Based on the 2435 parenteral exposures sustained by staff reported in 2005 from 170 Australian hospitals, it is possible that an estimated more than 18 500 needle-stick injuries (NSIs) could occur in Australian hospitals each year. These injuries are largely preventable. Each injury causes significant distress to the involved healthcare worker. To reduce the local burden of NSI, administrators and clinicians require incident and organisation-specific information. This information enables targeted prevention strategies, including safety engineered devices, to be implemented. The larger the dataset of NSI information, the better the opportunity to develop appropriate targeted strategies. Unfortunately, the Australian healthcare sector has, to date, largely overlooked the issue of standardising NSI monitoring, with a small 56-hospital, quasi-national surveillance system becoming non-operational in 1998. However, the recent initial enthusiasm the sector has demonstrated for increased patient and healthcare worker safety provides an excellent platform from which to consider possible models that could be adopted for routine monitoring of NSIs and mandated use of safety engineered devices.