Thoughts After My First Needlestick Injury

Thoughts After My First Needlestick Injury

Safety first

By Christine Contillo, RN, BSN
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Last year I became part of a group I’d managed to avoid during my 30 years of nursing. I joined the ranks of those who have suffered a needlestick injury, putting me at risk for a blood-borne illness. The CDC estimates that there are 384,325 sharps injuries each year, resulting in approximately 2,500 cases of blood-borne illness. The risk of developing Hepatitis B after a single unintentional exposure is up to 30 percent, based on the viral load of the patient and the amount of blood transferred. In one study published in the June 28, 2007, New England Journal of Medicine, 99 percent of all fifth-year medical/surgical residents had suffered multiple injuries, but only half properly reported each one. So, all in all, I was in good, if not always compliant, company.

Thankfully, all health care workplaces are now required by the Bloodborne Pathogens Standard to have both engineering and workplace controls to minimize the potential risk for this kind of problem. Having been the person in charge of record keeping for public worker needlestick injuries for many years, I was already familiar with the procedure and could readily see what had gone wrong. My clinic uses safety syringes and needles with an accessory device, and while activating the hinge the syringe slipped out of my hand and darted into my leg. Contributing to this was the fact that my sharps container was inconvenient and hard to reach. It has since been relocated.

I complied with our exposure control plan and immediately washed the area with soap and hot water for 20 minutes. Then I reported the injury to my nurse manager. While she took it seriously and immediately made arrangements for me to see the Occupational Health Department, the ER doctor I saw before leaving the building showed his age when he said, “Really? A needlestick? You’re worried? I‘ve had lots of them and never bothered to report it.” He seemed more concerned about who was going to cover the rest of my shift.

In this case just about everything was on my side. I’d had all three Hepatitis B shots back in the early 1990s — when hospitals first began to offer them to employees — and the titer came up positive when my blood was drawn. This of course would not show if I’ve contracted any illness yet, so I’m scheduled for several more during the next year. I’ve completed two of my blood-draw visits, and aside from losing two hours of work there have been no ill effects.

The patient readily agreed to be tested and was negative for Hepatitis B, Hepatitis C and HIV. She could still be in the window of infection where she’d not yet test positive, which is the reason for me to continue the testing schedule, although it’s not likely.

The upside is that when giving a vaccine or drawing blood, which I do all day, I now concentrate a little more on safety for the patient and for me. As someone told me, always give 100 percent of your attention when using needles and 200 percent when using butterflies   

Resources
For more information about needlestick injuries and the Bloodborne Pathgoens Standard, visit these sites:

U.S Department of Labor Occupational Safety and Health Administration (OSHA)
National Institute for Occupational Safety and Health

Christine Contillo, RN, BSN, has worked as a nurse since 1979 and has written extensively for various nursing publications, as well as
The New York Times.

This article is from workingnurse.com.

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