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PREVENT NEEDLESTICK INJURIES
               By
                Dr Anjum Hashmi
                MBBS,CCS(USA),MPH
                Infection Control Director
                MCH Najran
WHAT IS A NEEDLESTICK?
• 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.
EPIDEMIOLOGY OF NSI
 • Infections are caused by needlestick injuries
• 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
• EPInet 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.
• One should always report injuries to employer
  immediately.
• EPInet report of 1999 also mentions that 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.
EPIDEMIOLOGY OF NSI
Where do these
injuries occur?
• These injuries have been
  reported from all
  healthcare settings,
  including:
• Ambulatory settings.
• Physician offices.
• Nursing homes.
• Skilled nursing facilities.
• Home health care.
• Hospitals.
WHO IS AT RISK?
• 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.
• Phlebotomists.
• Physicians.
• Technicians.
• Hospital Cleaners.
• Laundry workers.
• Medical waste collectors.
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.
HOW TO PROTECT FROM NSI
• 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.
HOW TO PROTECT FROM NSI
• BE AWARE
• 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.
• Frequent and distracting
  interruptions.
NEEDLESTICK SAFETY
• OSHA's Bloodborne            • Provide personal protective
  Pathogens Standard,            equipment for example,
  effective in 1991 and          gloves and face shields.
  revised in 2000, requires    • Use engineering controls for
  employers to protect           example, safety devices.
  healthcare workers from:     • Implement work practice
• Exposure to HIV and            controls e.g., no needle
  hepatitis B and C virus.       recapping, disposing of
• Employers must:                sharps immediately after
• Develop a written exposure     use.
  control plan.                • Provide hepatitis B
• Implement universal            vaccination at no cost.
  (standard) precautions.      • Provide evaluation and
                                 follow-up care if an injury
                                 occurs.
SHARPS DISPOSAL
• Proper disposal of needles and other sharp
  devices is an important part of needlestick
  prevention.
• Nearly 15 percent of needlestick injuries occur
  during or after disposal.
IMPORTANT REQUIREMENTS FOR
   SAFE SHARPS DISPOSAL INCLUDE:
• 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.
PROTECT YOURSELF AND OTHERS BY
        ADOPTING THESE PREVENTION
                STRATEGIES
• BE PREPARED                           • DISPOSE WITH CARE
•   Remind your employer to
    evaluate and purchase safety        • Never recap needles!
    devices                             • Dispose of used needles in
•   Be sure you receive training on       sharps disposal containers
    any new safety devices
•   Always use safety devices           • Avoid overfilling sharps
•   Place a sharps disposal container     disposal containers
    close to the procedure area.        • CARE FOR YOURSELF
•   Limit interruptions during
    procedures                          • 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                       • Report all needlestick and
•   Ask for assistance with patients      other injuries
    that might be uncooperative,
    such as children
WHAT TO DO IF YOU ARE INJURED
PREVENTING NEEDLESTICK INJURIES IS
  THE BEST WAY TO PROTECT YOURSELF
• 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
• Wash the wound with soap and water.
• Identify the patient involved so that they can be evaluated
  for an infection.
• 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
SAFETY DEVICES
• 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.
• There are different types of safety
  devices and technologies that are
  available to prevent needlestick and
  sharps injuries.
EVALUATION OF SAFETY DEVICES
• Look for features that will add to your safety. Some of the
  desirable characteristics of safety devices include:
• Permit the practitioner's hands to remain behind the needle
  at all times
• Integrate the safety feature into the device so the features
  are not just an accessory.
• Are simple and easy to use.
• Can be used effectively by both left and right handed
  employees.
• Determine easily whether the safety feature has been
  activated.
• Cannot be defeated once permanently engaged.
• Are safe and effective in patient care.
FEW SAFETY DEVICES
            1.HYPODERMIC SYRINGES AND NEEDLES




