scoop method for recapping

[michelecl]

i am an lpn in an assisted living facility. i am currently 28 days away from graduation for my rn. i have worked in this facility for about 8 mths and in that time i have asked for safety insulin needles from our don and rd. we are on our 3rd rd and i have been asking her for 2 mths for the same thing. i have been saying this is dangerous and it is the law, someone is going to get stuck, because i was taught in school to use the scoop method for safety of pts and visitors as well as yourself. . well this week the needle slipped on the table and jammed through the cap and my other hand was poked. my rd is writing me up for improper procedure, when everything i have researched says that the scoop method is to be used when needed(and in this case since this facility i work in says they do not have to provide us with safety needles). any advice is needed. i refused to sign the write up because the company is also in the wrong by allowing use to work in unsafe conditions.

[Flo., BSN, RN]

'm sorry that you got stuck and it stinks that your facility does not support you in a safe and healthy manner. Does your facility have sharps containers at the bedside? Is she writing you up for using the scoop method or doing the scoop method incorrectly?

[hiddencatRN, BSN, RN]

Do you have copies of your requests for safety needles? After you got stuck, how did the facility respond other than writing you up (did you see occupational health for risk assessment etc?)?

[MN-Nurse, ASN, RN]

well this week the needle slipped on the table and jammed through the cap and my other hand was poked.

you should take your medicine and sign the write up.

if your other hand was poked, you are doing the scoop procedure incorrectly. further most types of safety needles would not have prevented your accident anyway. in fact, i can't think of any that would prevent a stick from a student "slipping" and jamming a needle into the first object encountered.

one of the popular ones is the type that have a barrel you manually slide over the needle after administering. i don't even use those, i just take the needle directly to the sharps container.

[NoviceRN10]

One of the popular ones is the type that have a barrel you manually slide over the needle after administering. I don't even use those, I just take the needle directly to the sharps container.

You don't recap any needles you use? Where I work we are required to recap even the blunt cannulas. I would never just toss an insulin, heparin, lovenox or any other neeedle into the sharps container.

[Rick68fl]

The official answer is to NEVER recap a needle.

Having said that, in the real world, the cap is laying on a table/counter/etc. and you are holding the syringe with the needle on it.

Without touching the cap with your hand, you slide the needle into the cap and use it to pick the cap up and allow it to settle back onto the syringe, covering the needle. Then, and only then, you "snap" the cap back on.

I assume that's what you are calling 'the scoop.'

Doing it correctly, there is no way you should get a needle stick.

[MN-Nurse, ASN, RN]

You don't recap any needles you use? Where I work we are required to recap even the blunt cannulas. I would never just toss an insulin, heparin, lovenox or any other neeedle into the sharps container.

Heck no I NEVER recap a needle after administration.

Ever.

Where do you work?

[Rick68fl]

I would never just toss an insulin, heparin, lovenox or any other neeedle into the sharps container.

Umm... Exactly what do you think the purpose of the SHARPS container is then??

[hiddencatRN, BSN, RN]

You don't recap any needles you use? Where I work we are required to recap even the blunt cannulas. I would never just toss an insulin, heparin, lovenox or any other neeedle into the sharps container.

Really? As long as we put needles in the sharps container we've followed proper procedure at my hospital.

The only needles I recap are blunts that I've used to draw up a med that I'm now taking to a patient's room to put on a syringe pump or give IVP. I don't recap after administration since we have sharps containers located in every patient care area.

I'd be curious to know how long ago your workplace made that policy.

[VivaLasViejas, ASN, RN]

Assisted living facilities are different, as they are based on a social model of care rather than the medical model. Thus you don't see sharps containers all over the place---usually the main one is located in the medication/treatment room, plus there are usually some smaller portable ones for the staff to take with them on their insulin rounds. Some facilities let residents keep them in their rooms, but the more sickly and demented our population grows, the less often you'll see that.

As to the OP, I feel that a write-up is unwarranted and punitive under the circumstances, unless the policy for sharps disposal is clearly spelled out in the operations manual and states that recapping must never be done at any time. If the facility chooses not to use safety needles---a penny-wise, pound-foolish way to do things, if you ask me---then they must supply you with portable sharps containers. It's as simple as that, and you should state this plainly on the write-up when you sign it.

There's no real reason not to sign, it doesn't mean you're guilty of anything or that you agree with the 'discipline'. But, from a manager's point of view, an employee who refuses to sign comes across as belligerent and uncooperative, and if you plan to take it higher up the corporate food chain (and I think you should), you don't want to burn your bridges. Under your signature, explain exactly why you disagree with the actions taken against you, be professional in your language and grammar, and make a copy for your records. I can't overemphasize how important that step is---personnel records get 'lost' all the time, and you may need that copy one day as evidence that you tried to do things the right way, and were stymied by management. CYA!

[tokmom, BSN, RN]

I would never re cap to put a syringe in a sharps container. What is the rational?

Our syringes draw the needle back up in the body of the syringe, therefore you can't stick yourself.

OP, I wouldn't sign the write up either.

[vampiregirl, BSN, RN]

I had never realized the importance of activating the lock feature on a used syringe- it was just something I've always done, but never thought about. Until I went to change out a full sharps container that had not been correctly assembled/ secured and I received a needlestick. I'm now a huge advocate for activating the safety lock feature on any used needles if there is one available. My stick fell into the "freak occurrence" category, but I was shocked at the number of unsecured needles there were.