What to do if you prick yourself with used needle?

[xmilkncookiesx, RN]

Hi all.

If you're working as a nurse and give a needle injection (insulin, lab draws, etc.) and you prick yourself, what do you do? I understand it may depend on the hospital policy, but I just want a baseline knowledge of what steps is to be done immediately after it happens.

I do know you'd have to have blood drawn of course, to check for HIV, Hep C, check CBC, I'm not sure what else you'd have to get check for and what other labs (maybe all labs just to be extra safe?) they really look into.

Also, what if the lab is short staff and you need labs drawn stat for either your patient (when getting blood drawn) and when you prick yourself during or after the process? what to do?

What medications would you have to be put on right away? What injections, etc.?

I'm a second semester nursing student, and I worry this might happen to me and would at least like to be prepared and know what to do for both the patient and I.

Thank you :)

[klone, MSN, RN]

You tell your charge nurse, manager, or house supervisor. You notify your employee health department. You don't need a STAT blood draw for something like this, because a couple hours is not going to change the situation.

[Meriwhen, ASN, BSN, MSN, RN]

1. Clean the wound thoroughly.

2. Report the stick to your charge/supervisor/manager.

(You can do both 1 and 2 at the same time if necessary. But if you have to choose between the two, IMO clean the wound first, then worry about tracking down the charge)

3. Call or report to occupational/employee health for assessment and treatment. They have protocols that will be followed based on what happened, type of injury, patient's medical history, and so on. Testing, treatment and medications will vary depending on what risk factors your patient has.

3b. There's nothing you need to do for your patient. Get the wound cleaned and treated. Occupational health will get access to the patient chart and the health information there. Your patient will likely have their blood tested if they consent to it. Some states have laws that allow the patient to be tested against their will in these cases. Other states do not...

4. Keep in mind that less than 1% of needle sticks result in transmission of infectious disease. I know that's small comfort when you're on the wrong end of the needlestick. And that less-than-1% doesn't mean you delay getting treatment or ignore recommended treatment protocols. Getting the stick properly treated is one of the things that helps decrease that risk.

Hope this helps.

[la_chica_suerte85, BSN, RN]

First thing's first: get to know the needles you're using at each of your clinical facilities. There are some really different ones out there and what may look like a safety feature you've encountered before will turn out to be very different. If you're very concerned that this may happen, see if you can practice with one in the med room first (or, better yet, in skills lab!) before doing anything with any meds near any patients.

[evastone, BSN, RN]

I can tell you what happened to me. A while ago, I accidentally stuck myself with a needle while giving meds. It was my own fault; I didn't follow proper protocols with needle handling.

I immediately washed my hands with soap and water and sent a colleague to contact the supervisor. I was sent downstairs to the ER where I had blood work taken. At the same time, someone was taking blood from the patient whose needle stuck me so that we could see if he had any diseases.

A doctor spoke with me about the risks vs benefits of taking antivirals. He suggested at the time that since I was pregnant and the patient was unlikely to have any communicable diseases, it would not be in my best interest to take anything. I followed his advice.

I met with employee health two weeks later to have more blood taken and was told that the patient was negative for anything serious (hepc, HIV...). I again had testing at two months and six months. I was supposed to get tested at a year but never ended up making the appointment as I left the job shortly before I hit the year mark. Luckily, my OBGYN tests for these diseases as well.

Your experience can vary a bit based on the facility, but I don't think it would be that different from what I went through. I wouldn't worry about getting stuck though. The risk of catching blood borne diseases are low. Plus, if you're careful, most exposures can be avoided.

[xmilkncookiesx, RN]

Thank you for sharing that!

well, I have a SIM coming up and it says the "lab is not staffed tonight due to budget cuts. Doctor orders labs STAT on the patient". Then it goes on to say the nurse was drawing labs on the patient and during the process, accidentally stuck herself.

it tells us that she went down to the ER and had lab drawn on her. But it said lab isn't staffed because of the budget cuts.

so I'm wondering what do you do in this kind of situation? What focused assessments do you do in this nurse? What education do you tell her or review with her?

[HouTx, BSN, MSN, EdD]

Bizarre Sim question.... if the lab is not staffed, there would be no way to obtain a STAT anything. In the real world, there would be no such thing as a closed lab in an acute care setting because this service has to be available 24X7 to maintain accreditation - even in teensy critical access facilities. I am assuming that this fictitious place is an acute care setting because it has an ED (downstairs) and inpatients. Do they mean that there is no phlebotomist available? That's no biggie. In many settings, nurses draw their own labs anyway.

ALL HOSPITALS in the US will have very specific policies and procedures for any type of exposure, including needle sticks. This is required by both JC & CMS accreditation (ICP standards). It is a basic OSHA requirement (management of employee injury / blood borne pathogens) as well - and this applies to ALL health care settings.

So maybe, the answer would be "contact the American Embassy".... cause it would appear you're not working in the US. I guess this is what happens when "tests" are created by people who don't actually know how anything works - LOL.

[xmilkncookiesx, RN]

I guess this is what happens when "tests" are created by people who don't actually know how anything works - LOL.

I agree. But unfortunately, that is the way they worded it in the docucare system prior to opening sim.

[Double-Helix, BSN, RN]

I'm confused as to whether you're asking about getting results for the STAT labs that the MD ordered for the patient, or the labs that the nurse had drawn after her exposure. If it's the nurse's labs, you don't need those results STAT. he blood would be drawn, labeled, and stored appropriately until a lab tech was available.

Perhaps this link will help you with your homework: CDC - Bloodborne Infectious Diseases - Emergency Needlestick Information - NIOSH Workplace Safety and Health Topic

[xmilkncookiesx, RN]

After we finished sim lab (the next day after I posted this topic) I came to find out that:

you let the blood drip for a while (the needle injury)

then flush it/clean it

get consent from both the nurse and patient (source)

get blood sample

adm. meds to the nurse

does this sound about right?

[Double-Helix, BSN, RN]

It sounds right. But I'm curious, how did the "no staff in the lab" come into play?

[xmilkncookiesx, RN]

Idk, that's just what they threw in there. It's closed now, I can't open it back up. But they said, "its night shift, the lab is not staffed due to budget cuts". Something within those lines.

It also mentioned a new grad nurse was drawing blood from a patient that was STAT labs, and when cleaning up, pricked herself. It was deep and bleeding and she ran to you (us, the "other nurse") and was asking what to do.

next it said that we "took her down to the ER and are to get labs drawn". I was confused because it mentioned that the lab was not staffed. Maybe they meant "understaffed" but instead put "not staffed"? I'm not sure. But that was the assigned scenario