                                      Syringe with sliding sleeve


Syringe with retractable needle




                                  Syringe with hinged cap
2.Blood collection devices



Phlebotomy device with                    Phlebotomy needle w/hinged cap
retractable needle




                                            Winged (butterfly) needle with
     Winged (butterfly) needle retracts
                                            sliding sleeve
     after use
3.SCALPELS                                        4.LANCETS



                                              Lancets with tips that extend and
                                              retract when activated
       Scalpel with retractable blade




Scalpel with shield covering the              Lancets with retractable tip
blade after use
                             5.BLUNT TIP SUTURE NEEDLES

                                                 Suture needles with blunt tip
                                                 for suturing fascia
Prevent Needlestick Injuries
REFERENCES
 • Hashmi A, Al Reesh SA, Indah L (2012) Prevalence of Needle-
   stick and Sharps Injuries among Healthcare Workers, Najran,
   Saudi Arabia. Epidemiol 2:117.
 • Occupational Safety and Health Administration (OSHA)
   Navigate to "Safety and Health Topics," and choose
   "Bloodborne Pathogens." www.osha.gov.
 • Centers for Disease Control and Prevention Navigate to the
   "A-Z" index and choose "sharps safety" or "needlesticks“
   www.cdc.gov.
 • Safety Institute, Premier, Inc.www.
   premierinc.com/needlestick.
 • American Nurses Association | www.needlestick.org.
 • APIC (Association for Professionals in Infection Control and
REFERENCES
• ECRI Institute | www.ecri.org.
• EPINet (The International Health Care Worker Safety Center's
  Exposure Prevention Information Network) |
  www.med.virginia.edu/epinet.
• International Sharps Injury Prevention Society | www.isips.org.
• Service Employees International Union | www.seiu.org.
• Training for the Development of Innovative Control Technologies
  www.tdict.org.
• California Department of Health Services Sharps Injury Control
  Program www.sharpslist.org.
• Massachusetts Sharps Injury Surveillance System, Occupational
  Health Surveillance Program, Massachusetts Department of Public
  Health www.mass.gov/dph/ohsp.
THANK
                               YOU



Mariner 10's Pic of Venus.
On Feb. 5, 1974, Mariner 10
took this first close-up
photo of Venus.

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Prevent Needlestick Injuries

