Facebook Twitter LinkedIn Syndicate. Minus Related Pages. Photo by Getty Images. Sharps injuries overview. How do needlestick and sharps injuries occur? These work practices include: Disposal-related activities e. Links with this icon indicate that you are leaving the CDC website. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website.
You will be subject to the destination website's privacy policy when you follow the link. These instruments include needles, lancets, scalpels and broken glass. Needlestick Injuries NSIs are defined as an accidental skin penetrating stab wound caused by hollow-bore needles such as hypodermic needles, blood-collection needles, IV catheter stylets, and needles used to connect parts of IV delivery system.
The Management of Needlestick Injuries. Dtsch Arztebl Int. Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers. Am J Ind Med. In general, needlestick injuries NSIs are caused by simple and preventable mistakes in handling sharp medical devices.
Percutaneous injuries may be caused by objects like needles, surgical instruments or glass. Nearly every 2nd hollow-bore needlestick also endangers the HCW to the risk of a blood exposure See Figure 2. It is known, that most exposures occur within the patient room, followed by operating room and the emergency department See Figure 5.
Additional factors with a negative impact on safe handling were healthcare worker HCW fatigue, uncooperative patients, or teams affected by staff shortage. The availability of actual figures regarding the incidence rates of needlestick injuries NSIs is insufficient and limited in general, especially for national and global figures.
Two major factors are responsible for this situation:. In the U. At least 20 different pathogens involving viruses, bacteria and fungi can be transmitted to healthcare workers HCWs through NSIs. The seroconversion rate and availability of vaccinations or post exposure prophylaxis PEP treatments also play a critical role, as infected HCWs face the consequences of developing acute and chronic diseases and even the probability of death.
Various studies have estimated the financial impact of NSIs. The Fig. The effective prevention of needlestick injuries NSIs to avoid the exposure to blood or body fluids BBF requires a comprehensive approach combining various strategies and actions 4,9,11, A general training and educational program on universal precautions and proper use of sharp devices must be established in a hospital.
This has to include not only the safe application of hollow-bore needles, but also their disposal, the adaptation of safe work practices and the reporting of NSIs. Experience shows that continuous reinforcement of educational strategies alone may be insufficient to sustain a reduction of NSIs. Therefore the prevention of NSIs has to be enforced by the use of needle protective devices.
The introduction of safety devices instead of non-protected conventional devices can achieve a significant reduction of the risk of NSIs. The effectiveness of safety devices varies between the device type and departments within the healthcare setting. Consequently, in some areas the transmission of pathogens from percutaneous injuries could be nearly eliminated See Fig. Under evidence-based criteria, the clinical data are incomplete.
For the Cochrane database, a systematic review found very low quality evidence that needle protective devices result in a decrease of NSI compared with non-protected conventional devices. However, their use is not regarded as a complete solution to reducing sharps related injuries amongst health care workers. Furthermore, safer sharps devices should be introduced alongside appropriate educational programmes. Sharps Disposal Containers. Needles are often associated with drug use, such as heroin or steroids.
However, this is not always the case — some people have to inject themselves on a regular basis using sharp needles to manage medical conditions such as diabetes. Other jobs where there might be an expected risk of a sharps injury will include:.
In these types of job, the highest risk activity for a sharps injury will often be the handling of rubbish or discarded items. The HSE reports sharps injuries as among the most common causes for injuries in the waste sector. Steps employers should take to protect employees that may encounter sharps during their work time:.
It is very important that staff who may encounter sharps have had training on how to deal with them. The higher the level of risk, the more in depth the training is required to be and the more controls will need to be in place.
In a hotel housekeeping team, for example, it may be sufficient to provide sharps training as part of more general health and safety training. Although cleaners and housekeepers may encounter needles or razors discarded by hotel guests, these would most likely only be occasional instances.
A similar approach would work in other areas, such as gyms, where there is anticipation of finding sharps in bins or changing rooms, but the instances of handling them will usually be minimal. Health and safety law is applicable to the risk of injuries from sharps, as it is for other workplace risks.
