prevention of needlestick injury among chinese nurses
DESCRIPTION
This PPT aims to prevent needlestick injuries among Chinese nurses, Maybe, it is helpful for youTRANSCRIPT
- 1. Prevention of Needlestick Injuries Zhao X (China)
- 2. Introduction
- Each year more than 1.5 million NSIs happen among Chinese HCWs, an average of 4410 NSIs per day
- Near 80 percent of health workers in China have experience of NSI
- 17.9 percent have more than 5 times needlestick injuries
- 3. Risks of Needlestick Injuries
- as many as 20 different pathogens are capable of transmission from patients or laboratory specimen to healthcare workers (HCWs) in the event of a NSI.
- Of these 20 pathogens, HIV, HBV, and HCV are the three most common diseases transmitted via NSI.
- A single exposure to HIV, HBV, or HCV in the context of a NSI places a HCW at average risks of infection of 0.3%, 6% to 30%, and 1.8%, respectively (CDC 2004; NIOSH 2000).
- 4. Hepatitis B Virus ( H B V )
- In America
- 12, 000 HBV infections occurred in HCWs in 1985
- 500 HBV infection occurred in HCW in 1997
- Intervention implemented:
- widespread immunizations of American HCWs for HBV
- But, there is a 6%-30% risk that an exposed, susceptible HCWs will become infected with HBV.
- 5. Hepatitis C Virus ( H C V)
- The precise number of HCWs who acquire HCV occupationally is not known in China.
- In the United States, HCWs exposed to blood in the workplace represent 2% to 4% of the total new HCV infections occurring annually.
- One study in the United States show that HCV transmission occurred only from hollow-bore needles compared with other sharps.
- 6. Human Immunodeficiency Virus ( H I V)
- The first case of HIV transmission from a patient to a healthcare worker was reported in 1986
- Through December 2001, American Central for Disease Control and Prevention (CDC) had received voluntary reports of 57 documented and 138 possible episodes of HIV transmission to HCW in USA
- The average risk of HIV transmission after a percutaneous exposure is estimated to be approximately 0.3%
- 7. Cost of Needlestick Injuries
- Cost
- Direct costs:
- initial and follow-up treatment of exposed HCWs
- (it is estimated to range from 4000-2,4000 depending on the treatment
- provided)
- Indirect cost
- Emotional cost (fear, anxiety)
- lost time from work, etc
- 8. Host Environment Agent Epidemiologic Homeostasis
- 9. Epidemiology of needlestick injury
- Who?
- Where?
- When?
- How?
- 10. Who is at risk of injury?
- 11. Where do injuries occur?
- 12. How do injuries occur?
- 13. What device are involved in percutaneous injuries?
- Disposal syringes (32%)
- Suture needles (19%)
- Winged steel needles (12%)
- Scalpel blades (7%)
- Intravenous (IV) catheter stylets (6%)
- Phlebotomy needles (3%)
- 14. Hollow-bore needles (59%) !!!
- 15. Importance of hollow-bore needle injuries
- NIOSH (2000) point out that the risk of infection for a HCW in the event of a NSI depends on
- his or her immune status at the time of injury
- the pathogen involved
- the severity of the injury (e.g. how much blood was the worker exposed to?)
- whether or not effective treatment is available
- 16.
- Devices requiring manipulation or disassembly after use is associated with a higher rate of injury
- 17. Prevention Strategies
- Hierarchy for prevention of needlestick injury
- First: eliminate and reduce the use of needles where possible .
- Using alternate routes for medication delivery and vaccination when
- available and safe for patient care.
- Second: isolate the hazards.
- Provide a rigid cover that allows the hands to remain behind the needle.
- Ensure that the safety feature is in effect before disassembly and remains in effect after disposal
- Be an integral part of the device
- Be simple and obvious in operation
- 18.
- Handle hypodermic needles and other sharps minimally after use and use extreme care whenever sharps are handled or passed.
- Use the "hands-free" technique (described below) when passing sharps during clinical procedures.
- Do not bend, break, or cut hypodermic needles before disposal.
- Do not recap needles.
- Dispose of hypodermic needles and other sharps properly.
