IN RESPONSE TO INCREASING needle sticks and sharps injuries at a large, urban trauma center in the northeastern United States, a nurse educator assembled a focus group of OR staff members to determine what they perceived to be barriers to successful implementation of a sharps safety program. THE FOCUS GROUP IDENTIFIED inadequate communication, powerlessness, resistance to change, intimidation, inconsistencies in practice, negative attitudes, inexperienced staff members, and time constraints as barriers to a successful change implementation. USING THIS INFORMATION, the nurse educator identified strategies to implement a practice change to decrease the rate of needle sticks and sharps injuries.