When managers or health and safety trainers are designing training around sharps, relevant legislation to keep in mind includes:. In certain workplaces, there is an expectation for some instances of sharps injury to occur. This is especially true in high pressured, fast paced environments where there is repetitive or prolonged exposure to hazardous objects. In clinical environments, needles and scalpels are essential tools that provide necessary medical care to patients. However, if an alternative to a sharp can be used effectively for some activities such as the drawing up of medication or fluids , the non-sharp alternative such as a medical straw or blunt needle should be opted for.
Wherever possible, however, it is important that managers and employees work together to reduce the risks of sharps injuries occurring. In high-risk areas, additionally, training should cover what to do in an emergency and what prophylaxis treatments are available.
A sharps injury log is designed to keep track of the kind of objects that are causing injuries, whether these need to be replaced, and to assess changes that need to be made to improve health and safety protocols within the workplace that will decrease the risk of exposure to blood-borne viruses.
Although it is inevitable that some sharps injuries will happen, the instances of these occurrences can be minimised by:. Between and , the NHS received 1, incident claims for needlestick injuries. The cost of paying out for the successful claims was over 4 million pounds. In addition to this shocking amount of money are the hidden costs both financial and human of sharps injuries:. The fact remains that many needlestick and other sharps injuries are preventable. By being compliant with health and safety advice and infection-control protocols, using correct PPE and disposing of sharps correctly, employees can help to promote a safer working environment.
It is also vital that primary users dispose of their sharps correctly so as not to harm other staff, as the majority of claims to the NHS come from ancillary workers such as cleaners, porters and maintenance staff.
Management in turn must ensure they are keeping up to date with legislation and best practice and that they review data on incidents from sharps injuries regularly. You should always report a work-related sharps injury to your line manager or supervisor and seek medical attention as soon as possible.
Your workplace will have their own protocol to follow, which should have been outlined to all staff during their training and induction. There will most likely be an incident report to complete, once relevant medical treatment has been sought.
If your company has an occupation health team, they will need to be involved. Other types of sharps injury, where the object was not contaminated or the source of the injury is unknown, are not required to be reported to the HSE. It is important that injuries are always reported within the workplace and any relevant procedure is followed and the sharps injury log is updated accordingly. The Agreement makes clear that healthcare staff are at risk of serious infections due to their daily work.
More than 20 dangerous pathogens, including hepatitis B, C, and HIV, can be transmitted as a result of needlestick injuries [1]. It applies to all workers private and public in the healthcare sector, as well as students, agency nurses, and healthcare staff in other workplaces, such as prisons. The key requirement of the Directive is risk assessment.
The aims of the Directive are:. This directive states that employers must take all appropriate steps to ensure that neither the worker nor the unborn child is exposed to a health risk in the workplace see also Expectant mothers , Gender , and Young workers. Risk assessment means identifying hazards and controlling the risks in the workplace. The guiding principles that should be considered throughout the risk assessment process can be broken down into five steps [5] [26] :.
All sharps injuries are a hazard that can lead to a risk of infection: What might cause harm? What can go wrong? Prevention measures to eliminate or reduce sharps injuries can be done in different ways. These measures include:. The hierarchy of controls, reflecting the efficacy of the measures, indicates that the first priority and most effective level is the elimination or substitution of needles and other sharps, where possible, i.
The next level is to isolate the hazard through the use of an engineering control, e. This is followed by work-practice controls universal precautions, no recapping and administrative controls policies and training programmes.
Work practice controls should not be a substitute for engineering controls and should only be considered if the technology to eliminate or reduce the hazard is not yet available. Training measures, however, should complement all types of controls.
The last priority and least effective are individual control measures : personal protective equipment, such as gloves, masks, gowns, etc. Different systems are available to eliminate unnecessary use of needles. Needle-free systems provide an alternative to needles for some procedures, reducing the risk of injury from contaminated sharps, e. Safety devices are designed to prevent workers being injured by contaminated needles or other sharps.
They are equipped with safety features which prevent needlestick injuries Tab. Until now it has not been technically possible to use safety devices with premature babies [28].
There is evidence that the use of safe devices, when combined with training and safe work practice, can reduce the risk of needlestick injuries. A pilot-study to test different safe devices was carried out in 12 hospitals in Hamburg, Germany.
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