AORN 2025 Sharps Safety Update: Addressing Needlestick Injuries in the OR

Perioperative Sharps Injuries: A Growing Patient and Staff Safety Concern


The 2025 guidelines released by the Association of periOperative Registered Nurses (AORN) reinforce a growing concern: needlestick and sharps injuries (NSIs) remain a top occupational hazard in surgical care. Despite decades of awareness campaigns and regulatory pressure, perioperative environments continue to experience the highest rate of sharps-related injuries. Recent data shows that 43% of all reported NSIs occur in the OR, more than any other area of healthcare practice [1].

Suture needles continue to be the most frequent culprit, with incidents often occurring during passing, disassembly, or improper disposal. Alarmingly, up to half of these injuries still go unreported [1], masking the full scope of risk. While nonsurgical sharps injuries have declined since the passage of the Needlestick Safety and Prevention Act, AORN data indicates a 6.5% increase in surgical NSIs, highlighting a gap between compliance on paper and real-world safety in the OR [2].

New AORN Guidelines for 2025: What’s Changing in Sharps Safety Protocols


The updated AORN sharps safety guideline incorporates the latest evidence on device performance, behavioral factors, and institutional practices. The guideline now recommends active involvement of perioperative staff in evaluating safety-engineered devices, regular use of hands-free passing techniques, and immediate disposal of sharps in clearly marked, rigid containers. Perhaps most notably, AORN calls for a shift away from annual training toward continuous, scenario-based micro-education and post-incident debriefs [1].

These changes reflect a recognition that checklist-based compliance is not enough. Instead, AORN is pushing for a culture of proactive risk identification and real-time response, especially for high-risk activities like suturing, injections, and handling used devices during high-acuity procedures.

Why the OR Remains the Most Dangerous Place for NSIs


Needlestick injuries are more than just a function of equipment, they stem from the nature of surgery itself. Fast-paced, high-pressure environments with multiple personnel, instruments, and procedural demands create ideal conditions for accidental exposure. Traditional safety devices may interrupt flow or require awkward movements that disrupt the surgical rhythm. Even with training, fatigue, distraction, and production pressure often cause lapses in safe handling, especially when sharps disposal bins or passing zones aren’t optimally placed [2].

Engineering Sharps Safety Devices for the Surgical Workflow


The 2025 AORN update emphasizes that engineering controls must complement workflow, not fight it. One example is HypoHolder, a Class I FDA-registered sharps safety device developed by KODA Ideaworks. HypoHolder is designed for single-handed needle uncapping, recapping, and disposal. It uses a magnetic base and sterile insert to stabilize hypodermic needles, allowing clinicians to work safely and efficiently, even during fast-paced or high-stress surgical procedures. While HypoHolder is not a universal solution, it illustrates the kind of user-centered innovation AORN encourages: tools that align with OR realities while promoting safety without delay [3].

Reducing Surgical Needlestick Injuries Requires More Than Compliance


The new AORN guideline recognizes that preventing sharps injuries in surgery requires more than box-checking. Hospitals and surgical teams must embed safety into daily practice through a mix of practical tools, process design, and culture. Integrating feedback from frontline teams, encouraging transparent reporting, and piloting devices that support intuitive safety behaviors are essential. Injury prevention cannot be reactive, it must be proactive, personalized, and built into every procedure.

Conclusion: Sharps Safety in Surgery Demands Smart Tools and Strong Culture


Needlestick injuries in the OR are preventable, but only with focused action and aligned tools. AORN’s 2025 guideline underscores the need to modernize surgical safety protocols with real-time education, intuitive equipment, and shared accountability. Tools like HypoHolder support this transformation by offering safe, efficient needle handling aligned with clinical demands. To protect healthcare professionals and optimize patient safety, hospitals must go beyond policy and make perioperative sharps safety a top operational priority.

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[1] AORN. (2025). Sharps Safety Guidelines Update. Retrieved from https://www.aorn.org/guidelines/clinical-resources/sharps-safety
[2] Association of Occupational Health Professionals. (2023). The Increasing Risk of Sharps Injuries in Perioperative Settings. Retrieved from https://www.aohp.org/Pages/Resources/Safety/SharpsInjuries.aspx
[3] HypoHolder. (2025). FAQ and Product Overview. Retrieved from https://www.hypoholder.com/faq