What would you consider a sharps injury

[T-Wave, RN]

Hi All,

I am looking for some feedback.  When is a sharps injury not a sharps injury?  I am about to get into it with an provider over semantics.  Just because it doesn't involve a needle, doesn't mean that someone wasn't at risk of a sharps injury.

We had an incident were some reusable equipment was taken from the clinic to a patient's bedside were an intra-vitreal "tap and inject" was done for a patient with endophthalmitis (FYI: vancomycin and ceftazadime).  An adjustable caliper (see picture) was used.  The equipment was then returned to the clinic in an emesis basin with other supplies inside.  A staff member goes to collect the other items, doesn't know this is there.  It was a near miss.  It broke the glove, but not the skin. 

So my question to the group: Had the staff member been stuck/ had skin broken, would you have called this a sharps injury and activated sharps (I.e. needle stick) injury protocol?  Am I over reacting?

Best regards,

T-Wave

[amoLucia]

YES!  JMHO

I'd bet if the provider were injured with a skin poke that would be a rousing YES!

[Rose_Queen, BSN, MSN, RN]

We would certainly consider that a sharps injury in the OR

[Hannahbanana, BSN, MSN]

Yes, it is properly so classified, even if the skin is not broken, because although there wasn’t actual injury the sharp instrument was managed in an unsafe way that could have resulted in one. Your risk mgmt people will have something to say about that...but they won’t know if it’s not reported. 

[FlorentineRN]

It is a blood borne pathogen exposure for sure if the fluids come in contact with the skin.

If the “sharp” punctured the skin it could be considered a needle stick.

More important is for each blood borne pathogen exposure to be assessed individually.  Occupational Health can review the medical records of the source patient for history of hepatitis, HIV and high risk behaviors.  This is the true key in deciding if post exposure prophylaxis is indicated.

Of course, used hollow bore needles are the most dangerous.

 

[FlorentineRN]

If I may add to my own comments…..  The device should not have been in the sink with the emesis basin.  If it is a disposable instrument it should have been discarded in a sharps container at the point of use.

If it is reprocessed after use, you should have a protocol for transporting those items to the pick up area for sterile processing staff.