needle-stick injury

[livingroomcomputer]

I am considering becoming a nurse. However, the possibility of dying due to a needle-stick injury is one factor that is holding me back. After reviewing stats on the internet, this seems to be a significant risk. Any thoughts?

[Mommy TeleRN, RN]

What stats were you looking at? The stats I have seen are pretty low, esp with HIV which doesn't live long outside the body. Perhaps your stats were old? We really don't even use that many dirty needles now days. Most everything is needleless. I use needles to draw up meds, but then discard it because the syringe hooks directly to the IV tubing so there is no dirty needle.

Most of the shots are subq (lovenox and insulin) These go into fatty tissue so there isn't that much blood, the needles are tiny, and they have safety devices you employ immediately after injection. I probably give

I guess maybe the biggest risk "maybe" is with an IV catheter needle because this goes directly into a vein. But it has a little button you immediately can push to retract the needle after you insert the IV.

Personally I am safe but not overly concerned.

[MrsMommaRN]

there are risks associated with every profession. most institutions prefer to be almost needless. yes you will give your sub q injections into fatty tissue and an intra muscular injection. if you are using standard precautions i.e. hand washing, gloving, no recapping of needles you should be safe.

there is not to say there may be an occasion where you may be stuck by a neeedle. your risk for a needle stick is low. while you are in school you will be taught how to properly handle the needles and such.

if nursing is truly in your heart go for it.

[CarVsTree]

Well said MommyNrse2b...

I actually was stuck with a needle while holding down a combative patient. The nurse gave an IM injection and as she pulled the needle out, she caught me on the arm.

Now, this pt. was the poster child for why you shouldn't use drugs. Even so, my risk for catching anything was extremely low. I think out of the entire country there are 300 cases of contracting HIV or Hep C. Our country has over 200 million ppl, not sure how many healthcare workers, but an extremely low number.

The stick was very superficial and IM injections involve very little blood. So, I opted not to go on the HIV cocktail. While I was down in the ED, they got the patient's permission for labs and he was - for HIV/Hep C (which was actually miraculous considering his hx).

Bottom line, it was a freak situation in which I got stuck. I was also an inexperienced tech at the time and probably should not have been where I was. I have never stuck myself as a nurse. There's no re-capping of needles and all our systems are needleless. As PP said, there aren't that many injections given and even then you learn how to be careful, use safety devices, don't re-cap and put things in the sharps containers right away.

[TazziRN, RN]

I have never seen high stats like you mention. If you look at all the things that health care professionals have contracted because of needle sticks, then hepatitis would be at the top of the list, but the actual number of people who get it compared to ones who don't is extremely low. In other words, don't look at the number of incidents, look at the percentages of everything.

There are much riskier things to do than become a nurse!

[livingroomcomputer]

thanks for the encouragement, mom2bears. I realize that you are right; all professions have their risks. Anyway, this is the info that I was referencing. Even though the Canadian information is from only 7 years ago, things probably have changed significantly with the advent of needle-less systems. The second source is from 2003.

From the Canadian Centre for Occupational Health and Safety:

Needlestick injuries may also transmit hepatitis C. The risk factors for hepatitis C virus transmission in occupational settings is 1.8% (range 0% to 7%).

Needlestick injuries are far too common hazard. Some hospitals report one third of nursing and laboratory staff suffer such injuries each year.

Available statistics probably underestimate the severity of the problem because many workers do not report their injuries. This makes it difficult to know exactly how serious the problem is or how well prevention programs work.

I tried to include the tables, but formatting issues prevented this.

This one doesn't directly apply to nursing, but is relevant:

From http://www.medicalnewstoday.com/articles/75273.php

Date: 28 June 2007

The survey, which took place in 2003, revealed that 99 percent of surgeons-in-training suffered an average of eight needle-stick injuries in their first five years. Of these surgeons, only 49 percent reported injuries to an employee health service. Of those who reported, 53 percent had experienced an injury involving a patient with a history of intravenous drug use and/or infected with HIV, hepatitis B (HBV) or hepatitis C (HCV).

[TazziRN, RN]

Okay, where are you getting a high number from??? According to this, the overall risk and actual injury incident rate is LOW!

[livingroomcomputer]

"low" and "high" are subjective, I guess.

For comparison, here are some other stats:

Percentage of U.S. population with HIV = 0.34 to 0.39 %

Percentage of U.S. population that dies each year in

circumstances related to drunk driving = 0.006 %

Percentage of U.S. population that develops lung cancer

each year = 0.06 %

[Mommy TeleRN, RN]

99% of surgeons are getting 8 needlesticks a year? Hmm I hope I get the 1% to operate on me lol. Trying to figure that number out!

I have heard of one needlestick on the one year I have worked on my floor. It's a pretty big floor. The nurse got stuck after she'd drawn blood from a patient's line and she stuck a needle on the syringe to stick the lab tube. A big no-no. We have a needleless device you can hook to the syringe that is a big barrel with a needle way up inside of it that fits over the lab tube. If she would have used it she wouldn't have gotten stuck.

Safety first!

[Creamsoda, ASN, RN]

From personal experience, I have had one recently. It was totally my fault though. I work in ICU, so everyone will have drugs drawn up in a syringe such as valium or fentanyl so we can give it quickly if we need to. We always draw up the whole vial which is a few doses usually. Well I was giving my patient some pain meds IVP into her central line, and after I had accessed the line, I recapped, and the needle went straight into the palm of my hand. I was pretty shocked that I had even done it. What I should have done was one hand recap. Even though the needle was not in the patient, it was in a line that was contaminated with her blood so I had to send of her bloodwork so she could get tested. She was a low risk patient for having any disease, so I didnt have to get my blood drawn, but for the first 24 hrs of waiting to see if she tested positive for anything was quite nerve wracking. Luckily she was negative. We all know that technically we are not supposed to recap at any time but we all do it, and I need to remember to at least recap one handed/passively. Just make sure you are doing things as per procedure and you will cut your chances significantly of getting stuck.

Cher

[Mommy TeleRN, RN]

Cher - just curious for my own learning - you actually stuck the port with the needle? Any reason just the syringe could not be attached?

[Creamsoda, ASN, RN]

We dont use the leur lock ports...I wish we did but I think its an expense thing. We use the needle ones- the port with the beige colored thng that you put the needle in. I guess I also could have put a blunt canula on the syringe as well as those go into the same port, but for some reason I didnt...need to remember to start doing that more often.

Cher