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.

[wooh, 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.

Because it might stick another needle? That's what the sharps box is for, to collect sharp things.

I only recap unused syringes. Once they're used, they go in the sharps asap. Taking time to recap is just taking time to accidently stick someone.

[akulahawkRN, ADN, RN, EMT-P]

Because it might stick another needle? That's what the sharps box is for, to collect sharp things.

I only recap unused syringes. Once they're used, they go in the sharps asap. Taking time to recap is just taking time to accidently stick someone.

While a sharps container is a good thing to use, one should always recap needles whenever possible simply because there is always the possibility that the sharps container may not have been assembled correctly. I believe one of the posters above was a "victim" of such an instance. In any event, it is a good practice to get into. Furthermore, some facilities have sharps containers available all over the place, some have them at centralized locations but not at each and every bedside.

Penny wise and pound foolish…

[Wishinonastar, BSN]

Call OSHA and ask their advice. I am writing an exposure control plan right now and the OSHA regs really frown on not having proper safety equipment to protect yourself. It is clearly spelled out in OSHA regs that you don't recap needles unless you absolutely have to and then you use the scoop method. Hands off.

Insulin needles are super sharp- I also had a stick from one many years ago at a patient home. Her plastic jug was downstairs on top of the fridge and she was bedbound on the second floor. I went upstairs and she was learning to administer insulin. After the shot I looked around- no needle container. She said it was downstairs so I recapped to carry it downstairs (for safety LOL) and right through the side, right through my glove and into my hand. I had to go through HIV and other testing over a period of a year. A real eye opener. No one wrote me up though. Back then it was a common thing to recap.

I never recap now and always toss them in the red box uncapped- except for my own needles from my allergy shots at home. I strongly recommend that NO ONE recap insulin needles. The plastic cap is nothing to them, like butter. Take a little red box with you into the room and toss it in. If you can't then carry it on a tray to the red box.

I think that they want to write you up to place the blame on you and take the heat off themselves for their lack of providing safe equipment. In general there is nothing you can do about a manager like this, but look at the safety procedures and training that are in place there. If they are lacking then OSHA should get involved. Were you trained in how to handle needles at this facility?

[beckster_01, BSN, RN]

If our insulin needles did not have a safety device on them, then I would ask for a portable sharps container to dispose of it immediately or recap the needle using the scoop method. At my facility there is a sharps container for each patient, but it is usually a good 10-15 feet from the patient itself. I, personally, am very clumsy. With the number of times I trip on my own feet or run into other workers, I would not feel comfortable walking to the sharps box with an open, contaminated needle. As it is, I activate the safety device as soon as the needle comes out of the patient. That way I never, ever have to take a step with a needle in my hand

[psu_213, BSN, RN]

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.

So after you inject the pt, you don't activate the safetly mechanism? This sounds dangerous especially if the sharps container is not right there. At my first job they had a 'roving' inservice so that every RN could demonstrate how to use these devices as there had been a house wide increase in needlesticks resulting from nurses not using the safety mechanism.

[psu_213, 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.

No, never (EVER) recap a needle that has been in a pt. The whole purpose of the sharps bin is that you can throw in a needle (even uncapped) and it will be in a place it cannot stick someone. Can you explain your rationale?

[klone, MSN, RN]

Right, I'm wondering why you're recapping, period.

[klone, MSN, RN]

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

You wouldn't? Why not?

[Horseshoe, BSN, RN]

Re-capping used needles has been against policy at every place I've ever worked.

I ignored policy once and re-capped an insulin needle. The needle went straight through the cap and stuck me.

Where I work now, we have sharps containers at the bedside. You are never supposed to re-cap a needle before putting it into the sharps container. Nor are you to allow the sharps containers to become too full. If you have followed those policies, I fail to see the rationale for re-capping.

[psu_213, BSN, RN]

While a sharps container is a good thing to use, one should always recap needles whenever possible simply because there is always the possibility that the sharps container may not have been assembled correctly

I don't like the overuse of the word "unbelieveable" (if it happened, it is believeable!). Anyway, I find it unbelieveable the number of people advocating recapping! I would never recap, and if the wrong person saw me do it at work, it would be written up for it. Also, I think it is a cop out to say "well, this facility doesn't have enough sharps containers." Contact whomever is necessary to get more, even if it means going to the regulatory agencies outside the facility--for the basic safety of the nurses and other staff. This is a totally unacceptale practice that has no place in nursing.

[klone, MSN, RN]

While a sharps container is a good thing to use, one should always recap needles whenever possible simply because there is always the possibility that the sharps container may not have been assembled correctly.

But the purpose of a sharps container is to contain sharps. Recapping a sharp invites the possibility of a needle stick. The ONLY time I ever recap a sharp is if I haven't used it yet (like if I've drawn up a med from a vial). I NEVER EVER recap a sharp after I've injected it into a person. EVER.

[Horseshoe, 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.

while a sharps container is a good thing to use, one should always recap needles whenever possible simply because there is always the possibility that the sharps container may not have been assembled correctly. i believe one of the posters above was a "victim" of such an instance. in any event, it is a good practice to get into. furthermore, some facilities have sharps containers available all over the place, some have them at centralized locations but not at each and every bedside.

penny wise and pound foolish...

i found this on the osha web site:

properly handle and dispose of needles and other sharps according to the bloodborne pathogens standard.

handling needles/sharps:

• do not bend, recap, or remove contaminated needles and other sharps unless such an act is required by a specific procedure or has no feasible alternative [29 cfr 1910.1030(d)(2)(vii)].
  
• do not shear or break contaminated sharps. (osha defines contaminated as the presence or the reasonably anticipated presence of blood or other potentially infectious materials on an item or surface) [29 cfr 1910.1030(d)(2)(vii)].