Wednesday, June 25, 2014
How to Handle a Common Hazard: The Needle Stick Injury
The needle stick injury. You know you want to avoid it, and you want your staff members to avoid it this hazard, too. And yet sometimes - accidents can happen. We’re talking about an accidental needle stick, a common occupational hazard. How common? Approximately 295,000 accidental needle stick injuries occur annually, based on an International Health Care Worker Safety Center report. However, the CDC indicates a higher number is likely, as these numbers are based on self-reported incidents. On the whole, needle stick incidents are under-reported.
Naturally, it’s vital that health care staff experiencing an incident receive immediate attention. The goal, obviously, is to lower the risk of contracting a pathogen, to lower the chances of contracting diseases like HIV or human immunodeficiency virus, Hepatitis C or HCV, and HBV or Hepatitus B.
According to a recent article in The Hospitalist magazine, making a rapid, skilled response to a needle stick injury greatly decreases such disease risks.
Can training staff to avoid needle stick situations help? At MedTrainer, our course offerings are designed to help medical staff do so. And, can proper training help to mitigate adverse affects, should accidents occur? Absolutely. MedTrainer’s program emphasize not just rules and regulations, but practical solutions to accidents.
So let’s take a look at what a healthcare worker should do if a needle stick injury occurs.
First: Wash the area with soap and water. Yes, you can use antiseptic solutions, too, but there is no data that recommends this use as reducing the potential of disease transmission versus the use of soap and water.
Second, seek out care in your facility. Report any sharp related injury to the appropriate person or department. Identify the patient source from the needle stick, to evaluate the potential of disease. Remember, the rate of disease transmission is reduced significantly if post-exposure prophylaxis is employed.
A health care worker receiving a needle stick injury is at greater risk for transmission of disease than with other occupational exposures. Receiving with a deep injury, or one obtained with a device contaminated with blood, or involving a needle that has been placed in a patients vein, increases that hazard.
However, contracting HIV after a needle stick injury is comparatively rare. Following needle stick injury even involving a known HIV-positive patient source, there is a one-year risk of only 0.3%. Naturally this doesn’t mean that needle stick injuries should be taken lightly, and staff should be educated in both the hazards, care of avoiding such an injury, and in regard to treatment and actions following such an incident. But it does mean that staff members affected by needle sticks should not panic.
Hepatitis B virus is more easily spread through needle stick incidents, however, the use of immunization by healthcare staff has created a significant decline in such infection.
All the same, unless post-exposure preventative measures are employed, a healthcare worker exposed to the virus through a needle stick has a 6% to 30% risk of becoming infected, with the greatest risk from a patient known to be hepatitis B e antigen-positive. But don’t panic: when administered within one week of injury, multiple doses of hepatitis B immune globulin, otherwise known as HBIG, will protect 75% of exposed health care workers from transmission.
In short, quick action regarding needle stick exposure will dramatically help to prevent such diseases. Cleaning the wound, identifying the patient source and any HIV, HCV or HBV status, and identifying the need for and acting on prophylactic treatment is all key.
At MedTrainer we know that educating healthcare staff is vitally important to promote healthy reactions to needle stick accidents. Learning about seroconversion rates, options for prophylactic treatment and more will assist in fast action and accurate evaluation of risk.
If a source patient is known to be HIV-positive, has a positive rapid HIV test, or if HIV status cannot be quickly determined, prophylactic treatment should be performed, using a two or three drug regimen.
Such treatment, when indicated, should begin ASAP. While most health care workers who receive an accidental needle stick will not develop an infection, it is always important to minimize risk. Receiving the Hepatitis B virus (HBV) series vaccine, cleaning any needle stick immediately, reporting the exposure, testing the source patient’s health status, and if necessary administering the correct prophylactic procedure will greatly reduce the chance of infection.
Healthcare workers who accidentally receive needle stick injuries require immediate identification and attention but with this action are at relatively low risk of disease.
Another aspect of education is proper prevention of needle sticks in the first place. MedTrainer’s educational system is designed to train and prevent costly injuries. One educational tip: preventing the transmission of disease by needle stick injuries is aided greatly by wearing gloves. A majority of injuries occur during the handling of a needle between use and disposal rather than actually during use. Training programs that explain and illustrate care used when dealing with needles and sharps offer a jump in safety in particular where needle discards are concerned. Emphasizing care and caution in handling needles and sharps before and after use is vital, and training programs that do so result in a large jump in staff safety.
Along with proper training and education, and access to safety enhancements such as gloves, making sure staff has proper rest breaks is also key to preventing needle stick injuries. In fact, health care workers had on average been working over fifteen hours before injury, and over fifty percent of these workers indicated that fatigue was a strong component to injury. Long hours without rest breaks are basically a costly accident waiting to happen.
Rest breaks are important to staying alert and relieving the potential for exhaustion.
Another training aspect to stress is to prevent recapping of needles. Emphasizing this point reduces the chance of injury. Many staff members who received injury were, in fact, recapping.
Also vital to stress: reporting needle stick injuries. Recent studies have shown that only about one in four were reported. Without reporting such incidents, prophylactic care is not received, even when clearly indicated.
Yes, needle stick injuries are an occupational hazard. Being educated about proper procedures to prevent such occurrences and how to handle such a situation if it occurs is highly recommended. Prompt treatment of such injuries is vital.
Educating staff on proper procedures should such an accident occur, on disease transmission rates, as well as on careful procedures to avoid needle stick incidents in the first place, are all a part of a healthy, informed staff. And MedTrainer can help you achieve just that.