accidental fingerstick

Nurses General Nursing

Published

I am so worried.

I was giving an injection to my patient when I accidentaly struck myself with the needle after injecting the patient.

He has MRSA (which after reading about it, says its everywhere skin, blood)

I made an incident report but I am so worried I will get sepsis.

He also has cancer, pneumonia. Im worried about the mrsa. Should my employer offer me something?

sorry meant to say needlestick not fingerstick

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Specializes in ER, Trauma.

Document everything, followup with the infection control nurse or your own doctor as soon as possible. I believe they will reassure you a lot. While all your fears are possible, I believe you'll find they are improbable. Good luck and as a favor to me, will you do a follow up post or two so we know how things work out for you. Thanks.

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Specializes in ER, ICU, Home, pre-hospital.

You should have an infection control policy at you facility. Your supervisor should be advised, hopefully they will possibly test your pt. for hep, hiv, maybe more. Chances of infection depend on many factors, including: did your finger bleed? (that can wash out germs), but the deeper the stick, the higher the risk, etc., BTW, MRSA would suck, but we all know it is not unlikely that health care providers have already colonized MRSA or something else on their body's, in there noses, etc. and being colonized is not the same as an "active or acute infection". Just follow up, also, if your pt. tested positive for anything, then it could be important to immediately or ASAP, get your own blood drawn to document whether you already are positive, b/c you already had it, or document you are negative so that if you do have a "positive" blood draw in a few weeks, then you know when it happened. Make any sense? just a few quick thoughts, I bet you'll be fine, but it depends on your pt.'s history.

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Specializes in ED, CTSurg, IVTeam, Oncology.

concur with our colleagues' responses above. just wanted to add that, while the mrsa is bad, it is not absolutely without recourse, as vancomycin remains effective; i'm thinking of something even worse. this may already be water under the bridge, ie too late to do anything about it, but for the sake of other readers, i'm still posting the suggestion; you should have gone immediately to the ed and asked about an option for starting post exposure hiv prophylaxis.

see these:

treating hiv exposuredecreasing hiv risk with post-exposure prophylaxis

post-exposure prophylaxis

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updated u.s. public health service guidelines for the management of occupational exposures to hiv and recommendations for postexposure prophylaxis

in such cases, time is of the essence. the thought process is, that even if hiv does enter your system via the needle injury, that the viral count is yet so low that taking anti-virals may prevent the infection from ever gaining a foothold in your system. in effect, helping your body kill the aids virus before it spreads to a point where the system can no longer cope with it, and you're permanently infected.

from the first link:

  • two drug pep recommended
    • exposure to asymptomatic hiv+ person by solid needle stick or superficial injury that break the skin
    • a mucous membrane exposure to a large volume of hiv infected blood that's source is asymptomatic (consider for a lesser volume, a few drops)
    • a mucous membrane exposure to a small volume of hiv infected blood that's source is symptomatic.

    [*]three drug pep recommended

    • exposure to asymptomatic hiv+ person via deep puncture from a large bore hollow needle
    • a puncture from a needle with visible blood on the needle
    • a puncture from a needle used in a patient's vein or artery.

    [*]three or more drug pep recommended

    • any needle stick exposure from any type needle used on a symptomatic hiv+ person
    • a mucous membrane exposure to a large volume of hiv infected blood whose source is symptomatic.

    [*]possibility of two drug pep under certain circumstances

    • needle stick with any type needle and any degree of exposure if the source has an unknown hiv status but has hiv risk factors
    • needle stick with any type needle and any degree of exposure if the source has an unknown hiv status and unknown risk factors but a setting in which exposure to hiv+ persons is likely
    • a mucous membrane exposure to any volume of blood whose source has an unknown hiv status but has hiv risk factors
    • a mucous membrane exposure to any volume of blood whose source has an unknown hiv status but is in a setting where where hiv exposure is likely

depending on what one reads, some recommend starting a pep course within 72 hours, while others suggest the best effectiveness to be within the first few hours (eg 1-2 hours post exposure; for all intents and purposes, this effectively means immediately). but, like the old adage, 'an ounce of prevention, et cetera...', is really worth a pound of cure. one really needs to be careful at work, especially when we're rushing to complete the many tasks that is nursing. we should always remind ourselves that we're no good to anyone else if we ourselves become incapacitated. good luck, and please stay well.
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Were you able to read the hx for the patient?? This is a good start because something may be documented that could help you with your postexposure treatment.

