with expertise in sharps management. Increase social housing residents awareness of local community health centre services, Needle Syringe Programs and participating pharmacy outlets. The education and training may not target, consult and promote the program to the right people. System: Disposal facilities for the collection, service & treatment of sharps Public hospitals Provide a free sharps disposal service. Needle and Syringe Program (NSP) Outlets provide a network of disposal facilities. NSW Users and AIDS Association (NUAA) Advice and outreach service. Residents can dispose of sharps containers at the hospital sharps disposal service free of charge. Service is available to any member of the public. Service is available to any member of the public 24 hours a day, 7 days a week. All NSP outlets are required to accept all used community sharps free of charge regardless of how the sharps were generated or whether a person is an NSP client. Service also provides education, training and information to residents. The majority of NSP outlets offer a 24 hours a day, 7 days a week sharps disposal option. Anonymous disposal of sharps containers. NUAA offers a 24 hours a day, 7 days a week sharps disposal option. Not all residents may be able to readily access the service due to transport, parking or personal mobility issues. Service does not include the supply of replacement sharps containers. Not all NSP outlets are accessible 24 hours a day, 7 days a week. Sydney-based only. Not all residents may be able to readily access the service due to transport, parking or personal mobility issues. Note: Refer to Step 2 and Section 5 of this toolkit for information on resources, networks and useful contacts. Page 74

75 Options Pros Cons System: Disposal facilities for the collection, service & treatment of sharps Community health centres Local Health Districts may provide community sharps disposal facilities and sharps containers in community health centres. Public disposal bins Community sharp bins could be installed in close proximity to social housing properties. Bins can be strategically placed in areas such as parks, public buildings, and carparks. On-site community sharp disposal bins system Dedicated bins located on the grounds of the social housing properties for the collection and disposal of sharps. Ease of access and convenience for residents to dispose of their personal sharp containers. Some local health districts may include a program for supply of new sharps containers. Reduce the incidence of residents stockpiling containers of sharps at home. Readily accessible location for disposal of sharps waste. Larger sharps bins accommodate for all size personal use sharp containers. Readily accessible and convenient location for residents to safely dispose of their personal sharps containers. Greater confidentiality for disposal of sharps waste. Waste service collection services are cost effective to include under council s collection services compared to the high costs for a social housing provider. Some residents may prefer to use a disposal option that provides greater confidentiality. Residents may not feel comfortable using public disposal bin facilities. Initial set-up costs for purchase of bins. Note: Refer to Step 5, Table 1 for the type of sharps waste bins to consider for your on-site community sharps system. Page 75

76 Appendix 2: Sharps waste disposal procedure Sharps Waste Disposal Procedure Applies to UNSAFELY DISCARDED SHARPS WASTE Procedure Cleaning Never place hands into any hidden areas (e.g. drains, cavities, washing or garbage bags) where the hands or fingers are not clearly visible Preparation For Disposal Use protective equipment such as gloves, tongs and clothing for picking up discarded injecting equipment Take a sharps disposal bin to the items for disposal Disposal Do not attempt to recap, break or bend needles To avoid accidental injury make sure no one is standing nearby when collecting sharps Place the sharps container on the ground beside the sharps to be collected - never hold the container Pick up the needle/syringe by the barrel using tongs or gloved hand Place the needle/syringe in the sharps container, sharp end first Follow Up Action Wash hands with warm water and soap and dry Notify your manager of the waste Replace sharps bin with a new empty bin when three-quarters full Keep sharps waste separate from other waste Clearly identify sharps waste Further Information Kirketon Road Centre City of Sydney Your Licensed Waste Contractor T: Page 76

77 Appendix 3: Needlestick injury procedure Needlestick Injury Procedure Applies to PUNCTURING OF SKIN BY A DISCARDED NEEDLE/ EXPOSURE TO BLOOD Procedure Immediate Management Wash the site with soap and water Do not squeeze but if bleeding allow the blood to flow Apply antiseptic and a band-aid If blood gets in your eyes, rinse them with a mild salt solution or tap water If blood gets into your mouth, spit and then rinse with water a few times Safely dispose of the needle into a sharps disposal bin Follow Up Action Notify your manager of the injury Contact a doctor or health service within 24 hours of a needlestick injury for further advice Complete and lodge an Incident Report with the insurance provider for the premises Further Information Kirketon Road Centre St Vincent s Hospital, Darlinghurst Emergency Royal Prince Alfred Hospital, Camperdown Emergency PEP Hotline Your local doctor T: Page 77

78 Appendix 4: SAVE Community Sharps Management Video vimeo.com/saveprogram A still from the video Page 78

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