This study aimed to determine nurse reported organizational risk management and nurses' perceptions of workplace risk associated with sharps-related injuries. A cross-sectional survey was carried out on a sample of nurses from the New South Wales Nurses' Association, Australia in 2007 (n = 7423), and there were 1301 eligible participants. Overall, 73% participants reported that organizational policies were followed in the event of a “sharps including needlestick” injury. Participants reported working in sharps safety oriented organizations, routine hepatitis B vaccination, sharps disposal containers at point-of-use locations and availability of safety engineered devices in their organizations. Sharps including needlestick injury data were not routinely provided to staff, many nurses reported recapping and just one-third had recently attended sharps injury prevention training. Nurses' perceptions of risk associated with sharps including needlestick injury were variable. Health-care organizations are responsible for provision of safe workplaces and work practices, policies, workplace culture and prevention strategies, and appropriate responses when nurses are injured. These results have been used to propose recommendations to improve some of these risk management strategies.