Jump to content

blood exposure question

yeoman yeoman (New) New

I'm a student nurse, and I'm kind of freaking out this morning after a clinical shift reflecting on something that I didn't react to right away.

I was helping someone do an accu-chek and accidentally poked myself with one of the spare, unused lancets on the tip of my thumb. I looked at my glove and didn't see a hole or any blood coming through, and so I didn't think anything of it. I realized today after getting home though, that I handled a cotton ball that was handed to me (still wearing my gloves) from that patient directly after that had some their blood on it. After I had taken my gloves off after we were done I noticed that the poke I had given myself had bled a little bit.

I don't know what to do, or how scared I should be... this patient did not have known Hep-C or HIV. I did not get any frank blood on my glove of theirs, nor did any of mine ever come through the glove to the outside.

I think I should file an incident report or something, but at the moment I've never been more scared or anxious in my life even though this wasn't even a proper needle-stick injury or anything. I think I know what I need to do, but I guess I'm just looking for someone to tell me if I should be super worried or not? I don't know.

Flare, ASN, BSN

Specializes in school nursing, ortho, trauma.

Well, per the terms of service we can't dish out any medical or legal advice. I will say that you probably should fill out the incident report and follow their procedures - and I will also say that a tiny poke from a clean needle through a glove coming in contact with a blood tinged cotton ball would not weigh too heavily on my mind.

i should clarify that the poke occurred while I had a glove on -- so the glove was punctured and not intact while I was handling the cotton ball...

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

We really can't give medical advice.....you should have spoken to your instructor. If you are really concerned call your PCP or you can go to your local ED to see if you need any boosters or RX of any kind......but since you are a student you probably are up to date.

The actual incidence of disease transmission is actually pretty low........check out the CDC web site for needlestick injury policies and Rx ect......

Take a deep breath.....you're ok....:)

http://www.hivatwork.org/education/needlestick.cfm

You should fill out an incident report...talk to you instructor.....call or e-mail her if you have her number.....

A spare, unused lancet had an exposed needle tip? I can't envision it - don't they have some kind of covering on them? I've been a nurse many years, and a diabetic nearly 10 years, and I can barely recall lancets without some type of protective cover.

So I am confused.

And, any needle stick requires an incident report. Period.

The likelyhood that you will have any health sequelae from this is minimal. You need to calm down, and do your paperwork.

When working as a nurse one has to pay attention and be extemely careful. Can not imagine something like this happening before I even got out of school. Seek medical care like previous poster states.

Rob72, ASN, RN

Specializes in Infectious Disease, Neuro, Research.

Report the stick. "I didn't think about it at the time, but..." Should you be worried? Statistically, no. I'm an old hospital-trained phlebotomist, and my only stick, in (now) 20 years, involed a safety device. (sarcastic eye-roll)

Develop a sharps handling regimen from which you do not deviate.

For me this means (**do as your institution mandates/I do not offer legal advice/I am not condoning unsafe practices/etc./etc**) recapping with a 1 hand scoop, the off hand being tucked to my chest or behind me. Transport the capped sharp to the HazBox holding my arm firmly across my chest, needle-tip pointed parallel to a line from my sternum to Lt shoulder (if someone bumps into you, the sharp is caught between your bodies and natural flexion draws your arm, not the sharp, towards you). When carrying a scalpel or similar item, I carry it parallel to my forearm at waist level, point to the rear, or across my body as with a needle, depending on the environment.

All of the above applies to clean or dirty, covered, sharps. I honestly cannot think of a time when it is necessary to transport and uncapped/sheathed sharp.

I'm assuming your stick was related to loading the lancing device? If so, (in the future) stop, discard the sharp and your gloves, wash your hands, then start again. You can simply say you touched the lancet, "oh, shoot, I touched it..." Take it in stride, and you'll be safe, and maintain the stunning aura of competence we all strive to maintain.:D

BabyLady, BSN, RN

Specializes in NICU, Post-partum.

1. You were poked with a CLEAN unused lancet.

2. You handled a cotton ball AFTER you donned gloves.

Ask yourself this:

Would you have called into work and told the facility you could not work if you had been sewing a button right before your shift started and poked yourself with needle knowing you had HIV-infected patients on the floor?

Of course you wouldn't, because that is why we use gloves, right?

Nurses are all the time getting paper cuts (that is my personal thing), etc. That is why we use gloves when we come into contact with any potentially contaminated material and wash our hands afterwards.

Folks..IT IS IMPORTANT to use common sense when it comes to needle sticks...you need to report DIRTY needle sticks...that is being stuck with a needle AFTER it has come into contact with the patient or fluids contaminated with BODY fluids. Clean, unused drugs don't count.

One of my co-workers, who has been a nurse alot longer than me, was sent by upper management to a safety class after she "reported" a needle stick, insisted on going to the ER...cost the facility tons of money in labwork and paperwork...only to find out later it was a CLEAN needle she was barely grazed with...management was furious because this nurse didn't know the difference between risk vs no risk. The needle was sterile!!!!!

If there was a risk, then risk management would send you home every time you got a papercut on your finger while working.

Edited by BabyLady

1. You were poked with a CLEAN unused lancet.

2. You handled a cotton ball AFTER you donned gloves.

.

no, the poke from the lance occurred while I was wearing gloves, but I didn't notice that it had cut my skin until after the fact and handling of the cotton ball. Don't ask me how, but I barely felt it. I feel incredibly stupid, believe me.

