Yikes! I've Been Stuck!

The story of what happened the shift I experienced a needle stick injury, feelings and facts!

Yikes! I've Been Stuck!

I was wrapping up all the loose ends of the day as my shift was winding down. I always like to present my reports about assigned patients to the oncoming nurse,  like a package with a bow on top. On this particular day, I had a patient return to the floor late following a procedure, and I walked to their room to administer the subcutaneous heparin shot that was overdue.

As I was giving the medication, my phone was both ringing for a call and buzzing with a telemetry alert. The patient’s IV pump started alarming “air-in-line.” The patient was asking for a soda, ice, and pain medication. My mind jumped with the interruptions, and so did my hand after I gave the shot while pushing the retractable safety device. It did not work, the needle instead went through my glove and stuck into my finger.

Immediately I felt panicked. All of the alarms and voices went into blurry background noise, and I thought of what I urgently had to do. From the recesses of my brain, I remembered: “squeeze blood from the site, wash immediately” as I quickly and quietly performed these tasks.

I sat down and collected myself taking deep breaths. I knew it was just a small poke, but it was an exposure to a patient’s blood and body fluids just the same. At that time of the evening, the charge nurse and the nurse managers had left for the day. I called the nursing supervisor, who directed me to complete the proper forms on our facility’s intranet.

The reporting process was seamless, and luckily the patient was agreeable to having the recommended blood levels checked on my behalf. Then, as directed by the occupational health nurse, I waited for the results and silently prayed my patient did not have any communicable diseases. 

The Facts

Instead of worrying, I decided to keep my mind busy by researching facts about needle stick injuries. The Occupational Safety and Health Administration (OSHA) estimates about 600,000 to 800,000 injuries per year occur to health care workers from skin puncture injuries. Nurses are the most likely healthcare professionals to obtain an inadvertent needle stick.

The risks of transmission from a bloodborne pathogen are actually very low. If a patient is positive for the hepatitis C virus (HCV), the risk is 1-2% for contracting the disease, Hepatitis B virus (HBV) is 6-30%, and human immunodeficiency virus (HIV) is 0.3%. However, if the nurse has the vaccine for hepatitis B updated, the risk drops to below 0.1%. The risks are much lower if the injury was just a stick versus a full-blown cut. My initial research calmed my fears, understanding that the risks were minimal. 

The Law

In 2000, Congress passed the Needlestick Safety and Prevention Act, which is a regulation that prescribes safeguards to protect workers from the hazards of sharp injuries. Additional regulations from this Act are outlined in the OSHA Bloodborne Pathogens Standard, which gives provisions for employers to maintain the prevention and care of exposure to body fluids.

All healthcare agencies are required to have a plan in place for mitigating, reporting, and treating needlestick exposures. Each nurse should review their facility's policies and procedures around an exposure, so if it ever does occur, the process is already familiar and can be activated quickly. Generally, the reporting includes the time and date that the incident occurred, the circumstances, and the parties involved. The employer is required to test the blood of the exposed worker if desired, as well as the patient. The employer is obligated to make a confidential medical exam and follow-up guidance, which is mandated to be at no cost to the employee.  

Ten ways to prevent injuries

  1. Pay attention to the task at hand! Distraction was the reason I was injured. 
  2. Never recap a needle. This is actually against the law!
  3. Dispose of needles in a sharps container, but make sure it is not overfilled as you risk getting injured by an inadvertent stick.
  4. Always use the safety devices. They are required by law to be provided by employers.
  5. Enlist another colleague to help subdue patients who may make sudden movements while using a needle. 
  6. Use needleless systems whenever possible.
  7. Participate in bloodborne pathogen training.
  8. Ensure vaccination status for Hepatitis B is up-to-date, including a positive titer.
  9. Report the issue immediately if it occurs.
  10. Follow up with the occupational nurses if an exposure occurs for proper treatment.

The Results 

My story had a happy ending. The patient’s blood test indicated they did not have HBV, HCV, or HIV. I continue to be thankful that I did not suffer a negative outcome from this potential exposure. Good health is the best present nurses can give themselves!

References/Resources

OSHA: Bloodborne Pathogens and Needlestick Prevention

American Nurses Association (ANA): Needlestick Factsheet

ISIPS: Needlesticks Overview

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Sara E.

About Sara E., BSN

Sara E., BSN, RN-BC has over 25 years experience as a bedside nurse. Information is her own and not a substitute for medical advice.

2 Articles   11 Posts

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.

I got lucky with the only accidental needle stick I've had. It was an insulin syringe, after I had drawn up the patient's insulin, but before I injected the patient. As I tried to cap the needle to bring the insulin across the unit, the needle bent and when right through the cap into my thumb. I didn't feel like I had been distracted, but it was the perfect reminder to pay better attention with needles. It hasn't happened again since then. I was lucky that it was the best possible mistake I could have made to learn from. 

Thank you for sharing your article with very practical advice for other nurses. 

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4 hours ago, JBMmom said:

I got lucky with the only accidental needle stick I've had. It was an insulin syringe, after I had drawn up the patient's insulin, but before I injected the patient.

Same but mine was heparin.  First back to yours, thank God they now have insulin pens.

Yes I  scratched myself after drawing up heparin but before any patient contact and no release of heparin.  

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Specializes in Med-Surg.

Way back in the 90's I had a needle stick and the details are a bit hazy but I dropped a needle and syringe and stuck myself picking it up when I looked up at him talking to me while I was picking it up.  This was before we had the needles with the safety features they have today and I stuck myself real good.

Back then they offered you HIV prophylaxis in the form of a three-medication regimen since the tests didn't come back immediately.  The patient didn't take care of himself and was an alcoholic but I didn't think he had other risk factors so decided to wait for the results a few days without taking those medications which had not been out that long.  

I did luck out and he tested negative for everything and I learned my lesson and haven't been stuck since.  

If I've learned anything has a nurse, it's when I get distracted and loose my focus that I make a mistake.

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Specializes in Clinical Research, Outpt Women's Health.

Yep. 27 years ago. Used cervical block needle. Finished the procedure and washed it as quickly as possible. They tested the patient and I did my blood tests every 6 weeks for a while. All good.

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You never forget your first (and hopefully last) needle stick...

 

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Specializes in Med nurse in med-surg., float, HH, and PDN.

Uh-huh, me too! Doing Home Health, patient was post-op from some surgery during which she received 4 units of blood. I was at her home to teach her about giving herself insulin, using a sliding scale, drawing the insulin into the syringe, and injecting herself. After I demonstrated the injection, the needle scraped the tip of the index finger of my left hand. 

My reaction was, "OH S**T! ... Now I have to self-report ! There goes the rest of my day!" Fortunately the CSM at our office re-assigned the few patients I had left to see. Then I was sucked into the necessity of going through the whole procedure for needle-sticks, doing all the paper-work, going to the Urgent Care Center, getting a Hep B shot, and then wait for days to hear if I was HIV negative. (I was negative). 

Fortunately it never happened again. WHEW!

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