APPENDIX VIII

LESSON PLAN

Title of Course: Laptop assisted teaching

Topic: Needle Stick Injury

Name of the student teacher: Jatinder Kaur

Place: Pediatric Units/ Conference hall

Sample: Staff nurses working in Pediatric units.

Duration: 60 minutes

Method of teaching: Lecture cum discussion

Teaching aids: PPT slides, chlak board, flash cards

General objectives: At the end of the session staff nurses will gain knowledge and
understand regarding the Needle stick injury and their complications.

Specific objectives: On completion of laptop assisted teaching staff nurses will be able to:

1. Introduce Needle stick injury.

2. Define Needle stick injury.
3. Enlist the causes of Needle stick injury.
4. Explain the types of infections transmitted by Needle stick injury.
5. Enlist the workers who are at the risk due to Needle stick injury
6. Describe the places where sharp injuries occur.
7. Enlist the devices involved in Needle stick injuries.
8. Clarify the factors that influence for acquiring infections by Needle stick injury.
9. Explain the universal precautions.
10. Enumerate the medical management of Needle stick injury.
11. Explain the nursing management of Needle stick injury.
S.NO TIME SPECIFIC CONTENT TEACHING LEARNING AV AIDS EVALUATION
OBJECTIVE ACTIVITY ACTIVITY
1. 1Min To introduce My name is Jatinder Kaur M.Sc Nursing PPT
self. (Peadiatric) 2nd year student from Adarsh College
of Nursing, Patiala.

INTRODUCTION
2. 3 min To introduce Lecture cum Listening PPT, What do you
The origin of needles was found in Greek and
the Needle discussion Chalk mean by Needle
Roman. Irish physician Francis Rynd invented the
Stick Injury. Board Stick Injury?
hollow needles. Modern needles are manufactured
from high carbon steel wire. a needle has three
parts, the hub, the shaft, and the bevel. The shafts,
the long slender stem of needle. Needle stick
injuries are a hazard for people who work with
hypodermic syringes and other needle equipment.
These injuries can occur at any time when people
use, disassemble, or dispose of needles. Needlestick
injuries are known to occur frequently in healthcare
settings and can be serious. Phlebitis, redness offen
seen afer needle injury. While the introduction of
universal precautions and safety concious needle
designs has led to a decline in needlestick injuries,
they continue to be reported,
 albeit on a much smaller scale than in the past.
Awareness of needlestick injuries started to develop
soon after the identification of HIV in the early
1980s. However, today the major concern after a
needlestick injury is not HIV but hepatitis B or
hepatitis C. Guidelines have been established to
help healthcare institutions manage needlestick
injuries and when to initiate post-exposure HIV
prophylaxis. The needlestick safety and prevention
act was signed into law in november 2000.

3. 4 Min To define the DEFINITION Lecture cum Listening PPT, What is the
Needle stick A Needle stick injury is a percutaneous piercing discussion Chalk definition of
injury. wound typically set by a needle point, but possibly board needle stick
also by other sharp instruments or objects. injury?
Or
A penetrating stab wound from a needle that may
result in exposure to blood or other body fluids.
The main concern is exposure to the blood or other
body fluids of another person who may be carrying
infectious disease.
S.NO TIME SPECIFIC CONTENT TEACHING LEARNING AV AIDS EVALUATION
OBJECTIVE ACTIVITY ACTIVITY
4. 4 Min Enlist the CAUSES: Lecture cum Listening PPT, What are the
causes of  Unsafe work practice discussion Chart causes of Needle
Needle stick  Failure to use safety engineered needles stick injury?
injury.  Failure to dispose properly
 Disposal system failures
 Inappropriate guidence
 Lack of inservice education system
 Lack of manpower
 Lack of time and patience

5. 4 Min Explain the Lecture cum Listening PPT What are the
INFECTIONS TRANSMITTED BY SHARP
types of INJURY discussion infections that
infections are transmitted
There are so many infections transmitted
transmitted by by needle stick
but common infections are:
Needle stick injury?
 Hepatitis B (30%)
injury.
 Hepatitis C(3%)
 HIV(0.3%)
Rare infections occur:
 Gonorrhoea
 Ebloa fever
 Malaria
  Syphilis
 Tuberculosis
 Herps
 Mycobacteriosis
 Streptococcus aureus

