This document provides information on needlestick injuries, including their causes, risks, prevention, and appropriate response. It describes how needlestick injuries most commonly occur through improper handling or disposal of sharps. It emphasizes the importance of safe sharps handling techniques like not recapping needles, use of puncture-resistant sharps containers, and a hands-free approach when passing sharps. The document also outlines steps to take after a needlestick occurs, including wound care, reporting procedures, and post-exposure prophylaxis to prevent transmission of bloodborne diseases. Root cause analysis of sharps injuries can help identify factors to address through quality improvement measures for enhanced safety.

2. What is needlestick injury?
A wound caused by
accidental penetration of the
skin by a needle. Needlestick
injuries can cause
transmission of bloodborne
pathogens.

3. Epidemiology of Needlesticks
and Other Sharps-related Injuries
Data on needlesticks and other sharps-
related injuries are used to characterize
the who, where, what, when, and
how of such events.
Surveillance data from the National
Surveillance System for Health Care
Workers (NaSH) are used to provide a
general description of the epidemiology
of percutaneous injuries.

4. Staff:
Sharps pose a serious danger to health care
staff. Providers are at risk when handling,
passing, or using sharps during service
delivery.
Maintenance and waste-disposal staff are at
risk when sharps are not properly disposed
of or when waste containing sharps is
mishandled. Sharps can cause injury and
transmission of serious infections, including
HIV, hepatitis B & Hepatitis C.
Who is at risk?

5. Clients: Clients can be placed at risk if
improperly discarded sharps are found in
unexpected places, like linens.
Community: Improper disposal of sharps
poses a great threat to members of the
community. Sharps that are discarded
where they may be found by scavengers,
children, and others may cause serious
injury and infection. Everyone in the local
community is at risk of the spread of
infection when scavenged syringes and
needles are reused and improperly
disposed.

6. Where, When and How Do Injuries Occur?
Where? NaSH data show that the majority
(40%) of injuries occur on inpatient units,
particularly medical floors and intensive care
units, and in operating rooms.
When? Injuries most often occur after use and
before disposal of a sharp device (41%)

7. How?
 Sharp items are found in areas where they are
unexpected, such as on surgical drapes or
linen
handling or disposing of waste
used hypodermic needles or
that
other
bed
When
contains
sharps.
·When sudden movement by the client at the
time of injection causes a provider to be
accidentally stuck

8. During use of a sharp device on a patient
(39%), and during or after disposal (16%)
·While recapping hypodermic needles after
use.
·Manipulating used sharps (bending, breaking,
or cutting hypodermic needles), which can
cause the blood inside to splatter or cause
staff to accidentally injure themselves
· When one staff member accidentally sticks
another staff member when carrying
unprotected sharps

9. Your risk of infection following
a needlestick injury varies
depending on the virus being
transmitted.
e.g., the risk of infection after
exposure to hepatitis B is about
20% to 30%, while the risk is 3%
to 10% after exposure to hepatitis
C and about 0.4% after exposure
to HIV.

10. How can you prevent
injuries from sharps?
 Handle hypodermic needles and other
sharps
extreme care
minimally after use and use
whenever sharps are
when
clinical
handled or passed.
· Use the "hands-free" technique
passing sharps during
procedures.

11. Do not bend, break, or cut hypodermic
needles before disposal.
· Do not recap needles.
· Dispose of hypodermic needles and other
sharps properly.

12. Many accidental needlesticks occur when
staff are recapping needles. Recapping is a
dangerous practice: If at all possible, dispose
of needles immediately without recapping
them.
If it does become necessary for you to recap
a needle (for example, to avoid carrying an
unprotected sharp when immediate disposal
is not possible), do not bend or break the
needle and do not remove a hypodermic
needle from the syringe by hand.
Recapping: The "one-hand" technique

13. To safely recap needles, use the "one-
hand" technique:
Step 1
Place the cap on a flat surface, then
remove your hand from the cap.
Step 2
With one hand, hold the syringe and use
the needle to "scoop up" the cap.
Step 3
When the cap covers the needle
completely, use the other hand to secure
the cap on the needle hub. Be careful to
handle the cap at the bottom only (near
the hub).

14. During a clinical procedure, health care
workers can accidentally stick one another or
their clients when passing sharps, especially
when there is sudden motion by staff
members carrying unprotected sharps, when
clients move suddenly during injections, or
when sharps are left lying in areas where they
are unexpected (such as on surgical drapes).
Handling Sharps

15. Safe passing of sharp instruments
“safe zone” (“neutral zone”) or "hands-free”
“safe zone” (“neutral zone”) or "hands-free”
Uncapped or otherwise unprotected sharps
should never be passed directly from one
person to another. In the operating theatre
or procedure room, pass sharp instruments
in such a way that the surgeon and
assistant are never touching the item at the
same time.

