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Discussion

Needlestick Error

A colleague of mine confided in me an error he made and I wasn't sure what to advise, so I put it to you:

He was collecting blood for a relatively healthy pt to check FBE. When he uncapped the butterfly needle he stuck himself in the thumb, but did not realise until after he had inserted the needle into the pt vein. He noticed as his glove began to darken. There was no blood collected from this vein as tube suction was faulty. Collection was successful from a different vein with a new needle.

What would you do? What should he have done?

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    He needs to admit his error to his supervisor and testing will then be done on patient and himself.

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    Yeah, he needs to report it. Unfortunately, it is estimated that half of all needlestick injuries go unreported... I can imagine it's situations like this. He won't have to tell the patient, but he needs to tell his boss.

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    he should tell the patient. I would want to know and it's part of our code of ethics to do so. He needs to tell the supervisor and both should have blood work done

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    • Experts
    A colleague of mine confided in me an error he made and I wasn't sure what to advise, so I put it to you:

    He was collecting blood for a relatively healthy pt to check FBE. When he uncapped the butterfly needle he stuck himself in the thumb, but did not realise until after he had inserted the needle into the pt vein. He noticed as his glove began to darken. There was no blood collected from this vein as tube suction was faulty. Collection was successful from a different vein with a new needle.

    What would you do? What should he have done?

    As you have written it, it sounds like your colleague stuck himself with the needle first (stuck himself during the uncapping), THEN inserted this needle into the patient.

    If that's the case, it's the patient who has the needlestick issue, not your colleague.

    He needs to report this ASAP for his patient's sake. The patient was exposed to a needle contaminated by your coworker's blood: the patient will need appropriate treatment, and your colleague may need to undergo blood testing to see if he has any infectious diseases that could possibly be transmitted during this stick.

    Best of luck to both your colleague and the patient.

    And hopefully, this won't happen again...but if it does, don't wait to report it. Report it ASAP.

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    You don't always realize that you stuck yourself right away.

    It is not an "error". It is a needlestick injury with possible exposure and needs to be reported. Your friend will not get in trouble.

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    • Author

    I did encourage him to report, as I understand it's really the patient at risk. I'm not sure what he expected from me when confiding in me, as I have not had a NSI. Has anyone had, or know anyone who has had something of this nature happen to them?

    As a side note, our workplace has mandatory blood borne disease testing on entry. He is negative for the heps and HIV from what he has said.

    To me, this is an ethical issue. How would you align our code / ethical obligations with what occurred? I'm struggling with being supportive.

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    I know this is a few weeks old but I hope he reported this. The patient, and your colleague, need to have testing done. This happened to my daughter when she went in for a vaccination. My daughter freaked out which caused the nurse to accidentally prick herself but with all the action occurring proceeded to insert the needle into my daughter. I was shocked that it happened but didn't know what to do. We went home, called a doctor friend, who told us to call our doctor to let them know. We were told to come in for blood work. Thankfully, everything was fine. But still a little unnerving. It happens but follow-up needs to happen.

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    You don't always realize that you stuck yourself right away.

    It is not an "error". It is a needlestick injury with possible exposure and needs to be reported. Your friend will not get in trouble.

    He may not have realized that he actually broke his skin with the needle, but if he knew the needle even touched his glove, he should have gotten a new needle.

    Either way, he needs to report this to his supervisor.

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    • Experts
    I did encourage him to report, as I understand it's really the patient at risk. I'm not sure what he expected from me when confiding in me, as I have not had a NSI. Has anyone had, or know anyone who has had something of this nature happen to them?

    As a side note, our workplace has mandatory blood borne disease testing on entry. He is negative for the heps and HIV from what he has said.

    To me, this is an ethical issue. How would you align our code / ethical obligations with what occurred? I'm struggling with being supportive.

    Can he produce negative test results dated as of the date of the needlestick? If he can't, he needs to report it and go in for testing ASAP.

    Even if he can produce negative test results, he still needs to report it and go in for testing as the tests dated upon hire may have been premature (as in he is positive but tested too early). Plus, they don't cover any activity that may have occurred since hire.

    Your coworker may not like having to do it, but it's part of the drill when there's a needlestick involved. I'm sure if he were on the opposite end of the needle, he'd be howling for the patient to be tested six ways to Sunday ASAP. So he needs to smile, suck it up, report it and get those tests done.

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    He didn't realize he stuck himself?

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    I did encourage him to report, as I understand it's really the patient at risk. I'm not sure what he expected from me when confiding in me, as I have not had a NSI. Has anyone had, or know anyone who has had something of this nature happen to them?

    As a side note, our workplace has mandatory blood borne disease testing on entry. He is negative for the heps and HIV from what he has said.

    To me, this is an ethical issue. How would you align our code / ethical obligations with what occurred? I'm struggling with being supportive.

    I don't think this is a true ethical dilemma. Your friend should have reported the incident to his supervisor, but he didn't. In any case he is negative for hep B, C and HIV, according to you. So this will not be an issue for the patient.

    I'm in favor of not making a big deal out of nothing.

    There is really nothing for you to do. You weren't there. You didn't witness the incident. You don't have anything to report.

    If it were me I would just be like "Bro... next time you do something stupid don't tell me about it."

    Done. Next problem.

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