6. 5 Min Enlist the PPT,

WORKERS WHO ARE AT RISK FOR BLOOD
Lecture cum Listening Which workers
workers who flash
BORNE INFECTION DUE TO NEEDLE STICK
discussion are at the risk
are at the risk cards
INJURY:
of infection due
due to
Health care workers with frequent blood exposures are:
to Needle stick
Needle stick
 Nursing staff
injury?
injury.
 Physicians
 Nursing students
 Surgeons
 Emergency care providers
 Clinical wastage handlers
 Laboratory technicians
 Cleaning staff

Lecture cum PPT, What are the

7. 3 Min Describe the WHERE DO SHARP INJURIES OCCURE: Listening
discussion Chalk places where
places where  Patient room
board sharp injuries
sharp injuries  Operating room
occure?
occur.
 Outpatient
 Emergency
S.NO TIME SPECIFIC CONTENT TEACHING LEARNING AV AIDS EVALUATION
OBJECTIVE ACTIVITY ACTIVITY
 Laboratory

8. 4 Min Enlist the WHICH DEVICES ARE INVOLVED IN Lecture cum Lestening PPT Which devices
devices SHARP INJURIES discussion are involved in
involved in Six devices account for 78% of all injuries are: Needle stick
Needlestick  Disposable syringes injury?
injuries.  Suture needle
 Winged steel needles
 Intravenous needles
 Phlebotomy needles
 Scalpels

Lecture cum Listening PPT Which factors

Clarify the FACTORS THAT INFLUENCE RISK FOR
9. 5 Min
discussion influence for
factors that ACQUIRING INFECTIONS
acquiring
influence for Factors are:
infections by
acquiring  Amount of virus present in contaminated
Needle stick
infections by fluid
injury?
Needle stick  Depth of injury
injury.  Type of device
 Amount of blood
 Prevalence of virus in patient population
 Immune status of HCW
  Immediate aftercare and use of PEP
 Plasma viramia of source

10. 7 Min Explain the BODY FLUIDS TO WHICH UNIVERSAL Lecture cum Listening PPT What are the
universal PRECAUTIONS APPLY discussion universal
precautions to  Blood precautions?
prevent cross  Vaginal secretions
infection.  Semen
 Cerebrospinal fluid
 Pleural fluid
 Amniotic fluid
 Pericardial fluid
 Other body fluids containing blood

STANDARD PRECAUTIONS
 Barriers protection
 Hand washing at least 20-30 seconds
 Safe technique
 Safe handling
 sharp items discard in sharp containers
 specimens
 spill of blood
 body fluids
S.NO TIME SPECIFIC CONTENT TEACHING LEARNING AV AIDS EVALUATION
OBJECTIVE ACTIVITY ACTIVITY
LIST OF PPE( personal protective equipment)
 Shoe cover
 Gown
 Cap
 Mask
 Goggles
 gloves

11. 10 Enumerate
Min MEDICAL MANAGEMENT Lecture cum Listening PPT, What is the
the medical
Chalk
POST PROPHYLAXIS OF HIV discussion medical
management board
management of
of Needle  Post-exposure prophylaxis (PEP) means
needle stick
stick injury. taking HIV medicines within 72 hours after
injury?
a possible exposure to HIV to prevent HIV
infection.
 PEP must be started within 72 hours (3
days) after a possible exposure to HIV. The
sooner PEP is started after a possible HIV
exposure, the better.
 If you are prescribed PEP, you will take
HIV medicines every day for 28 days.
  Use of NRTI ( nucleoside reverse
transcriptase inhabitors ) ziduvidine 200mg,
lamuvidine 150mg for 4 week.
 Non nucleoside nevirapine not
recommended