16. The assistant places the instrument in a
sterile kidney basin or in a designated "safe
zone" in the sterile field.
The assistant tells the service
(speak out loud) that the
in the kidney basin or
provider
instrument is
safe zone.
The service provider picks up the
instrument, uses it, and returns it to the
basin or safe zone.

17. When giving injections:
·Unexpected client motion at the time of
injection can lead to accidental
needlesticks. Therefore, always warn
clients when you are about to give them
an injection.

18. Managing injuries and exposure
Studies have shown that
squeezing a wound does not reduce the
risk of infection. In addition, do not use
caustic agents, such as bleach, on injuries
from sharp objects.

19. IF AN EXPOSURE OCCURS
What should I do?
PUNCTURE WOUND:
e.g. Needles tick or sharp injury, bite or
scratch
Encourage bleeding of the wound by
applying gentle pressure.
DO NOT SUCK
IMMEDIATELY – Wash well with soap
under running water.
Dry and apply a waterproof dressing as
necessary.
Report the incident to your manager.
Complete Incident Report Form.

20. Initiate investigation as to the cause of the
incident and risk assessment.
INJURY FROM CLEAN/UNUSED INSTRUMENT
OR NEEDLE…
Contact Infection Control by telephone if you
are unsure or require advice.
INJURY FROM USED INSTRUMENT OR
NEEDLE, BITE OR SCRATCH…
REPORTASAP but WITHIN 1 HOUR
Attend Employee Health or Emergency
Department

21. If body fluids splash into:
EYES/NOSE
Irrigate with cold water for at least 15 minutes
If body fluids splash into:
MOUTH - DO NOT SWALLOW
Rinse out several times with cold water
ASAP but WITHIN 1 HOUR Attend Employee
Health or Emergency Department

22. Post exposure prophylaxis
Detailed protocols for the
administration of post exposure
prophylaxis is written in the
Sharps Injury Prevention Protocol.
For hepatitis C: There is no (PEP)
post exposure prophylaxis available for
hepatitis C. Neither immune globulin
nor antiviral drugs have been shown to
reduce the risk of hepatitis C
transmission.

23. All staff who are at risk of
exposure to blood or other
body fluids should follow the
hospital vaccination protocol
against hepatitis B virus.

24. Safe disposal of sharps
To dispose of sharps correctly:
· Do not recap, bend, or break needles
before
the needle from
disposal, and do not remove
the syringe by hand.
needles and syringes
 Dispose of
immediately after use in a puncture-
resistant sharps-disposal container.

25. Containers
Puncture-resistant sharps-disposal
containers should be conveniently located in
any area where sharp objects are frequently
used (such as injection rooms, treatment
rooms, operating theatres, labour and
delivery rooms, and laboratories).

26. X

27. Compliance
Employee's compliance with safe work
practices reduce exposure to blood and other
body fluids, including reductions in sharps-
related injuries .
staff awareness of health and safety is
important to staffs own health and well being.

28. Reporting
 Proper reporting of needle-stick
injuries is obviously crucial to initiate
early prophylaxis or treatment.

29. Quality improvement for patient safety
A sentinel event is an unexpected
occurrence involving death or serious
physical or psychological injury, or the risk
thereof.
“that signal the need for immediate
investigation and response”

30. Quality improvement for patient safety
Root Cause Analysis (RCA) is a process for
identifying the basic or causal factors that
underlie variations in expected
performance. This process is being used
widely in healthcare settings to identify
factors that lead to adverse patient
outcomes or are associated with a "sentinel
event" (e.g., medication errors, laboratory
errors, falls).
The RCA concept also can be applied to
sharps injury prevention.

31. The purpose of the RCA is to understand
how and why a Sentinel or High Risk Event
occurred and to prevent the same or similar
Event from occurring in the future.
Quality improvement for patient safety

32. The key to the RCA process is asking the
question "why?" as many times as it takes to
get down to the "root" cause(s) of an event.
· What happened?
· How did it happen?
· Why did it happen?
· What can be done to prevent it from
happening in the future?

33. · Name and/or identification number of
healthcare worker
· Date, time, and work location of the injury
· Occupation of the worker
·Type of device involved in the injury, and
presence or absence of an engineered
sharps injury prevention feature on the
device involved
· Purpose or procedure for which the sharp
device was being used; and
· When and how the injury occurred.
Data to reported:

34. FLOWCHARTOF REPORTING
FORMBBF

36.  If you want a copy of this slides , contact Infection
Control nurse……
khima.rudach@gmail.com
91 94261 43385
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