What is needlestick injury?

A wound caused by accidental

penetration of the skin by a
needle. Needlestick injuries
can cause transmission of
bloodborne pathogens.
 Epidemiology of Needlesticks
and Other Sharps-related Injuries
Data on needlesticks and other sharps-
related injuries are used to characterize the
who, where, what, when, and how
of such events.
Surveillance data from the National
Surveillance System for Health Care
Workers (NaSH) are used to provide a
general description of the epidemiology of
percutaneous injuries.
 Who is at risk?
Staff:
Sharps pose a serious danger to health care staff.
Providers are at risk when handling, passing, or
using sharps during service delivery.
Maintenance and waste-disposal staff are at risk
when sharps are not properly disposed of or
when waste containing sharps is mishandled.
Sharps can cause injury and transmission of
serious infections, including HIV, hepatitis B &
Hepatitis C.
Clients: Clients can be placed at risk if
improperly discarded sharps are found in
unexpected places, like linens.
Community: Improper disposal of sharps
poses a great threat to members of the
community. Sharps that are discarded where
they may be found by scavengers, children, and
others may cause serious injury and infection.
Everyone in the local community is at risk of
the spread of infection when scavenged
syringes and needles are reused and improperly
disposed.
Where, When and How Do Injuries Occur?

Where? NaSH data show that the majority (40%)

of injuries occur on inpatient units, particularly
medical floors and intensive care units, and in
operating rooms.

When? Injuries most often occur after use and

before disposal of a sharp device (41%)
How?
 Sharp items are found in areas where they are
unexpected, such as on surgical drapes or
bed linen
When handling or disposingof waste used that
contains hypodermic needles or other
sharps.
·When sudden movement by the client at the time of
injection causes a provider to be accidentally stuck
Duringuse of a sharp device on a patient
(39%), and during or after disposal (16%)
·While recapping hypodermic needles after
use.
·Manipulating used sharps (bending, breaking, or
cutting hypodermic needles), which can cause the
blood inside to splatter or cause
staff to accidentally injure themselves
· When one staff member accidentally sticks
another staff member when carrying
unprotected sharps
 Your risk of infection following
a needlestick injury varies
depending on the virus being
transmitted.
e.g., the risk of infection after
exposure to hepatitis B is about
20% to 30%, while the risk is 3% to
10% after exposure to hepatitis C
and about 0.4% after exposure to
HIV.
 How can you prevent
injuries from

 Handle sharps?hypodermic needles and

other
sharps minimally after use and
extreme care use whenever sharps
handled or passed. are

· Use the "hands-free" technique when

passing sharps during clinical
procedures.
Donot bend, break, or cut hypodermic
needles before disposal.
· Do not recap needles.
· Dispose of hypodermic needles and
other sharps properly.
 Recapping: The "one-hand" technique

Many accidental needlesticks occur when staff

are recapping needles. Recapping is a dangerous
practice: If at all possible, dispose
of needles immediately without recapping
them.
If it does become necessary for you to recap a
needle (for example, to avoid carrying an
unprotected sharp when immediate disposal is
not possible), do not bend or break the needle
and do not remove a hypodermic needle from the
syringe by hand.
 To safely recap needles, use the "one-
hand" technique:
Step 1
Place the cap on a flat surface, then
remove your hand from the cap.
Step 2
With one hand, hold the syringe and use the
needle to "scoop up" the cap.
Step 3
When the cap covers the needle completely,
use the other hand to secure the cap on the
needle hub. Be careful to handle the cap at
the bottom only (near the hub).
 Handling Sharps

During a clinical procedure, health care workers

can accidentally stick one another or their clients
when passing sharps, especially when there is
sudden motion by staff members carrying
unprotected sharps, when clients move suddenly
during injections, or when sharps are left lying in
areas where they are unexpected (such as on
surgical drapes).
Safe passing of sharp instruments
“safe zone” (“neutral zone”) or "hands-free”
Uncapped or otherwise unprotected sharps
should never be passed directly from one
person to another. In the operating theatre or
procedure room, pass sharp instruments in
such a way that the surgeon and assistant are
never touching the item at the same time.