POST EXPOSURE MANAGEMENT OF

HEPATITIS C:
 Detemine status of source ( Anti HCV)
 No active prophylaxis immunoglobulins not
effective
 Interferon not recommended for prophylaxis
 Blood test immediately and at 6 months,
liver function test and anti HCV at 4-6
months

POST EXPOSURE MANAGEMENT OF

HEPATITIS B:
The efficency of Hepatitis B immunoglobulin and
HBV vaccine for postexpousure protection in
occupational expousre can be referenced. Hep B
vaccine contains Hepatitis B surface antigen.
S.NO TIME SPECIFIC CONTENT TEACHING LEARNING AV AIDS EVALUATION
OBJECTIVE ACTIVITY ACTIVITY
Hepatitis B Immunisation Schedule:
Immunisation dose schedule
First 0
Second 1
Third 6
1st dose of Hep B vaccine is 1ml with Intramusclar
(Deltoid). After giving the dose check the side
effects of vaccine atleast 1 hour.

NURSING MANAGEMENT OF NSI

12. 10 Explain the Lecture cum Listening PPT What is the
Min 1) Do not panic, stop the procedure
nursing discussion nursing
immediately.
management management of
2) Immediate clean exposure site
of Needle Needle stick
3) Skin wounds should be washed with soap
stick injury. injury?
and running water, No evidene that
antiseptics are useful.
4) Caustic agents( bleach), alcohol, betadine
may do more harm than good
5) Flush mucous membranes throughly with
water ( no soap).
 6) Do not put the pricking finger into mouth,
rinse out several times with cold water and
check the site for redness.
7) Eyes irrigated with a liter of normal saline
if eyes are involved.
8) Identify source of patient.
9) Mind your last vaccination date.
10) Report if you are not vaccinated.
11) Report the casualty medical officer.
12) Promptly notify your supervisor.
13) Fill out the needle stick injury form
14) Testing done at regular intervals.
15) Booster dose of vaccination should be
given.
16) Educate the health workers regarding bio
medical waste.
17) Introduce the ten categories of bio medical
waste.
18) All bags and containers for bio medical
waste should be marked with biohazard
symbol.
S.NO TIME SPECIFIC CONTENT TEACHING LEARNING AV AIDS EVALUATION
OBJECTIVE ACTIVITY ACTIVITY
To RECAPITALIZATION:
recapitalize
 To introduce the Needle stick injury.
the topic
 Define Needle Stick injury.
 Enlist the causes of needle stick injury.
 Explain the types of infections transmitted
by needle stick injury.
 Enlist the workers who are at the risk due to
needle stick injury.
 Describe the places where sharp injuries
occur.
 Enlist the devices are involved in Needle
stick injury.
 Clarify the factors that influence for
acquiring infections by needle stick injury.
 Explain universal precautions.
 Enumerate the medical management of
needle stick injury.
 Explain the nursing management of needle
stick injury.
BIBILIOGRAPHY

1. Available from: http://www.madehow.com/Volume-

3/Syringe.html

2. M A-H, Ms L. Behavior of healthcare workers after

injuries from sharp instruments. Trauma 2013 Aug 14.
Available from: https://europepmc.org/article/PMC/3860676

3. William C. Shiel Jr., MD, FACP, FACR. [Internet].

Available from:
https://www.medicinenet.com/needlestick_injury/definition.htm

4. Available from:
https://emedicine.medscape.com/article/784812-treatment

5. Needlestick Injury Management Guidelines in

Healthcare Setting [Internet]. Available from:
http://nursingexercise.com/needlestick-injury-management/

6. Carrie A. [Internet] Available from:

https://www.medsafe.com/blog/osha-compliance/

7. - NIOSH Workplace Safety and Health Topic

[Internet]. 2018. Available from:
https://www.cdc.gov/niosh/topics/bbp/emergnedl.html

8. Government of Canada CC for OH and S. Needlestick

and Sharps Injuries : OSH Answers [Internet]. Available
from: https://www.ccohs.ca/
S.NO TIME SPECIFIC CONTENT TEACHING LEARNING AV AIDS EVALUATION
OBJECTIVE ACTIVITY ACTIVITY