In response to health care workplace regulations in the United States, the handling and disposal of needles and other sharps devices used in patient care has improved, and the use of safety-engineered sharps devices has greatly increased. A recent survey of hospital nurses has found higher rates of injury and lower rates of safety equipment use in countries other than the United States.

Using data gathered in 1998 and 1999 in a survey of more than 34,000 RNs in the United States, Canada, the United Kingdom, and Germany, researchers examined the reported use of safety devices and rates of injury from sharps. In the United States (Pennsylvania RNs were considered representative), 78% of nurses used needleless IV tubing systems, and 37% used safety-engineered needles, compared with 58% and 14%, respectively, in Canada, and 9% and 7% in Germany. The annual sharps injury rate per 1,000 full-time positions in the United States was around 150, while the rates in Canada (209) and Germany (488) were significantly higher. In the United States and Canada, ED and operating room RNs had the highest rates of sharps injuries; neonatal nurses had the lowest. Among the countries surveyed, the United States had the highest use of safety-engineered devices and the lowest rate of sharps injuries, suggesting that workplace regulations in this country have had a positive effect on the safety of health care workers.