blood exposure question

[yeoman]

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.

[Mrs. SnowStormRN, RN]

What did your professor say?

[Esme12, ASN, BSN, RN]

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:

[RNTOBE_1970]

if you are concerned, call the National PEP Hotline [phone]. It is staffed by MDs at San Francisco General.