Needle stick (major angry vent!)

I work in a family practice clinic that also has a very busy walk-in clinic. We do a lot of minor surgical procedures there and generate a lot of instruments. We share the nurses station as well as all our equipment with the family practice next door to us so the nurse that works there and I take turns keeping our instruments clean and sterilized. This month is her turn.

Yesterday she was stuck in the finger by a suture needle that was left clamped in a needle driver.

Used instruments are soaked in a container with disinfectant then they are scrubbed clean with more disinfectant and a brush, rinsed and left on a tray to dry before being pouched and autoclaved. The nurse had cleaned the instruments on Tuesday and on Thursday (yesterday) started to assemble the sets. That's when she was stuck by the suture needle. It was on the drying tray. The needle was stuck to the teeth of the driver, she had to give it a good knock against the inside of a specimen cup to get it off.

We don't know if it had soaked in the disinfectant and she accidently missed the driver while cleaning it or if one of the docs put it on the drying tray thinking they were dirty instruments. Bottom line was that one of the docs had left that needle behind. What's worse is that this isn't the first time that sharps have been left behind for us to deal with (I found a scalpel blade still on the handle in the solution. ) but this is the first time someone has been hurt.

To add to the turmoil, we have no idea which patient this came from so we had to call all the patients who had sutures done in the last week. Thankfully there weren't many and we will be asking them all to have a blood test done to check for HIV and hepatitis. Unfortunately, one patient has refused.

I don't know what the legality of all this is and I'm not sure what the nurse and the clinic will do about this. But I am so upset because it's something that just SHOULDN'T have happened. Aren't docs taught in med school how to dispose of sharps properly???

I feel so bad for the other nurse.

Laura

[sjoe]

"To add to the turmoil, we have no idea which patient this came from so we had to call all the patients who had sutures done in the last week. Thankfully there weren't many and we will be asking them all to have a blood test done to check for HIV and hepatitis. Unfortunately, one patient has refused."

Why should all these patients be unnecessarily worried, not to mention be inconvenienced by lab tests, because your office is disorganized? And what difference does it make anyway, whether any or all of them are HIV+ and/or Hep B positive?

A responsible professional would simply assume these patients were positive/infected and deal with it from there--testing the stuck employee now, 30 days on prophylactic treatment if she so chose for this VERY low-risk injury, testing again after a couple of months, etc.

This is NOT your patients' problem, and inappropriate for your office to make it be.

IMHO.

[itsme]

I agree with sjoe. I would be very up[set if the clinic called me and I had to go in for another blood test over carelessness by whomever. Why not just have the nurse tested? Mistakes like this are what can give healthcare a bad name, because the public only hears of the "mistakes" and not all the p ositives. they will never know how many times the instruments were cleaned without any needles sticks, but you can bet they will sure wonder about the time they hear of one getting a stick!! Good thoughts going your way. Also inform those docs that you are not working in a safe environment if they are unable to utilize the appropriate sharps container, and it is your right to work in a safe environment!!

[brenzgrove]

that is horrible. and sometimes i wonder too, what goes on in these doctor's minds. why is knowing and abiding by the principles JUST OUR job? There was a doctor wher i did my pregrad, who threw a used needle at a nurse like a dart. Nasty old thing!

[Noney]

Originally posted by brenzgrove

that is horrible. and sometimes i wonder too, what goes on in these doctor's minds. why is knowing and abiding by the principles JUST OUR job? There was a doctor wher i did my pregrad, who threw a used needle at a nurse like a dart. Nasty old thing!

I hope the nurse filed charges.

Noney

[renerian, BSN, RN]

I had the same problem at the hospital. The docs/residents would leave their suture tray or central line kits all over the place.

renerian

[Noney]

Laura,

What is being done at the clinic to prevent this from happening again? I am sorry that happened to her, but if something isn't done it could happen again.

Noney

[iliel]

Your office dosn't sound "disorganized" to me, but hey.

I've been stuck, and it was a true freak accident. Had a syringe (dental) in a needle holder and was cleaning up. My surgical gown caught on the handle as I was reaching down, the thing flung out of the holder (the cap stayed in place) fell towards the floor and caught in my leg.

It sucked, we asked the pt before she left and she was VERY understanding. I went for tests and everything has been fine. The pt allowed us to contact her DR since she a recently had an HIV and Hep test so it never hurts to ask.

I hope things work out for your co worker, not knowing is the worst part.

[sjoe]

"What is being done at the clinic to prevent this from happening again? I am sorry that happened to her, but if something isn't done it could happen again."

Can and WILL.

"The docs/residents would leave their suture tray or central line kits all over the place."

It is possible that these people were trained to do exactly what they are doing, i.e. that techs/housekeeping/nurses/whomever would safely clean up these trays. It may be that some retraining would be appropriate.

[Rapheal]

We have one doc who when done with a central line will ball up all the supplies (sharps and all) and put them in the patient wastebasket. He knows not to do this but still keeps on doing it. If you try to retrieve the tray you risk a stick to yourself, if you leave it you are putting someone else at risk to get stuck. Darned if you do-darned if you don't.

I wish we could do alot of things different at the hospital (which I am leaving). Staff has gotten away with so much for so long and is resistant to change.

[kay]

"To add to the turmoil, we have no idea which patient this came from so we had to call all the patients who had sutures done in the last week. Thankfully there weren't many and we will be asking them all to have a blood test done to check for HIV and hepatitis. Unfortunately, one patient has refused."

Why should all these patients be unnecessarily worried, not to mention be inconvenienced by lab tests, because your office is disorganized? And what difference does it make anyway, whether any or all of them are HIV+ and/or Hep B positive?

A responsible professional would simply assume these patients were positive/infected and deal with it from there--testing the stuck employee now, 30 days on prophylactic treatment if she so chose for this VERY low-risk injury, testing again after a couple of months, etc.

This is NOT your patients' problem, and inappropriate for your office to make it be.

IMHO.

The reason for testing the patients is that IF one of the patients tests positive for HIV or Hep. C it would affect the decision whether or not to begin prophylactic treatment on the nurse. If none of the patients are positive AND because it is a low risk scenario then probably these prophylactic medications (which have horrible side effects) would not be given to the nurse.

Regardless of whether or not any of the patients are postive at the time of the blood test, the nurse would need to go for follow up blood work at set intervals for 6 months.

I feel for this nurse too. I stuck myself last year on a needle used for venepuncture on a known Hep C patient. I was lucky and did not contract it. The risk of contracting Hep. C or HIV is actually very low statistically but there is that risk and it is scary.

Hep B is much more easily contracted but at least we can give immunoglobulin for that (and hopefully most health care workers are already vaccinated against Hep B)

[caroladybelle, BSN, RN]

We have one doc who when done with a central line will ball up all the supplies (sharps and all) and put them in the patient wastebasket. He knows not to do this but still keeps on doing it. If you try to retrieve the tray you risk a stick to yourself, if you leave it you are putting someone else at risk to get stuck. Darned if you do-darned if you don't.

I wish we could do alot of things different at the hospital (which I am leaving). Staff has gotten away with so much for so long and is resistant to change.

Someone needs to sue his Butt for endangering safety of personnel.