What are Needlestick Injuries?
Needlestick injuries which are also known by the name of percutaneous injuries are quite a normal occurrence in the healthcare sector. It is estimated that approximately 200,000 healthcare workers are affected by Needlestick Injuries every year in the United States alone. There are approximately 20 bloodborne pathogens which can be transmitted to an individual as a result of Needlestick injuries. These include certain serious medical conditions like HIV, hepatitis B and C. An immediate response to Needlestick injuries can greatly decrease the risk of having bloodborne diseases as a result of this occupational hazard.
What to do if You Sustain a Needlestick Injury at Work?
Knowing about the disease contracted following Needlestick Injuries and the latest update on managing the condition is the best approach towards treating and managing this type of occupational hazard. As soon as you encounter a Needlestick Injury, wash the site of the injury by sterile water and soap. Try not to use any disinfectant or any bleach as it may not help the condition. Expressing blood from the injury site is also something which will not be helpful if the pathogen has already infected the blood and in no way does it reduce the transmission of disease due to Needlestick Injuries.
The next step to do is, depending on the protocol followed by your healthcare institution, notify your immediate supervisor about the Needlestick Injury. You can also inform the immediate response team or department which is responsible for managing exposures. You may need to fill out a detailed incident report. Once you are through with these formalities, you may proceed directly to the emergency room for treatment.
The role of the supervisor here is that he or she should contact the source of the Needlestick Injury which is the patient in this case and screen the patient for any bloodborne diseases in case if the status of hepatitis and HIV is not known of the patient. It should be noted here that the patient’s consent is required before initiating such tests. In case if the patient tests positive for hepatitis B then further tests should be conducted for hepatitis C as well. In case if the patient tests positive for HIV, then the viral load should be found out. The greater the viral load the more are the chances of the disease being transmitted after Needlestick Injury.
In the meanwhile, PEP or postexposure prophylaxis of the employee in question should not be stopped to wait for the test results. In cases of HIV related tests, since the results are not known within a day thus the CDC or the Center for Disease Control recommends to conduct a quick HIV test to check whether the employes tests positive or negative.
The physician evaluating the employee with Needlestick Injury tests immediately for hepatitis B and C and will take a baseline of the employee preexposure to compare it to the results postexposure.
It should be noted here that Occupational Safety and Health Administration has made is mandatory for all employers especially in healthcare sector and other occupationally hazardous sectors to have a form which needs to be filled out by the employee in case of an exposure or in this case a Needlestick Injury so that these incidences are properly documented.
The employee needs to fill in detail the date and time of the incident of the Needlestick Injury and giving a detailed description as to how the incident happened. It is important to mention whether the needle was clean or contaminated. The employee also needs to mention in detail whether there was any bleeding from the injury site or not immediately after the Needlestick Injury. The employee will also need to make a mention of whether any fluid or blood was injected or aspirated by the needle at the time of Needlestick Injury.
When recording the details of the source, the details of the HIV, hepatitis status of the patient should be documented. In case if a patient is diagnosed of HIV, then the stage of the disease and the viral load should also be mentioned. In case if the status of the mentioned diseases are not known then taking the patient’s history can be of great help in determining whether there could be a chance of the patient having such a condition like whether the patient is a recreational drug abuser, has had sexual intercourse with various partners and the like.
The employee needs to document the medications that may have been prescribed to him or her immediately after exposure. In case if the employee is pregnant, then that should also be clearly mentioned in the report.
As soon as the incident form is completed immediate treatment should be started for hepatitis B and C within 24 hours of the exposure for best results.
The Occupational Safety and Health Administration has made it mandatory for every healthcare institution to provide guidance for immediate reporting, evaluation, counseling, treatment, and followup following a Needlestick Injury. As a part of this plan, it is mandatory for all healthcare institutions to have 24 hour access to hepatitis vaccines and antiretroviral medications for timely intervention post a Needlestick Injury.
It also directs the institution to supply safer needles and instruments so as to avoid incidences of Needlestick Injury and to always be at par with the latest developments in terms of medicines and other advances made in the field of medical science to protect and prevent their employees from something like a Needlestick Injury. Some institutions have introduced needleless IV systems in their hospitals which have significantly reduced the incidences of Needlestick Injuries.
- Centers for Disease Control and Prevention (CDC) – Needlestick Injuries: https://www.cdc.gov/niosh/topics/bbp/emergnedl.html
- Occupational Safety and Health Administration (OSHA) – Bloodborne Pathogens: https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.1030
- National Institute for Occupational Safety and Health (NIOSH) – Preventing Needlestick Injuries in Healthcare Settings: https://www.cdc.gov/niosh/docs/2000-135/
- World Health Organization (WHO) – Injection Safety: https://www.who.int/news-room/fact-sheets/detail/injection-safety
- Mayo Clinic – Needlestick Injuries: https://www.mayoclinic.org/diseases-conditions/hepatitis-c/symptoms-causes/syc-20354278
- WebMD – HIV/AIDS: https://www.webmd.com/hiv-aids/
- National Center for Biotechnology Information (NCBI) – Post-Exposure Prophylaxis (PEP) for Occupational HIV Exposure: https://www.ncbi.nlm.nih.gov/books/NBK525989/
- American Nurses Association (ANA) – Needlestick and Sharps Injuries: https://www.nursingworld.org/practice-policy/work-environment/health-safety/needlestick-and-sharps-injuries/
- Journal of Occupational Health – Needlestick Injuries in Healthcare Workers: A Literature Review: https://www.jstage.jst.go.jp/article/joh/54/2/54_16-0270-RA/_article