Thanks for the replies so far... I thought it'd help calm me down but it honestly hasn't, and I do intend by all means to do an incident report... It really does suck, I feel an incomprehensible amount of stupidity and guilt, on-top of anxiety and fear.

BabyLady, BSN, RN

Specializes in NICU, Post-partum.

Gloves are made from the material they are for a reason...superficial holes "close" unless the material is stretched significantly...that is why you did not see a hole.

Anything on that cotton ball would have to do a an acrobatic act to get into your bloodstream, assuming that patient has anything.

Just know that if you had a full stick from a dirty buried needle from an HIV patient, the risk for THAT is less than a fraction of 1%...to put it in perspective for you.

Seriously, this is not something that I would lose sleep over.

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

1. You were poked with a CLEAN unused lancet.

2. You handled a cotton ball AFTER you donned gloves.

Ask yourself this:

Would you have called into work and told the facility you could not work if you had been sewing a button right before your shift started and poked yourself with needle knowing you had HIV-infected patients on the floor?

Of course you wouldn't, because that is why we use gloves, right?

Nurses are all the time getting paper cuts (that is my personal thing), etc. That is why we use gloves when we come into contact with any potentially contaminated material and wash our hands afterwards.

Folks..IT IS IMPORTANT to use common sense when it comes to needle sticks...you need to report DIRTY needle sticks...that is being stuck with a needle AFTER it has come into contact with the patient or fluids contaminated with BODY fluids. Clean, unused drugs don't count.

SHe technically touched a contaminated cotton ball with an open wound and a possible breech in her glove she is upset but she is new and will be fine..it is not only important to use "common sense" because not everyone has common sense. It is more important to follow policy and procedure to protect you in the long opne if something would happen. If you don't follow policy and procedure you will be left out in the cold and holding a bag with nothing in it...

One of my co-workers, who has been a nurse alot longer than me, was sent by upper management to a safety class after she "reported" a needle stick, insisted on going to the ER...cost the facility tons of money in labwork and paperwork...only to find out later it was a CLEAN needle she was barely grazed with...management was furious because this nurse didn't know the difference between risk vs no risk. The needle was sterile!!!!!

If there was a risk, then risk management would send you home every time you got a papercut on your finger while working.

The Management should be angry with themselves...there is plenty of information out there and recommendations from the CD what is considered a treatable(high risk) and non treatable (low risk) exposure....this should have been able to determined by the ED. If the employee insists the liability and cost of refusing her is greater than just treating her.....and sending someone to a saftey class is never a bad idea....

OP ... take a deep breath like I said before.....RELAX....I wouldn't lose sleep over this either

BabyLady, BSN, RN

Specializes in NICU, Post-partum.

The Management should be angry with themselves...there is plenty of information out there and recommendations from the CD what is considered a treatable(high risk) and non treatable (low risk) exposure....this should have been able to determined by the ED. If the employee insists the liability and cost of refusing her is greater than just treating her.....and sending someone to a saftey class is never a bad idea....

OP ... take a deep breath like I said before.....RELAX....I wouldn't lose sleep over this either

I am very curious...what risk is there to stick yourself with a STERILE needle and then continue your shift using universal precautions?

If there is one..then maybe we shouldn't be using them on the patients.

Management was right. Sorry, I cannot agree with you on this one.

Mrs. SnowStormRN, RN

Specializes in Mental Health, Medical Research, Periop.

What did your professor say?

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I am very curious...what risk is there to stick yourself with a STERILE needle and then continue your shift using universal precautions?

If there is one..then maybe we shouldn't be using them on the patients.

Management was right. Sorry, I cannot agree with you on this one.

In making sure I'm not giving medical advice....If you go to the CDC guidelines there are recommendations about treatment guidlelines. In the event of a blood and body exposure involving a needle...once the supervisor is notified decisions need to be made. If you are in acute care which I believe you are...there should be a policy and procedure and a packet that guide decision making, incident report and intervention. Usually the patient/employee is sent to the ED where the ED MD decides whether or not any further RX is warrented as well as educating/counseling the employee. Some workmans comp companies require education classed after needle stick exposures. The workings behind closed doors are more convoluted than you could ever imagine.

http://www.nepeandgp.org.au/lib/pdf/Protocol_needlestickinjury.pdf

http://www.cdc.gov/mmwr/preview/mmwrhtml/00052722.htm

http://wonder.cdc.gov/wonder/prevguid/p0000085/p0000085.asp

http://www.nursingworld.org/FunctionalMenuCategories/MediaResources/MediaBackgrounders/NeedlestickPrevention.aspx

http://www.nevdgp.org.au/info/division/needlestick_injury_what_to_do.htm

A Needle stick that HAS been exposed to blood or body fluid known as infected is 0.3%-0.6% of all sticks may have disease transmission and the disease most transmitted is Hep C.......so a clean needle stick?....do the math.

The reason I feel the administration was wrong is because they have an obligation to be sure this nurse has the proper education and the policies to back them. In the event an employee want treatment that we feel in unecessary we recommend they see their private MD. To treat an emplyoee badly because they are frighten and are not provided the correct information is the facilities fault not the employee......this is just my :twocents::twocents:

RNTOBE_1970

Specializes in Med-Surg, Psych, Tele, ICU.

if you are concerned, call the National PEP Hotline 1-888-448-4911. It is staffed by MDs at San Francisco General.

×

By using the site you agree to our Privacy, Cookies, and Terms of Service Policies.

OK