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Needlestick injuries

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Nurses are more likely than any other healthcare worker to sustain a needlestick injury and 70% of such injuries are believed to go unreported.

These injuries include any wounds caused when needles or other sharp objects (such as scalpels, stitch cutters and glass ampoules) accidentally puncture the skin.

This can expose health care workers to serious and potentially fatal bloodborne viruses including HIV, hepatitis B and hepatitis C.

Needlestick and sharps injuries are the most likely way that healthcare workers are exposed to these viruses through their work. How much of a risk of acquiring infection through a needlestick injury will vary according to the nature of the injury, the nature of the device and that of the bloodborne virus.

Around 40,000 needles or sharps injuries are reported every year and estimates are that the overall number – including those unreported ones – is more like 100,000.

Staff tend not to report such injuries either because they are too busy, they are scared, the injury happened ‘out of hours’ or they do not consider the patient to be high risk.

Despite this, it is essential that every such injury is reported immediately to allow for the appropriate action to be taken and to provide accurate surveillance data.

After a needlestick injury, the wait for a test result – sometimes a wait of up to 12 weeks – is obviously upsetting for the healthcare worker involved, even though the majority of needlestick injuries do not result in infection.

Prompt action is important because post-exposure prophylaxis (PEP) treatment – an antiviral medication that significantly reduces the risk of HIV infection – can help and is most effective when taken within a few hours of the injury.

Employers have a legal duty to assess and minimise the risks to their healthcare workers and guidance from the Department of Health published last year, known as the Blue Book, says that employers should:
- Identify the risk of exposure to blood from a needlestick injury
- Put procedures and policies in place to minimise risks
- Ensure all health care workers are trained in safe systems of work
- Encourage adequate reporting of all such injuries
- Make safer devices available where appropriate such as needles with safety mechanisms.

Ways of preventing a needlestick injury include always using a mobile sharps bin and taking responsibility for disposing of your own sharps; never resheathing needles or detaching a needle from a syringe before disposal; always practising universal precautions; never cleaning up sharps used by colleagues; and staying up to date on best practice by attending regular training updates.

Updated: September 2006

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