“safe zone” (“neutral zone”) or "hands-free”

The assistant places the instrument in a sterile
kidney basin or in a designated "safe zone" in
the sterile field.
The assistant tells the service
provider (speak out loud)that the
instrument is in the kidney basin or
safe zone.
The service provider picks up the
instrument, uses it, and returns it to the
basin or safe zone.
When giving injections:

·Unexpected client motion at the time of

injection can lead to accidental
needlesticks. Therefore, always warn
clients when you are about to give them an
injection.
 Managing injuries and exposure

Studies have shown that

squeezing a wound does not reduce the risk of
infection. In addition, do not use caustic
agents, such as bleach, on injuries from sharp
objects.
IF AN EXPOSURE OCCURS
What should I do?
PUNCTURE WOUND:
e.g. Needles tick or sharp injury, bite or
scratch
Encourage bleeding of the wound by
applying gentle pressure.
DO NOT SUCK
IMMEDIATELY – Wash well with soap
under running water.
Dry and apply a waterproof dressing as
necessary.
Report the incident to your manager.
Complete Incident Report Form.
Initiate investigation as to the cause of the
incident and risk assessment.

INJURY FROM CLEAN/UNUSED INSTRUMENT

OR NEEDLE…
Contact Infection Control by telephone if you
are unsure or require advice.

INJURY FROM USED INSTRUMENT OR

NEEDLE, BITE OR SCRATCH…

REPORT ASAP but WITHIN 1 HOUR

Attend Employee Health or Emergency
Department
If body fluids splash into:

EYES/NOSE
Irrigate with cold water for at least 15 minutes
If body fluids splash into:

MOUTH - DO NOT SWALLOW

Rinse out several times with cold water

ASAP but WITHIN 1 HOUR Attend Employee

Health or Emergency Department
Post exposure prophylaxis
Detailed protocols for the
administration of post exposure
prophylaxis is written in the Sharps
Injury Prevention Protocol.
For hepatitis C: There is no (PEP) post
exposure prophylaxis available for hepatitis
C. Neither immune globulin nor antiviral
drugs have been shown to reduce the risk
of hepatitis C transmission.
All staff who are at risk of
exposure to blood or other
body fluids should follow the
hospital vaccination protocol
against hepatitis B virus.
 Safe disposal of sharps

To dispose of sharps correctly:

· Do not recap, bend, or break needles
before disposal, and do not remove
the needle from thesyringe by hand.

 Dispose of
needles and syringes
immediately after use in a puncture-
resistant sharps-disposal container.
 Containers
Puncture-resistant sharps-disposal
containers should be conveniently located in any
area where sharp objects are frequently used
(such as injection rooms, treatment rooms,
operating theatres, labour and delivery rooms,
and laboratories).
X
 Compliance

Employee's compliance with safe work practices

reduce exposure to blood and other body fluids,
including reductions in sharps- related injuries .
staff awareness of health and safety is important
to staffs own health and well being.
Reporting

 Proper reporting of needle-stick

injuries is obviously crucial to initiate
early prophylaxis or treatment.
 Quality improvement for patient
safety

A sentinel event is an unexpected occurrence

involving death or serious physical or
psychological injury, or the risk thereof.
“that signal the need for immediate
investigation and response”
 Quality improvement for patient
safety

Root Cause Analysis (RCA) is a process for

identifying the basic or causal factors that
underlie variations in expected performance.
This process is being used widely in healthcare
settings to identify factors that lead to adverse
patient outcomes or are associated with a
"sentinel event" (e.g., medication errors,
laboratory errors, falls).

The RCA concept also can be applied to sharps

injury prevention.
 Quality improvement for patient safety

The purpose of the RCA is to understand how

and why a Sentinel or High Risk Event
occurred and to prevent the same or similar
Event from occurring in the future.
The key to the RCA process is asking the
question "why?" as many times as it takes to get
down to the "root" cause(s) of an event.
· What happened?
· How did it happen?
· Why did it happen?
· What can be done to prevent it from
happening in the future?
 Data to reported:

· Name and/or identification

number of healthcare worker
· Date, time, and work location of the
injury
· Occupation of the worker
· Type of device involved in the injury, and
presence or absence of an engineered
sharps injury prevention feature on the
device involved
· Purpose or procedure for which the sharp
device was being used; and
· When and how the injury occurred.
FLOW CHART OF REPORTING

FORM
BBF
 If you want a copy of this slides , contact Infection
Control nurse……
khima.rudach@gmail.com
91 94261 43385
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