Reporting Needle Sticks

[Jules A, MSN]

If you have been stuck with a dirty needle did you report it?

[mama_d, BSN, RN]

You never know what they might have...I got stuck by a dirty needle years ago after giving a LOL an injection; turns out she was hep C positive and hadn't been diagnosed yet. Luckily I didn't get it.

[lamazeteacher]

I'm so happy to see the results of your poll, as that wasn't the case when I worked as an Infection Control Nurse. I'm looking forward to seeing more responses, to see if that's the overall result.

I got a needle stick, when a squirmy toddler wiggled free of his parent's hands, pushing the needle I'd just used to inject his 9th vaccine shot, into my hand, I explained to the parents (reassuringly) that I'd need to have them go to the lab for a blood draw on their child, as a matter of procedure.

To my dismay, the clinic head nurse at the PHD where I was temporarily working PT, told them they didn't have to do that (they knew her from coming to the clinic before, and went to tell her what was happening). She had no idea what the protocol was for a needle stick!

I said that I'd go to have my blood drawn for a baseline, anonamously. She insisted that I go to their Occupational Health doctor instead, 20 miles away; and said, "They're nice people" (referring to the parents). I explained that I had been an IC nurse and Employee Health Nurse previously, and what the regimine was when HCWs get exposed to blood/body fluids.

My tests remained negative, and I've had subsequent negative ones, but I wonder how many NMs, supervisors, dept. heads, etc. stand in the way of HCWs receiving appropriate testing and possible early treatment for HIV and/ or

Hep C. Hopefully we've all been successfully vaccinated for Hep B.

[Crash_Cart]

I use to prepare and later remove the suture trays in the ER. These were not the newer plastic disposable trays, so they required "disassembly" for sterilization in the autoclave.

Seems some docs disposed of the needles (both the injection and suture needle) in the sharps container and others did not follow this practice. (I was always well aware of this fact, so I would always double glove just in case.) Well, I had a few close calls on occasion but one day the inevitable eventually happened. It occurred when a needle tip was protruding through a sterile towel while removing and separating forceps etc. from the used suture tray.

So, yes - I definitely reported it. Mostly, because I was kind of upset because the docs never followed any specific protocol for disposing the sharps from the tray when they were done using them. It was basically "my problem" to deal with.

So, I was screened for all the usual suspects and no problems were found. I was also provided excellent follow up on the incident by the infection control nurse. Not sure if all hospitals have specific "protocols" in place for dealing with needle sticks, but ours did.

Of course, I was nervous while waiting for the results to come back. I had all my Hep immunity shots prior to the incident.

I did learn the statistical incident of actual transmission was apparently low in these cases. Not sure of the stats exactly to back up that statement, but I am sure someone else knows or has such facts available.

Incidentally, the docs started following the sharps disposal protocol after this occurred and mostly because of the noise made by the infection control nurse. (Very, very nice lady actually...)

Later, the ER started utilizing disposable trays.

My Best

[lamazeteacher]

Medical schools traditionally neglect consciencious motivation for most actions physicians do. Therefore, we're forced into the role of "mom", to discover unintentional lapses and correct them.

I'm so glad that your hospital has a good IC nurse who role models making appropriate decisions. It's usually the LTCs, nursing homes, etc. that haven't funded even PT IC nurses as a resource. Many ERs and ORs have had situations occur that are harmful to others, due to neglectful practises of physicians.

In an ER that will not be ID'd, I was told that interns, residents and others copied the practises of staff physicians, inserting used needles into the "waterproof" mattresses on guerneys. One patient bled out on one. Then a new patient was placed on that mattress, and immediately became immersed in the blood of the prior patient....... It boggled the mind. Luckily the media never got wind of that.

The County Public Health Department has an Infection Control Policy handbook for use by all hospitals and other healthcare settings. That contains the information needed for Policy and Procedure manuals covering all aspects of necessary protocols.

However I remember needing their handbook to use when writing the IC manual for a program involving drug abusing pregnant women. The county had new guidelines about to be released, and refused to give me the current or past one for a year! It was infuriating, and eventually I got someone in Epidemiology to surreptitiously share his copy of the new one.

Politics!