needle stick injury be aware
TRANSCRIPT
WHAT YOU MAY NOT KNOW ABOUT
NEEDLE STICK INJURY
CAUSES OF SHARP INJURIES
STRESS……LACK OF TIME & PATIENCE
CARELESSNESS WHILE WORKING
PASSING SHARPS FROM ONE PERSON TO ANOTHER.
LACK OF KNOWLEDGE……SERIOUSNESS OF NSI
WHO IS AT RISK ?
NURSES.
DOCTORS.
TECHNICIANS.
EMERGENCY PERSONNEL.
ATTENDANTS.
ALL HCW !!!!
BREAKUP OF AFFECTED STAFF
10%13%
29% 48%
Nurses Doctors Technicians Housekeeping staff
Total number of cases - 336
SOURCES OF NSI 2004 2005 2006 2007 TOTALGarbage bag 18 21 22 06 67
Needle recapping 11 7 6 3 27
OT instruments 7 7 6 1 21
Checking blood sugar 9 17 7 0 33
IV line administration 15 11 5 3 34
Surgical blade 3 6 6 3 18
Blood collection 8 6 9 7 30
Suturing 2 6 10 0 18
Injection administration 10 6 17 4 37
Disposal 4 6 9 10 29
Others 5 4 9 4 22
Total 92 97 106 41 336
PROBABILITY OF INFECTION
AFTER A NSI
Rate of Hollow needle Minimal
blood
HIV 0.3 - 0.4% 0.1 ml
HCV 0 - 7% Not known
HBV 22 – 31% 0.0004 ml
Post injury / exposure protocol
Don’t PANIC !!!
Don’t squeeze the injured site
Wash with soap and water immediately
Report to the casualty & provide,
(i) Full history of injury or exposure
(ii) History of Hepatitis B immunization
(iii) Blood for testing
Injury from an HBsAg positive source, Maximum number of HCW are immunized against HBV due to the hospital policy
Investigations for baseline HBsAg and the antiHBs titre are done for the HCW. If the antiHBs titre is positive, no PEP is required
If the vaccination doses are incomplete and the antiHBs titre is positive, vaccination is continued as per schedule with no other interventions
If HCW is a non responder or has not completed the vaccination series and the antiHBs titre is negative, both the Hepatitis B immunoglobulin and vaccination against HBV are given
DO’S FOR BENCHWORKERS GET IMMUNIZED AGAINST HBV
DISPOSE YOUR OWN SHARPS.
TAKE RESPONSIBILITY
USE GLOVES & FORCEPS.
USE SHARPS CONTAINER.
USE NEW TECHNIQUES.
BE AWARE ABOUT NSI
Injury from an HCV positive source, The HCW blood is first tested for baseline antiHCV antibody
All HCWs who sustain NSI from HCV positive sources are referred to the gastroenterology team for liver function monitoring
The HCW is followed up by the GI doctor for 6 months.
If the antiHCV antibody ELISA test if positive, the test is reconfirmed using a recombinant immunoblot assay.
Injury from an HIV positive source, The HCW blood is tested for baseline antiHIV antibody
PEP guidelines by the Centers for Disease Control (CDC) are instituted immediately (basic or expanded ART regime according to the exposure code)
HIV status of the exposed HCW is then tested again at 6 weeks, 3 months and six months.
The HCW is also followed up for any side effects while taking the antiretroviral therapy.
PROPER DISPOSAL OF SHARPS
Use strictly only till the 3/4th mark
Get a new one before you exhaust the old one !!!
Check the Hypochlorite conc in can
Wear gloves
Discard sharps straight into container
DON’TS FOR BENCHWORKERS NEGLECT ANTI HBSAg TITER
RECAP, REUSE.
BEND, BREAK.
PASS, FLING SHARPS.
EMPTY SHARPS IN WRONG WASTE BAGS.
MISPLASE SHARPS.
USE BARE HANDS.
WHATS NEW FOR HCW SAFETY
ALWAYS FOLLOW RIGHT PRACTICES.
ACTIVELY EDUCATE NEW PERSONNEL
REPORT NSI RELIGIOUSLY & THROUGHLY
REMEMBER CONFIDENTIALITY IS ALWAYS MAINTAINED
ALWAYS FOLLOW UP AN INJURY
TRY TO MINIMIZE USE OF NEEDLES
TAKE HOME MESSAGES
IGNORANCE ISN’T BLISS
LETS HELP EACH OTHER
ELIMINATE RISK OF NEEDLE STICK INJURY
THANK YOU !!!