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Minimizing needle stick injury

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Minimizing needle stick injury

  1. 1. Preventing Needlesticks and Other Sharps Injuries… Everything You Need to Know
  2. 2. The Problem CDC estimates ~385,000 sharps injuries annually among hospital-based healthcare personnel (>1,000 injuries/day) Many more in other healthcare settings (e.g., emergency services, home care, nursing homes) Increased risk for bloodborne virus transmission Costly to personnel and healthcare system
  3. 3. Risks of Seroconversion due to Sharps Injury from a known positive source  Virus  HBV  HCV  HIV  Risk (Range)  6-30%*  ~ 2%  0.3% (*Risk for HBV applies if not HB vaccinated)
  4. 4. What is the Risk for HIV Alone? Percutaneous 0.3% Mucous membrane 0.1% Non-intact skin <0.1%
  5. 5. Costs of Sharps Injuries Baseline and follow-up laboratory testing Treatment of exposed personnel $71-~$5,000 depending on treatment provided Lost productivity Time to complete paperwork Loss of income / loss of career Emotional costs Societal costs O’Malley, et. al. Costs of Management of Occupational Exposure to Blood and Body Fluids. ICHE, July 2007, v 28, No. 7.
  6. 6. Who Gets Injured? Nurse 43% Technician 15% Student 4% Dental 1% Housekeeping/ Maintenance 3% Clerical / Admin 1% Other 5% Physician 28% Occupational Groups of Healthcare Personnel Exposed to Blood/Body Fluids, NaSH June 1995— December 2003 (n=23,197)
  7. 7. When Do Sharps Injuries Occur? During use 41% After use/before disposal 40% During and after disposal 15% Other 4% Source: NaSH, June 1995—December 2003
  8. 8. What Devices are Involved in Sharps Injuries? Six Devices Account for 78% of All Injuries  Disposable Syringes 30%  Suture Needles 20%  Winged-Steel Needles 12%  Intravenous Catheter Stylets 5%  Phlebotomy Needles 3%  Scalpels 8% Source: NaSH, June 1995—December 2003
  9. 9. How Do Injuries Occur With Hollow-Bore Needles? During Sharps Disposal 13% During Clean Up 9% In Transit to Disposal 4% Handle/Pass Equipment 6% Improper Disposal 9% Access IV Line 5% Transfer/Process Specimens 5% Recap Needle 6% Collision W/Worker or Sharp 10% Manipulate Needle in Patient 28% Other 5% Circumstances Associated with Hollow-Bore Needle Injuries NaSH June 1995—December 2003 (n=10,239) Disposal Related: 35%
  10. 10. Sharps Injuries Are Preventable Preventable 64%Nonpreventabl e 18% Undetermined 18% Preventability of Needlesticks in 78 NaSH Hospitals, June 1995--December 2004 (n=11,625)
  11. 11. First Strategy:
  12. 12. How Can Needle Use Be Eliminated or Reduced? Use needle-free IV delivery systems Use alternate routes for medication delivery and specimen collection when available and safe for patient care Streamline specimen collection systems
  13. 13. Needle-Free IV Delivery Systems IV delivery systems use valved ports and connectors, pre- pierced septa using blunt cannulas, or recessed protected needle connectors
  14. 14. Use aseptic technique when handling these systems!!! Needle-Free IV Delivery Systems
  15. 15. Next Strategy:
  16. 16. Safer Sharps Devices Engineered to Prevent Sharps Injuries
  17. 17. Injuries Related to Work Practices Injuries occur because of the following: Passing or transferring equipment Recapping contaminated needles Colliding with coworkers Decontaminating/processing used equipment
  18. 18. Injuries occur from sharps left in unusual places: Laundry Mattresses Tables, trays, or other surfaces
  19. 19. The Sharps Safety Continuum Prepare to use the device the moment the sharps are first exposed Take precautions while using sharps Take precautions during cleanup Take precautions during disposal
  20. 20. Sharps Safety Practices Be prepared Be aware Dispose with care
  21. 21. Before Beginning a Procedure Be Prepared
  22. 22. Organise equipment at the point of use
  23. 23. Make sure workspace have adequate lighting
