NEEDLE STICK INJURY

INTRODUCTION

By definition, sharps waste is a kind of (bio) medical waste that includes any kind of tool or object that is able to
puncture or cut the skin, hence the term “sharps”. It should be noted that they are classified as biohazardous
medical waste, and therefore can be harmful to both humans and animals.

The most common examples of sharps waste include: Hypothermic and

blunted needles,
syringes
Disposable
Some plastics blades, scalpels,
razors

Broken and/or
Certain medical
contaminated
tubes
glass

Microscope slides
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INTRODUCTION: 
 
Needle stick injuries are wounds caused by needles that accidentally puncture the skin. Needle stick
injuries are a hazard for people who work with hypodermic syringes and another needle equipment. These
injuries can occur at any time when people use, disassemble, or dispose of needles.

Different sharp objects are responsible for needle stick injuries, and this includes:

Scalpels​

Lancets ​

Glass from broken equipment ​

Syringes 
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NIOSH STANDARDS:

The National Institute for Occupational Safety and Health (NIOSH) requests assistance in preventing needle
stick injuries among health care workers. These injuries are caused by needles such as hypodermic needles,
blood collection needles, intravenous (IV) stylets, and needles used to connect parts of IV delivery systems.  
 
These injuries may cause a number of serious and potentially fatal infections with blood borne pathogens such
as hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV)—the virus that
causes acquired immunodeficiency syndrome (AIDS).

These injuries can be avoided by eliminating the unnecessary use of needles, the term health care worker
includes all workers in the health care setting who use or may be exposed to needles and other sharp devices
that may contain blood or other potentially infectious materials. 
 

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PROTECT FROM NEEDLE STICK INJURY:
 

 Certain work practices may increase the risk of needle stick injury. Studies have shown that needle stick
injuries are often associated with:

Not using
safety-
Recapping
engineered
needles
sharps or using
them incorrectly

Failing to
dispose of used
Transferring a
needles
body fluid
properly in
between
puncture-
containers
resistant sharps
containers

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Types of Needles and Sharps Disposal Containers:

 Needle are disposed based on the type of setting of care and treatment

Chemotherapy
Sharp Container

Patient Room Phlebotomy sharps

Sharp Collectors container

Pharmaceutical
Sharps Collector

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Chemotherapy Sharp Container:

 Chemotherapy Sharps containers are used for

disposal of sharps and syringes that have been
used while administration of chemotherapy drugs.
It securely stores sharps and needles containing
trace amounts of chemotherapy wastes and is
yellow colored to indicate that trace amounts of
chemotherapy waste is present inside the
container.

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PHLEBOTOMY SHARPS CONTAINER :

These containers provide a safe storage place for

blood contaminated sharps and needles.

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PHARMACEUTICAL SHARPS COLLECTOR:

These sharp collectors are used to

collect non-hazardous pharmaceutical
waste and are color-coded with a blue
lid. It is equipped with a gasket to
prevent leakage.

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PATIENT ROOM SHARPS COLLECTORS:

These sharps containers are

used to collect sharps and
needles that are to be
disposed of after use on a
patient.

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METHODS OF SHARPS DISPOSAL :

Hub cutters cut needles and

syringes right at the hub. This
ensures that no sharp remains
and minimum splatter occur.
These are found especially
useful by vaccinators who need
to frequently dispose of needles
after use with ease and safely.

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HEPATITIS B POST EXPOSURE PROPHYLAXIS :
  Significant exposure Non-Significant exposure
HBV status of exposed
person HBsAg negative
HBsAg positive source Source unknown Continued risk No further risk
source
Accelerated hep B
vaccine course
Accelerated hep B Consider course of Start course of hep No hep B
Unvaccinated
  vaccine course hep B vaccine B vaccine prophylaxis
HBIG with first dose

One dose of hep B One dose of hep B

Complete course of Complete course of Complete course of
Partially vaccinated vaccine and finish vaccine and finish
hep B vaccine hep B vaccine hep B vaccine
course course

Consider hep B
Fully vaccinated with Hep B vaccine booster vaccine booster if No hep B No hep B No hep B
primary course if last dose ≥1year ago last dose ≥1year prophylaxis prophylaxis prophylaxis
ago

HBIG
HBIG
 
  No HBIG No HBIG
Consider hep B
Known non-responder to Hep B vaccine booster    
vaccine booster No hep B prop
hep B vaccine
  Consider hep B Consider hep B
 
vaccine booster vaccine booster
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Second dose of www.prakara.co.in
at one month
HBIG at one month
PREVENT NEEDLE STICK INJURY:

Needle stick injuries can be avoided by eliminating the unnecessary use of needles, using devices with safety
features, and promoting education and safe work practices for handling needles and related systems.
 
As a healthcare professional, one can protect self from a needle stick injury by:

Avoiding recapping needles

Promptly disposing of used needles in conveniently placed and

appropriate sharps disposal containers
Reporting all needle stick and sharps-related injuries promptly to
ensure that you receive appropriate follow-up care
Telling your employer about any needle stick hazards you observe
and promptly reporting any needle sticks and near-misses

Participating in training related to infection prevention

Getting a hepatitis B vaccination

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WHAT TO DO IF YOU EXPERIENCE A NEEDLE STICK INJURY?

