The Center for Disease Control and Prevention (CDC) has reported that approximately 385,000 sharps-related injuries occur each year among health care workers in hospitals. The actual value of these injuries is likely even higher, since it has been estimated that nearly half of sharps injuries are never reported.2Proper use and disposal of sharps is critical to maintaining a safe working environment for all health care workers, but nurses are particularly susceptible to sharps injuries and should be equipped with the appropriate guidelines and resources.3In this week’s blog post sharps injury protection techniques will be highlighted.
Activities Associated with Needlestick Injuries
About 64% of nurses have been accidentally stuck by a needling while working in a hospital. The top three circumstances surrounding sharps-related injuries reported by nurses include:
- While giving an injection (28%)
- Before activating the safety feature (19%)
- During the disposal of the safety device (19%)4
In addition, needlestick injuries may also occur during the following work practices:
- Transferring a body fluid between containers
- Manipulating the needle in the patient
- Bumping into another worker while either person is holding a sharp
- Failing to properly dispose of used needles in puncture-resistant sharps containers5
Devices Associated with Needlestick Injuries
Despite the wide variety of needles and sharp devices nurses use for patient care, the majority of needlestick injuries are associated with hollow-bore needles and winged-steel type needles. Needle instruments that must be taken apart or manipulated following their use such as phlebotomy needles and prefilled cartridge syringes present increased hazards during use. Needles attached to IV tubing also pose a greater risk of injury since the tubing can cause increased difficulty disposing the needle into the sharps container.5
The most current federal law including information regarding sharps safety is the Needlestick Safety and Prevention Act/Bloodborne Pathogens Standard. This act describes the OSHA’s requirements for health employers to identify, evaluate, and implement safer medical devices and mandates the maintenance of sharps injury logs.6
More information regarding this act and sharp devices with safety features can be accessed here: https://www.govinfo.gov/content/pkg/BILLS-106hr5178enr/pdf/BILLS-106hr5178enr.pdf.
Employers should implement a bloodborne pathogen control program that provides their employees with education regarding safe sharps use, as well as establish standardized requirements for working with these devices. The CDC and National Institute for Occupational Safety and Health advise workers to follow these recommendations:5
- Avoid the use of needles where safe and effective alternatives are available
- Help your employer select and evaluate devices with safety features, and use these devices
- Avoid recapping needles
- Plan safe handling and disposal of needles before any procedure
- Dispose of used needle devices promptly in the appropriate sharps disposal container
- Report all needle and sharps-related injuries promptly so that the appropriate follow-up care may be provided
- Tell your employer about hazards from needles that you observe in the work environment
- Participate in sharps and/or bloodborne pathogen training and follow the recommended prevention practices
Nurses are commonly exposed to needles and other sharp devices in the workplace as part of providing patient care. Prevention of injuries related to sharps instruments is an important step towards improving the overall safety of the working environment, and preventing the transmission of bloodborne viruses including Hepatitis B Virus (HBV), Hepatitis C Virus (HBC), and Human Immunodeficiency Virus (HIV).5,7
- Panlilio AL, Orelien JG, Srivastava PU, Jagger J, Cohn RD, Carco DM, the NaSH Surveil- lance Group; the EPINet Data Sharing Network. Estimate of the annual number of per- cutaneous injuries among hospital-based healthcare workers in the United States, 1997- 1998.Infect Control Hosp Epidemiol 2004; 25(7):556-62.
- Roy E, Robillard P. Underreporting of blood and body fluid exposures in health care set- tings: an alarming issue [Abstract]. In: Proceedings of the International Social Security Association Conference on Bloodborne Infections: Occupational Risks and Prevention. Paris, France, June 8-9, 1995:341.
- American Nurses Association. Sharps injury prevention. Nursingworld.org. https://www.nursingworld.org/practice-policy/work-environment/health-safety/safe-needles/. Accessed April 23, 2019.
- McNamara M. Workplace safety and needlestick injuries are top concerns for nurses. Nursingworld.org. https://www.nursingworld.org/~4ad43a/globalassets/docs/ana/ana_inviro-survey-pressrelease-2008-final.pdf. Published June 24, 2018. Accessed April 23, 2019.
5. Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. Alert: Preventing needlestick injuries in health care settings.