- 19.
- Many accidental needlestick injuries occur when staff are recapping needles.
- Recapping is a dangerous practice: If at all possible, dispose of needles immediately without recapping them.
- If it does become necessary for you to recap a needle (for example, to avoid carrying an unprotected sharp when immediate disposal is not possible), do not bend or break the needle and do not remove a hypodermic needle from the syringe by hand.
- 20. Recapping: The "one-hand" technique Step 1 Place the cap on a flat surface, then remove your hand from the cap. Step 2 With one hand, hold the syringe and use the needle to "scoop up" the cap. Step 3 When the cap covers the needle completely, use the other
- 21. Handling sharps
- During a clinical procedure
- When passing sharps, especially when there is sudden motion by staff members carrying unprotected sharps
- when clients move suddenly during injections
- when sharps are left lying in areas where they are unexpected (such as on surgical drapes).
- Giving verbal announcements when passing sharps
- Avoiding hand-to-hand passage of sharp instruments by using a basin or neutral zone
- Ensuring cooperation from patients
- Dispose a contaminated needle immediately after use
- 22. Safe passing of sharp instruments
- Uncapped or otherwise unprotected sharps should never be passed directly from one person to another.
- In the operating theater or procedure room, pass sharp instruments in such a way that the surgeon and assistant are never touching the item at the same time.
- This way of passing sharps is known as the "hands-free" technique:
- 23. "hands-free" technique: First step: The assistant places the instrument in a sterile kidney basin or in a designated "safe zone" in the sterile field. Second step: The assistant tells the service provider that the instrument is in the kidney basin or safe zone. Third step: The service provider picks up the instrument, uses it, and returns it to the basin or safe zone.
- 24. When giving injections
- Unexpected client motion at the time of injection can lead to accidental needlestick injuries. Therefore, always warn clients when you are about to give them an injection.
- To protect clients, always use proper client preparation when giving an injection, and be sure that you handle IV fluids and multidose vials correctly.
- 25. If you are a head nurse in the unit, what you can do to
prevent NSI?
- Educating your staff
- A reduction in the use of invasive procedures
- (as much as possible)
- A secure work environment
- An adequate staff-to-patient ratio
- 26.
- Risk-taking personality profile
- Perceived poor safety climate in the workplace
- Perceived conflict of interest between providing optimal patient care and protecting staff themselves
- HCWs most readily change their risk behaviors when they thinks
- They are at risk
- The risk is significant
- Behavior change will make a difference
- The change is worth the effort
- 27. Introduction of safety devices
- Vanish point syringe
- Work principle
- How to use it appropriately
- Cost
- 28. Introduction of safety devices
- Sharps Container
- Work principle
- How to use it appropriately
- Cost
- 29. Post-exposure Treatment
- Source patient details
- Risk assessment
- Action plan
- Introduction of Nottingham Report Form Following Contamination from Blood or Body Fluids
- 30. Post-exposure treatment
- Available data from animal studies (Ferreiro & Sepkowitz 2001) indicated that
- systemic infection after a NSI does not occur immediately if antiviral therapy is delivered expeditiously, establishment of infection may be prevented.
- Therefore,
- If you are injured by contaminated needle, ensure effective treatment to be available as soon as possible
- 31. Useful information after exposure
- Disease Control and Prevention Center of Yannan Province
- Telephone number: 0871-3611773
- (available: 8am-11am, 2:30pm-5:30pm)
- Health Education Institution of Yannan Province
- Telephone number: 0871-5377136
- (available: 24hours)
- Disease Control and Prevention Center of Kunming
- Telephone number: 0871-4108357
- (available: 8am-11am, 2:30pm-5:30pm)
- 32. Useful websites
- Disease Control and Prevention Center of the Peoples Republic of China
-
- http://www.chinacdc.net.cn/n272442/n272530/index.html
- American Disease Control and Prevention Center (CDC)
-
- http://www.cdc.gov/
- American Occupational Safety & Health Administration (OSHA)
-
- http://www.osha.gov/
- 33. DISCUSSION
- Share your experience of needlestick injuries
- Your experience might help others!
- 34.
- Thank you
- for listening!