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Specializes in Psychiatry.

It is so very unlikely you would catch it. I take it you immediately washed the area, I would hope. Colonization cannot happen that fast and if you pricked your finger only it's only came into contact with a capillary. It's so very unlikely you got anything, and if any bacteria did enter your blood, it would be so minute your own immune system would take care of it. Infection via blood only can be transmuted through plasma (WBC) Unless the pt himself has sepsis.

I know it's hard and I would be worried as well, but try to relax! Most hospitals have their own protocol which usually involves seeing an epidemiologist and starting on prophylactic drugs, but in the case of MRSA it's very unlikely. And prophylaxis on vancomyacins risks out weigh its benefits, so I can see what prophylactic procedures were not initiated. Don't worry! I'm sure you'll be fine! :)

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Im a new nurse in LTC. Was giving insulin with flexpen when I pricked my finger after injecting insulin. Took of my glove and milked my finger with blood coming out. Washed my hands and filled out an incident report. My facility did not have a policy on needlesticks so I continued on with my work. Two days later my boss read my indident report and after I begged her she had him tested. But she told me I was being ridiculous that these old folks dont have anything unless it states on their chart. Anyway, his HIV came back + but his western blot was inconclusive.

I came to work and asked my boss to see his results, she said "dont worry about it. its negative" My co-worker told me to look at the results- she said that they're not telling the truth to me.

My boss left the results on her desk and I went through them and even spoke to the lab director about them who explained that the western blot was inconclusive.

My boss refuses to test the patient again. She says Im crazy and Im fired. She also told me that I waited an entire week to get my blood tested and thats against protocol.

They didn't have a protocol for needlesticks until a week later they put one in!! She said she wants no part of it and Im on my own with payment.

I had my blood tested now that my facility put in a protocol. But I have no insurance and my boss isn't paying for it because she said I waited too late to get tested.

She also is mad at me for talking to the pharmacy because of violation of hippa.

I feel alone. THere was no protocol when this happened and I feel I did my best at the time. I didn't know what to do and was scared about finances. Of all things, this patient had to test +

This whole thing is a mess. The doctor prescribed meds for me but its been 12 days since the incident and Im without insurance or work!!!!!!!!!!!!!

She also said she will sue my a@@ for hippa violation. If she didn't keep information away from me, I wouldnt have had to go through the results and call the lab

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Specializes in School Nursing.

Hire a lawyer, NOW. This is your life here.. Your superior had no right to give you false results and expect you to just accept that and move on. I'm so sorry you're experiencing this.

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Specializes in Anesthesia.

That is a very small gauge needle.....I know it's hard, but I would not worry about it too much.

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Specializes in CM; UR; HEDIS; Geri; Med/Surg.

Information about needlestick injuries should have been part of your orientation. Did you report it to the nursing supervisor at the time of the event? If so, what were his/her instructions? There should have been something in writing at the facility to address this since it involves exposure to blood/body fluids - it is a requirement. Didn't they give you any information during orientation on how to utilize work health services? Work health is not only for things like back injuries or falls...

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whoa, first so sorry you are going through this.

I don't know a lot about this but I think OSHA would like to hear about this. No needlstick policy, seems really bad. I see a whole lot wrong in this situation, none which is your fault.

Hopefully someone on these boards can point you in the right direction. Your rights seem very violated.

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She keeps telling me the results are negative when it says not conclusive. So how can she insisit they're negative? It says it point blank

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