What is a needlestick injury?
A needlestick injury occurs when the skin is accidentally punctured with a used hypodermic needle or other sharp object contaminated with blood or body fluids. Needlestick injuries are a potential source of exposure to bloodborne pathogens such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV).
Healthcare workers who use needles are at increased risk of accidental needlestick injuries. Other high-risk groups include intravenous drug users, tattoo artists, and sanitation workers. Needlestick injuries can occur during use, after use before disposal, during cleanup, or from improper disposal of used needles.
What are the risks of needlestick injuries?
Needlestick injuries pose a serious occupational health risk. Potential risks include:
- Infection – The main infections transmitted via needlestick injuries are hepatitis B, hepatitis C, and HIV. The risk of infection depends on factors like the depth of the injury, whether the needle was contaminated with infected fluid, and the viral load in the source patient’s blood.
- Psychological trauma – A needlestick injury can cause tremendous anxiety while awaiting test results. There may be lingering stress even after testing negative.
- Pain and injury – Needlestick injuries can damage nerves, tendons, ligaments, and blood vessels. This can cause chronic pain and reduced dexterity in the affected hand or finger.
The estimated risk of HIV transmission after a needlestick involving HIV contaminated blood is 0.3%. The risks are much higher for hepatitis B (6-30%) and hepatitis C (1-10%).
How can you prevent needlestick injuries?
Here are some key strategies to reduce the risk of accidental needlestick injuries:
Use safety engineered devices
Switch to needle devices with safety features such as:
- Retractable syringes – The needle retracts into the barrel after use.
- Self-sheathing needles – A cover extends or slides over the needle after use.
- Safety blood collection sets – Have a bluntable or retractable needle.
- Needleless IV systems – Replace needles with luer locks or recessed cannulae.
Studies show safety engineered devices can reduce needlestick injuries by up to 76%. Make sure devices are CE marked to indicate they meet European safety standards.
Avoid recapping needles
Recapping accounts for up to a third of needlestick injuries. Never recap needles after giving an injection or drawing blood. Always discard immediately after use in an approved sharps container.
Dispose sharps safely
Use puncture-proof sharps containers clearly labeled “Danger Contaminated Sharps”. Place containers in easily accessible locations as close as possible to areas of use. Never overfill containers. Seal and dispose of properly when three-quarters full.
Handle with care
Adopt safe techniques when using and disposing of needles:
- Focus fully on the procedure. Never rush.
- Plan a safe handling approach before beginning.
- Do not try to remove needles by hand from syringes.
- Do not bend, break or manipulate used needles by hand.
- Dispose in sharps container immediately after use.
Clean up properly
Spill kits should be available in case of accidents. Use forceps, not fingers, to retrieve dropped sharps. Follow established protocols for cleaning up blood spills.
Use personal protective equipment (PPE)
Wear gloves, eye protection, face masks and closed toe shoes when handling needles. Change gloves if torn or contaminated.
Get vaccinated
Ensure healthcare workers are up to date on HBV vaccination. Vaccination protects against HBV infection. Post-exposure treatment may also be recommended after a needlestick injury to reduce HIV and HCV transmission risk.
Report all exposures
Prompt reporting ensures evaluation of infection risk and eligibility for post-exposure treatment. An incident report should also be completed to identify opportunities for prevention.
Receive training
All staff should be trained on safe handling and disposal of needles. Update training regularly and ensure competency is assessed.
Encourage safe practices
Promote a culture of safety. Provide positive feedback when safe needle practices are followed. Have zero tolerance for recapping.
What should you do if injured by a needlestick?
Immediately follow these steps if injured by a needlestick:
- Wash the wound thoroughly with soap and water.
- Do not squeeze the injured area.
- Allow wound to bleed briefly before bandaging.
- Notify your supervisor immediately.
- Seek medical evaluation within 1-2 hours.
- Identify the source patient if known.
Timely evaluation allows consideration of post-exposure treatment and baseline testing. Report details of the exposure like whether PPE was worn, depth of injury, and if fluid was injected. Provide information on the source patient when available.
Conclusion
Needlestick injuries remain an occupational hazard for healthcare workers using sharps. Promoting a culture of safety and implementing preventive measures are key to reducing risk. This includes using safety devices, avoiding recapping, proper disposal, safe handling techniques, PPE, training, and immediate reporting of injuries. Preventing needlestick injuries protects healthcare workers from serious and life-threatening bloodborne infections.