Needle stick injuries (NIs) are a continuous cause of exposure to serious and fatal diseases among your healthcare employees. But you might not realize how often NIs occur or how seriously they can affect your medical staff—physically and emotionally. At hospitals and other non-acute healthcare facilities nationwide, needle stick injuries (from all needle-bearing devices) add up to more than 600,000 each year. This number is likely higher, since it is estimated that 50% of all needle stick injuries go unreported—despite hospital protocols.
Hospital nurses perform the most sharps-related procedures and incur the most needle stick injuries, yet other hospital personnel including lab staff, physicians, housekeeping, laundry, and garbage workers also sustain NIs. Fear of being infected by HBV, HCV, and HIV intensifies a healthcare worker’s anxiety in the weeks following a needle stick injury. Undergoing diagnostic blood tests and waiting for the results can depress workers and interfere with job performance even when a virus is not transmitted. If test results are positive, stress levels can soar as workers evaluate treatment options and contemplate the short- and long-term side effects. Pressure to seek treatment quickly heightens anxiety.
Preventing needle stick injuries from happening in the first place is the best defense against their potentially tragic consequences. Make sure your medical staff knows the facts and how they can do their part to minimize the risk of infection.
A number of circumstances and practices increase the likelihood of a needle stick injury.
Research shows that healthcare workers are most vulnerable to a needle stick when withdrawing an IV stylet, phlebotomy needle, or injection needle from an unstill patient. Patients undergoing bloodwork or receiving an infusion can make sudden movements, especially if antsy or agitated. That’s why it’s important to stay focused and pay attention to a patient’s state of mind before and during needle withdrawal. While predicting a jerky move from a formerly still patient is difficult, anticipating one from a visibly agitated patient can help your staff be pro-active. It is essential to step back and assess a patient’s capacity for cooperation and request additional help if that patient needs to be physically stabilized.
Needle stick injuries are more apt to occur when passing sharpies by hand during or after use. To avoid this, workers should make sure all equipment is situated on a tray placed within everyone’s reach and pass the syringe on the tray rather than manually. It’s important to alert other staff when placing or retrieving sharps.
A significant percentage of needle sticks occur during and after disposal. Workers need to know the location of a sharps disposal container and use it (regular trash bins are off-limits). Passing a used syringe via tray and emptying the tray into a puncture-resistant container reduces the risk of needle tip contact. Recapping needles after use should be avoided (10% to 25% of NIs occur this way). Whenever available, nurses should use sharps with safety features and make sure safety features are always activated and locked in place before disposal. Keeping hands away from a disposal container’s opening is advised.
Glove choice (size and type) also factors into needle stick injuries. Health workers should wear safety gloves that are puncture-resistant, and choose the right size. Gloves that are too big make it difficult to firmly grip or direct a needle; gloves that are too small are more likely to rip. When double-gloving, choosing gloves that provide a snug fit, especially when suturing is involved, reduces the risk of exposure to patient blood by as much as 87 percent when the outer glove is punctured; viral load is reduced by as much as 95 percent.
Transmission rates from patients infected with hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) can vary.
One million Americans have chronic HBV, and there are 50,000 – 100,000 new cases each year. Close to 4 million Americans show blood serum evidence of HCV, and the numbers continue to rise. An additional 1 million Americans are HIV-positive, and an estimated 180,000 – 280,000 people may be unaware that they are infected. In essence, your healthcare workers have every reason to fear being infected by a needle stick. Here’s what your staff is up against.
- HBV is highly infectious. If unvaccinated, without immediate medical intervention the risk of transmission can be as high as 30% depending on which surface antigens are present. That’s almost a one-in-three chance that a medical worker will become infected. Fortunately, most people will be able to clear HBV from their system, but about 5% to 10% will carry the virus for the rest of their life and after about 10 years run the risk of developing cirrhosis of the liver and liver cancer.
- The risk of HCV is about 1.8% to 3% or three in 100. Once infected, at least 85% to 90% of those infected with HCV become carriers. About 1% to 5% develops cirrhosis of the liver and cancer after about 15 years.
- The risk of contracting human immunodeficiency virus (HIV) is 0.3 percent to 5%. Despite current and emerging drugs to treat HIV, there is no cure. Sadly, virtually everybody infected with HIV will eventually die from AIDS.
Time constraints stop many hospital workers from reporting a needle stick injury—especially busy nurses inundated with patient care assignments.
The documentation required, along with the need to obtain a blood sample from the source patient and get one’s own blood tested, can overwhelm a staff already knee-deep in shift work. Rather than take action, healthcare workers attempt to weigh their risk of infection at the point of injury. Considering the transmission rates of HBV, HCV, and HIV from needle stick injuries, the thousands of U.S. residents currently infected with one of these viruses, and the number of new cases reported each year, “weighing your odds” is a gamble no healthcare worker should take. At the end of the day, every member of your healthcare team must feel compelled to fill out a needle injury report and get the necessary post exposure prophylaxis (PEP) without delay.
For more information on issues that affect your employees and your workplace rely on BOS Medical Staffing. Since 2008, our Georgia-based staffing firm has brought talented nurses, therapists and medical administrators together with top facilities. Contact BOS Medical today to talk about customized staffing solutions.