Needlestick and Sharp Injuries (Nsis) : From A Known Positive Source

Needlestick and Sharp Injuries (NSIs)
Needlestick and Sharp Injuries (NSIs) are accidental skin penetrating wounds caused by sharp
instruments in a medical setting. A break of skin can be from a needle or other "sharp" such as a
scalpel / glass. An injury from a contaminated needle exposes workers to bloodborne pathogens
that can cause serious or fatal infections.
The most serious infections are: HIV, Hepatitis B, Hepatitis C, HCW must ensure that he/she
should receive proper follow-up medical care after NSI.
EPIDEMIOLOGY OF NSI EPI net report of 1999 estimates that about 0.8 million NSIs occur per
years in America alone. Another report mentioned that on global level NSI affects about 3.5
million individuals per year. More than half of these injuries are never reported.
On an average about 30 NSIs occur, per 100 beds per year. A current survey showed despite all
prevention efforts, incidence of NSI still remained at 27 NSIs occur, per 100 beds per year. These
injuries have been reported from all healthcare settings, including: Ambulatory settings, physician
offices, nursing homes, skilled nursing facilities, home health care, Hospitals.
CDC estimates ~385,000 sharps injuries annually among hospital-based healthcare personnel
(>1,000 injuries/day) and causes:
• Increased risk for bloodborne virus transmission
• Costly to personnel and healthcare system
• Risks of Seroconversion due to Sharps Injury
from a known positive source
All HCWs are at risk of injury or infection as they handle sharps, such as, hypodermic needles, IV
catheters, phlebotomy devices, suture needles, scalpels, or lancets which includes: nurses,
physicians, technicians, hospital cleaners, laundry workers, medical waste collectors.
Needlestick injuries can occur at any time during the use or disposal of a device. For example: 40
percent of injuries occur during use, another 40 percent occur after use and before disposal, and
15 percent are disposal-related. Recapping needles, a practice that is prohibited, still accounts for
nearly 5 percent of needlestick injuries.
Other factors also contribute to NSI are lack of safety devices, inconveniently placed or overfilled
sharps disposal containers, busy, congested environments with heavy work pressure & rushing and
Frequent and distracting interruptions.
Where Do Sharps Injuries Occur?
• Patient Room 39% (Inpatient: Medical – ICUs)
• Operating Room 27%
• Outpatient 8%
• ER 8%
• Laboratory 5%
• Other 13%
When Do Sharps Injuries Occur?
• During use 41%
• After use/before disposal 40%
• During and after disposal 15%
• Other 4%
What Devices are Involved in Sharps Injuries?
Six Devices Account for 78% of All Injuries
• Disposable Syringes 30%
• Suture Needles 20%
• Winged-Steel Needles (Butterfly) 12%
• Intravenous Catheter Stylets 5%
• Phlebotomy Needles 3%
• Scalpels 8%
Sharps Injuries Are Preventable and Preventing Sharps Injuries is a National Priority.
Needlesticks can be very upsetting and stressful after the NSI, do following series of actions •
• Seek immediate medical help to assess the risk of developing an infection.
• Determine if the patient on whom the needle was used has HIV, hepatitis B or hepatitis C
infection.
• Wait for the results of your own blood tests and information on the patient.
• Determine with a medical specialist whether you will need medication to prevent an
infection.
• Exposure follow-up may include drugs with significant side effects.
• Blood tests and further evaluation may be needed for six months to a year following the
injury.
Important requirements for safe sharps disposal include:
1. Conveniently place sharps disposal containers where sharps are used. Be sure containers are at
a height that allows users to see the top of the container. Use lockable containers for locations
where security is an issue (for example, where there are children, in prisons or psychiatric
areas). Select containers that are closable, puncture-resistant and leak proof. Ensure that the
containers are clearly and correctly labeled - that is, red/yellow in color or biohazard symbol.
Replace sharps disposal containers promptly when full to avoid overfilling.
2. Protect yourself. Never recap needles! Devices. Dispose of used needles in puncture proof
container. Always use safety devices. Avoid overfilling sharps. Place a sharps disposal
container disposal containers close to the procedure area. Limit interruptions during
procedures.
3. Get a hepatitis B vaccination. Explain the procedure to patients this should be provided at no
to gain their cooperation and cost by your employer avoid potential movement during the
procedure
4. Report all needlestick.
5. Ask for assistance with patient when necessary e.g. might be uncooperative, such as children
6. If you sustain a needlestick injury immediately report your injury to your supervisor. Do not
wait until the end of your shift or the end of the procedure. Do not apply pressure to the wound;
allow it to bleed freely.
7. Wash the wound with soap and water. • Identify the patient involved so that they can be
evaluated for an infection.
8. Get a medical assessment. Follow the directions for any necessary blood tests, vaccinations, or
medications to prevent infection. • Document the incident in the forms provided by hospital
9. Most needlestick injuries can be prevented with the use of safety devices, which, in conjunction
with worker education and training and work practice controls, can reduce injuries by over 90
percent.

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Important requirements for safe sharps disposal include:

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