  24. 24. Assess the patient’s ability to cooperate and - Get help if necessary Ask the patient to avoid sudden movement
  25. 25. Obtain assistance from other staff or a family member to assist in calming or restraining a patient as necessary.
  26. 26. Proper placement of sharps container
  27. 27. If using a fixed sharps container it should not be fitted higher than 1.4 meter
  28. 28. Before the beginning of a procedure that involves the use of a needle or other sharp device: Identify the location of the sharps disposal container; if moveable, place it as near the point-of-use as appropriate for immediate disposal of the sharp. If the sharp is reusable, determine in advance where it will be placed for safe handling after use.
  29. 29. Before the beginning of a procedure that involves the use of a needle or other sharp device: If multiple sharps will be used during a procedure, organize the work area (e.g. procedure tray) so that the sharp is always pointed away from the operator.
  30. 30. During a Procedure That Involves the Use of Needles or Other Sharp Devices: Maintain visual contact with the procedure site and location of the sharp device.
  31. 31. During a Procedure That Involves the Use of Needles or Other Sharp Devices: When handling an exposed sharp, be aware of other staff in the immediate environment and take steps to control the location of the sharp to avoid injury to oneself and other staff.
  32. 32. During a Procedure That Involves the Use of Needles or Other Sharp Devices:
  33. 33. During a Procedure That Involves the Use of Needles or Other Sharp Devices: If the procedure necessitates reusing a needle multiple times on the same patient (e.g., giving local anesthesia), recap the needle between steps using a one-handed technique or a fixed device that enables one-handed recapping.
  34. 34. One handed recapping
  35. 35. Locking the cap of the needle
  36. 36. Using a one-handed technique recapping
  37. 37. Manipulate or remove sharps using a mechanical device
  38. 38. Activate the safety feature as the procedure is being completed, observing for audio or visual cues that the feature is locked in place. Safety syringes
  39. 39. During Clean-up following a Procedure:
  40. 40. During Clean-up Following a Procedure: Do not use bare hands to sort procedure tray
  41. 41. Use a mechanical device to pick up the sharp if it cannot be performed safely by hand.
  42. 42. After Disposal: Visually inspect sharps containers for evidence of overfilling before removal.
  43. 43. Use a mechanical device to remove sharps from overfilled box If a sharps container is overfilled, obtain a new container and use forceps or tongs to remove protruding devices and place them in the new container.
  44. 44. During Disposal: If a sharps container is overfilled, obtain a new container
  45. 45. Improperly Disposed Sharps: If an improperly disposed sharp is encountered in the work environment, handle the device carefully, keeping the hands behind the sharp at all times.
  46. 46. During disposal No recapping
  47. 47. During a procedure Do not carry sharps without a tray .
  48. 48. Wrong disposal can harm others Do not dispose sharps into regular garbage
  49. 49. Improper Disposal
  50. 50. Assemble container correctly Do not use sharps box without cover
  51. 51. FLOW SHEET FOR NEEDLE STICK/SHARPS INJURY NEEDLE STICK/SHARPS INJURY WASH THE INJURY UNDER RUNNING WATER (DO NOT SUCK/SQUEEZE FROM THE INJURED SITE) COVER INJURY WITH AN IMPERMEABLE DRESSING NOTIFY SUPERVISOR IF INJURY IS SERIOUS GO TO ER FOR APPROPRIATE TREATMENT
  52. 52. FLOW SHEET NEEDLESTICK/SHARPS INJURY COMPLETE AN OVA FORM (INCLUDE PATIENT/SOURCE MEDICAL NO.) GO TO EHS WORKING HOURS/AFTER WORKINH HOURS GO TO ER) GO TO GP LAB FOR BLOOD WORKS IF POSSIBLE DO BLOOD WORKS FROM SOURCE PATIENT AFTER CONSENT FROM TREATING PATIENT GO BACK TO EHS AT THE SPECIFIED FOLLOW- UP DATES GIVEN TO YOU FOR BLOOD WORKS
  53. 53. THANK YOU !!!

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