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NEEDLE STICK INJURY PROGNOSIS:

• Once a needle stick injury occurs, all healthcare workers need to follow up with the local Occupational Health
and Safety Clinic within 12 to 72 hours. 
• During the process, the individual (if married) must be asked to abstain from sexual intercourse until the HIV
testing is negative.  
• In fact, most infectious disease experts recommend safe sex or no sex until the second confirmatory HIV test is
also negative, which is usually 4 to 6 months (for married couples)
• If the initial workup is negative, then the individual needs to be followed up at 2 and 6 months.
• For those individuals who develop an infection following a needle stick injury, the prognosis is the same as if
they had acquired the organism via any other route.

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 NEEDLE STICK INJURY COMPLICATIONS:
Risk of HIV
Transmission

Risk of Transmitting
Spread of Hepatitis B
Syphilis 

Transmission of
Hepatitis C 

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ISBAR
 ISBAR......WHAT IS IT?

 ISBAR is a technique used for communicating important, often critical information that requires

immediate attention and action.

 Nursing ISBAR serves as a framework to structure conversations between nurses and doctors about

medical situations requiring immediate attention and action concerning a patient’s condition concerns the

logical sequence for transferring patient’s information.

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WHAT DOES ISBAR STAND FOR?

I S B A R

INTRODUCTION SITUATION BACKGROUND ASSESSMENT RECOMMENDATION

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ISBAR Communication Tool

• The ISBAR communication tool can help to facilitate effective communication between nurse and

other members of the interprofessional healthcare team when communicating information about a

client.

• It provides a framework so that communication is

FOCUSED
COMPLETE
CONCISE

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What are the elements of the ISBAR Framework?

 The ISBAR framework is simple. It consists of 5 elements that focus a conversation to relevant detail.

 This helps to focus the information and eliminate irrelevant information.

 These elements are

I – Introduction (Who you are, your role, where you are and why you are communicating)

S – Situation (What is happening at the moment?)

B – Background (What are the issues that led up to this situation?)

A – Assessment (What do you believe the problem is?)

R – Recommendation (What should be done to correct this situation?)

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ISBAR COMPONENTS AND EXPLAINATION OF THE PROFORMA:
ISBAR Components Example
Identify yourself with your first and last name,
role, and location.                                       Hello, I am calling about Nina, a 17-year-old
Introduction female client on 3A. I am Gita Cavell, a registered
Identify the client’s details: name, age, and room nurse on the unit.
number.
Briefly describe the concern.

The client was coughing and vomited during her

Situation State if the situation is urgent. 
rehab session.

Identify current symptoms and clinical needs.

Provide a brief summary of the concern.              
The client was tested for influenza and is on
droplet contact precautions. Another client was in
State diagnosis, comorbidities, and other health
Background the rehabilitation room with the suspected
issues.                            
infected client and the client was not wearing the
required PPE.
State lab values, medications, and allergies. 
Based on my assessment and the client’s
Provide an interpretation of summary of what you
Assessment symptoms, it’s probable that the client will test
think is going on.
positive for influenza.
Follow up with the unit manager about the
miscommunication regarding this client situation
State a clear request / recommendation with a
Request/Recommendation is required. The unit manager for the other client
time frame.
needs to be informed of the possible exposure to
influenza.
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What’s the purpose of using ISBAR?

Key reasons for using ISBAR are

 It is portable, memorable and easy to use

 Can be used to present information clearly in any situation

 Helps you to organise what you’re going to say

 Standardises communication between everyone

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What are the advantages of ISBAR?

The ISBAR framework

 Ensures completeness of information and reduces likelihood of missed data

 Is an easy and focussed way to set expectations for what will be communicated

 Ensures a recommendation is clear and professional

 Gives confidence in communication

 Focuses not on the people who are communicating but on the problem itself.

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Where can ISBAR be used?

• The ISBAR framework may be used in any information handover situation.

• For example:

SHIFT CHANGES

DISCHARGE TO COMMUNITY SERVICES

INTER HOSPITAL TRANSFERS

INTRA HOSPITAL TRANSFERS

MEDICAL EMERGENCIES

PROCEDURE DOCUMENTS

REPORTS, MEMORANDUMS, BRIEFINGS

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DOCUMENTATION AND COMMUNICATION:

The way we communicate can be affected by a range of factors, such as:

 The situation: what and why are we needing to communicate? Is it a shift handover? Is it urgent or non-

urgent? Are there any distractions or potential disruptions? Do you have time to plan what

you want to say? It’s ok to write what you want to communicate first, provided it is not a time

critical conversation.

 The method: is it face to face? is it verbally over the phone? Is it written in a page or email?

 The location: is it at the bedside? Is it at a meeting? Is it in the staff/handover room?

 The participants: is it nurse/midwife to nurse/midwife? Is it to other members of the multidisciplinary team?

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THANK YOU