WHAT YOU MAY NOT KNOW ABOUT

NEEDLE STICK INJURY

CAUSES OF SHARP INJURIES

STRESS……LACK OF TIME & PATIENCE

CARELESSNESS WHILE WORKING

PASSING SHARPS FROM ONE PERSON TO ANOTHER.

LACK OF KNOWLEDGE……SERIOUSNESS OF NSI

WHO IS AT RISK ?

NURSES.

DOCTORS.

TECHNICIANS.

EMERGENCY PERSONNEL.

ATTENDANTS.

ALL HCW !!!!

BREAKUP OF AFFECTED STAFF

10%13%

29% 48%

Nurses Doctors Technicians Housekeeping staff

Total number of cases - 336

SOURCES OF NSI 2004 2005 2006 2007 TOTALGarbage bag 18 21 22 06 67

Needle recapping 11 7 6 3 27

OT instruments 7 7 6 1 21

Checking blood sugar 9 17 7 0 33

IV line administration 15 11 5 3 34

Surgical blade 3 6 6 3 18

Blood collection 8 6 9 7 30

Suturing 2 6 10 0 18

Injection administration 10 6 17 4 37

Disposal 4 6 9 10 29

Others 5 4 9 4 22

Total 92 97 106 41 336

PROBABILITY OF INFECTION

AFTER A NSI

Rate of Hollow needle Minimal

blood

HIV 0.3 - 0.4% 0.1 ml

HCV 0 - 7% Not known

HBV 22 – 31% 0.0004 ml

Post injury / exposure protocol

Don’t PANIC !!!

Don’t squeeze the injured site

Wash with soap and water immediately

Report to the casualty & provide,

(i) Full history of injury or exposure

(ii) History of Hepatitis B immunization

(iii) Blood for testing

Injury from an HBsAg positive source, Maximum number of HCW are immunized against HBV due to the hospital policy

Investigations for baseline HBsAg and the antiHBs titre are done for the HCW. If the antiHBs titre is positive, no PEP is required

If the vaccination doses are incomplete and the antiHBs titre is positive, vaccination is continued as per schedule with no other interventions

If HCW is a non responder or has not completed the vaccination series and the antiHBs titre is negative, both the Hepatitis B immunoglobulin and vaccination against HBV are given

DO’S FOR BENCHWORKERS GET IMMUNIZED AGAINST HBV

DISPOSE YOUR OWN SHARPS.

TAKE RESPONSIBILITY

USE GLOVES & FORCEPS.

USE SHARPS CONTAINER.

USE NEW TECHNIQUES.

BE AWARE ABOUT NSI

Injury from an HCV positive source, The HCW blood is first tested for baseline antiHCV antibody

All HCWs who sustain NSI from HCV positive sources are referred to the gastroenterology team for liver function monitoring

The HCW is followed up by the GI doctor for 6 months.

If the antiHCV antibody ELISA test if positive, the test is reconfirmed using a recombinant immunoblot assay.

Injury from an HIV positive source, The HCW blood is tested for baseline antiHIV antibody

PEP guidelines by the Centers for Disease Control (CDC) are instituted immediately (basic or expanded ART regime according to the exposure code)

HIV status of the exposed HCW is then tested again at 6 weeks, 3 months and six months.

The HCW is also followed up for any side effects while taking the antiretroviral therapy.

PROPER DISPOSAL OF SHARPS

Use strictly only till the 3/4th mark

Get a new one before you exhaust the old one !!!

Check the Hypochlorite conc in can

Wear gloves

Discard sharps straight into container

DON’TS FOR BENCHWORKERS NEGLECT ANTI HBSAg TITER

RECAP, REUSE.

BEND, BREAK.

PASS, FLING SHARPS.

EMPTY SHARPS IN WRONG WASTE BAGS.

MISPLASE SHARPS.

USE BARE HANDS.

WHATS NEW FOR HCW SAFETY

ALWAYS FOLLOW RIGHT PRACTICES.

ACTIVELY EDUCATE NEW PERSONNEL

REPORT NSI RELIGIOUSLY & THROUGHLY

REMEMBER CONFIDENTIALITY IS ALWAYS MAINTAINED

ALWAYS FOLLOW UP AN INJURY

TRY TO MINIMIZE USE OF NEEDLES

TAKE HOME MESSAGES

IGNORANCE ISN’T BLISS

LETS HELP EACH OTHER

ELIMINATE RISK OF NEEDLE STICK INJURY

THANK YOU !!!