  • 1. PREVENT NEEDLESTICK INJURIES By Dr Anjum Hashmi MBBS,CCS(USA),MPH Infection Control Director MCH Najran
  • 2. WHAT IS A NEEDLESTICK? • 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.
  • 3. EPIDEMIOLOGY OF NSI • Infections are caused by needlestick injuries • 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.
  • 4. EPIDEMIOLOGY OF NSI • EPInet 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. • One should always report injuries to employer immediately. • EPInet report of 1999 also mentions that 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.
  • 5. EPIDEMIOLOGY OF NSI Where do these injuries occur? • These injuries have been reported from all healthcare settings, including: • Ambulatory settings. • Physician offices. • Nursing homes. • Skilled nursing facilities. • Home health care. • Hospitals.
  • 6. WHO IS AT RISK? • 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. • Phlebotomists. • Physicians. • Technicians. • Hospital Cleaners. • Laundry workers. • Medical waste collectors.
  • 7. 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.
  • 8. HOW TO PROTECT FROM NSI • 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.
  • 9. HOW TO PROTECT FROM NSI • BE AWARE • 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. • Frequent and distracting interruptions.
  • 10. NEEDLESTICK SAFETY • OSHA's Bloodborne • Provide personal protective Pathogens Standard, equipment for example, effective in 1991 and gloves and face shields. revised in 2000, requires • Use engineering controls for employers to protect example, safety devices. healthcare workers from: • Implement work practice • Exposure to HIV and controls e.g., no needle hepatitis B and C virus. recapping, disposing of • Employers must: sharps immediately after • Develop a written exposure use. control plan. • Provide hepatitis B • Implement universal vaccination at no cost. (standard) precautions. • Provide evaluation and follow-up care if an injury occurs.
  • 11. SHARPS DISPOSAL • Proper disposal of needles and other sharp devices is an important part of needlestick prevention. • Nearly 15 percent of needlestick injuries occur during or after disposal.
  • 12. IMPORTANT REQUIREMENTS FOR SAFE SHARPS DISPOSAL INCLUDE: • 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.
  • 13. PROTECT YOURSELF AND OTHERS BY ADOPTING THESE PREVENTION STRATEGIES • BE PREPARED • DISPOSE WITH CARE • Remind your employer to evaluate and purchase safety • Never recap needles! devices • Dispose of used needles in • Be sure you receive training on sharps disposal containers any new safety devices • Always use safety devices • Avoid overfilling sharps • Place a sharps disposal container disposal containers close to the procedure area. • CARE FOR YOURSELF • Limit interruptions during procedures • 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 • Report all needlestick and • Ask for assistance with patients other injuries that might be uncooperative, such as children
  • 14. WHAT TO DO IF YOU ARE INJURED
  • 15. PREVENTING NEEDLESTICK INJURIES IS THE BEST WAY TO PROTECT YOURSELF • 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 • Wash the wound with soap and water. • Identify the patient involved so that they can be evaluated for an infection. • 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
  • 16. SAFETY DEVICES • 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. • There are different types of safety devices and technologies that are available to prevent needlestick and sharps injuries.
  • 17. EVALUATION OF SAFETY DEVICES • Look for features that will add to your safety. Some of the desirable characteristics of safety devices include: • Permit the practitioner's hands to remain behind the needle at all times • Integrate the safety feature into the device so the features are not just an accessory. • Are simple and easy to use. • Can be used effectively by both left and right handed employees. • Determine easily whether the safety feature has been activated. • Cannot be defeated once permanently engaged. • Are safe and effective in patient care.
  • 18. FEW SAFETY DEVICES 1.HYPODERMIC SYRINGES AND NEEDLES Syringe with sliding sleeve Syringe with retractable needle Syringe with hinged cap
  • 19. 2.Blood collection devices Phlebotomy device with Phlebotomy needle w/hinged cap retractable needle Winged (butterfly) needle with Winged (butterfly) needle retracts sliding sleeve after use
  • 20. 3.SCALPELS 4.LANCETS Lancets with tips that extend and retract when activated Scalpel with retractable blade Scalpel with shield covering the Lancets with retractable tip blade after use 5.BLUNT TIP SUTURE NEEDLES Suture needles with blunt tip for suturing fascia
  • 22. REFERENCES • Hashmi A, Al Reesh SA, Indah L (2012) Prevalence of Needle- stick and Sharps Injuries among Healthcare Workers, Najran, Saudi Arabia. Epidemiol 2:117. • Occupational Safety and Health Administration (OSHA) Navigate to "Safety and Health Topics," and choose "Bloodborne Pathogens." www.osha.gov. • Centers for Disease Control and Prevention Navigate to the "A-Z" index and choose "sharps safety" or "needlesticks“ www.cdc.gov. • Safety Institute, Premier, Inc.www. premierinc.com/needlestick. • American Nurses Association | www.needlestick.org. • APIC (Association for Professionals in Infection Control and
  • 23. REFERENCES • ECRI Institute | www.ecri.org. • EPINet (The International Health Care Worker Safety Center's Exposure Prevention Information Network) | www.med.virginia.edu/epinet. • International Sharps Injury Prevention Society | www.isips.org. • Service Employees International Union | www.seiu.org. • Training for the Development of Innovative Control Technologies www.tdict.org. • California Department of Health Services Sharps Injury Control Program www.sharpslist.org. • Massachusetts Sharps Injury Surveillance System, Occupational Health Surveillance Program, Massachusetts Department of Public Health www.mass.gov/dph/ohsp.
  • 24. THANK YOU Mariner 10's Pic of Venus. On Feb. 5, 1974, Mariner 10 took this first close-up photo of Venus.