By Tina Powell, APRN-CNP
Certified Nurse Practitioner, Well at Work Occupational Health

The prevalence of needle stick and sharps-related injuries
The Centers for Disease Control and Prevention (CDC) estimates there are 385,000 needle stick and other sharps-related injuries sustained by hospital-based healthcare personnel and approximately 600,000 to 800,000 injuries from contaminated sharps each year in healthcare settings nationwide.

Those most at risk for needle stick and sharps-related injuries include nursing staff, laboratory staff, physicians, housekeepers, dental healthcare personnel, first responders and other healthcare workers.

Prevention
Effective prevention methods for needle stick and sharps-related injuries can significantly reduce exposure to bloodborne pathogens. Interventions include planning safe handling and disposal of sharps before any procedure, using safe and effective needle alternatives when available, activating the device’s safety features, avoiding recapping used needles, being responsible for the device you use by immediately disposing of contaminated needles or sharps in OSHA-compliant sharps containers, and promoting education and safe work practices.

Implementing these prevention methods is important; however, accidents can still occur, and therefore, it is also essential to understand what to do in the event of a needlestick or sharps-related injury. Understanding and implementing post-exposure interventions can help to reduce the risk of bloodborne pathogen transmission.

Bloodborne pathogens
Bloodborne pathogens are infectious microorganisms present in human blood that can cause disease. Common examples include human immunodeficiency virus (HIV), hepatitis B (HBV), and hepatitis C (HCV). Transmission of bloodborne pathogens requires exposure to infectious body fluids, which can enter through the skin, mucous membranes, or non-intact skin. 

Infectious fluids include blood, amniotic fluid, breast milk, semen, vaginal fluid, cerebrospinal fluid, pericardial fluid, peritoneal fluid, pleural fluid, or synovial fluid. It is helpful to note that saliva, vomit, urine, feces, sweat, and respiratory secretions do not transmit HIV unless visibly bloody.

Immediate post exposure interventions
Recommended post-exposure interventions include washing the exposed area with soap and water and irrigating the eyes with clean water, saline or sterile solution. For mucous membrane exposure, copious amounts of water or saline should be used to flush the area. 

All healthcare personnel who sustain a needle stick or sharps-related injury should report the incident to their supervisor or employee health clinic and seek medical evaluation promptly. An initial blood draw for a bloodborne pathogen work-up will be performed on the injured worker. If the source of the contaminated sharp is known, testing it for bloodborne pathogens is crucial, as the results inform treatment decisions for the injured worker.

If the source is unknown or positive for a bloodborne pathogen, follow-up testing for the injured worker is necessary at six weeks, 12 weeks and six months after exposure. A healthcare professional should manage testing and treatment, emphasizing the importance of seeking medical attention post-exposure.

Together, we can reduce the risk of needle sticks and sharps-related injuries in our workplaces. It’s essential to stay vigilant, adhere to safety protocols and support one another in creating a culture of safety. By implementing these preventive measures and post-exposure interventions, we can create a safer healthcare environment for everyone.