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Preventing needlestick injuries |  Case studies |  Diabetes more info |  Dry mouth II

Preventing Needlestick Injuries

The opinions within this web page are not ours. Authors have been credited for the individual posts where they are "How can I work in my institution to prevent needlestick injuries?" someone asked herself this question five years ago after learning that a needlestick injury had infected her with the human immuno- deficiency virus (HIV). She has since launched the National Campaign for Healthcare Worker Safety, in order to educate nurses and facilities on needlestick injuries, and to urge hospitals to implement safer devices. Like this, you may be among the thousands of health care workers who annually receive a needlestick contaminated with HIV. According to the a recent report, more than one million needlestick injuries to health care workers occur every year What to do if you get stuck The first Occupational Safety and Health Administration (OSHA) standard specifically written to protect health care workers was the 1991 Bloodborne Pathogen Standard. Although tremendous progress has been made as a result, more than 1,000 infections caused by 20 pathogens are estimated to be transmitted through sharps or needlestick injuries annually. The greatest threat to nurses are hepatitis B and C viruses (HBV and HCV)-not HIV, as many believe. In fact, one in six contaminations stems from HBV, one in 20 from HCV, and one in 300 from HIV. If you are stuck by a needle, immediately report to employee health services at your facility for evaluation, counseling, and treatment if appropriate. Timing is critical. The Centers for Disease Control and Prevention's (CDC) postexposure prophylaxis guidelines call for treatment with antiviral medications "within a few hours" following the needlestick. For more information, contact the National Clinician's Post-Exposure Treatment Hotline at (888) 448-4911. Formal reporting of the incident is also essential. It's estimated that only 10% of all needlestick injuries are recorded on OSHA 200 logs, which chronicle and classify incidents of occupational injuries and illnesses. Without accurate data, OSHA cannot justify the demand for safer devices. Lack of documentation has also made obtaining worker's compensation and other benefits more difficult for nurses. Prevention is possible According to the CDC, up to 86% of needlestick injuries can be prevented by using safer needlestick devices. Advances in engineering controls have made it possible to eliminate sharps from many uses-such as iv piggybacks-and to blunt or retract the needle so it's no longer a danger. Placing sharps containers within reach and at eye level in every patient room also reduces the risk of injury. You can be active on several levels in order to help prevent needlestick injuries. Work with your state nurses association (SNA) and your colleagues to encourage your institution to address the issue. Review needlestick injury data in your facility and ask the following questions: In what areas have needlestick injuries increased, and where has there been a decrease? Have nurses and other health care workers been reporting injuries? What happens at your workplace in the event of a needlestick incident? Can you receive support, including immediate evaluation for postexposure prophylaxis? What is being done to reduce the injury rate? Also, remember that several organizations can offer protection. For example, OSHA will cite hospitals for failure to evaluate and use safer products. Your SNA can assist you in filing a complaint with OSHA. Another option is the negotiation of contracts containing firm language. Several SNAs have successfully negotiated contracts that require hospitals to involve nurses in reviewing needlestick injury data, as well as in evaluating, selecting, and implementing safer devices. FACT SHEET ON NEEDLE STICK INJURY: Health care workers (HCWs) suffer between 600,000 and one million injuries from conventional needles and sharps annually. These exposures can lead to hepatitis B, hepatitis C and Human Immunodeficiency Virus (HIV), the virus that causes AIDS. At least 1,000 HCWs are estimated to contract serious infections annually from needlestick and sharps injuries. Registered nurses working at the bedside sustain an overwhelming majority of these exposures. Needlestick injuries are preventable. Over 80% of needlestick injuries could be prevented with the use of safer needle devices. Less than 15% of U.S. hospitals use safer needle devices and systems. In 1992, the Food and Drug Administration issued an alert to all health care facilities to utilize needleless IV systems wherever possible. This alert is merely a recommendation, not a mandate. Therefore, health care facilities are under no legal obligation to comply. The first safe needle designs were patented in the 1970s, and the FDA has approved over 250 devices for marketing as safety devices. More than 20 other infections can be transmitted through needlesticks, including: tuberculosis, syphilis, malaria and herpes. Cost Savings from Needlestick Prevention Hospitals and health care employers in California are expected to save over $100 million per year after implementing the California Occupational Safety and Health Administration's requirement for safe needle devices. According to the American Hospital Association, one case of serious infection by bloodborne pathogens can soon add up to $1 million or more in expenditures for testing follow-up, lost time and disability payments. The cost of follow-up for a high-risk exposure is almost $3,000 per needlestick injury even when no infection occurs. Safe needle devices cost only 28 cents more than standard devices. Hepatitis B Hepatitis B is now preventable due to the vaccine that must be offered to HCWs and is given to children at birth. Regulatory and legislative efforts were largely responsible for the reduction of deaths from hepatitis B as a result of vaccine programs. Following these regulatory and legislative efforts, including the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard, cases of hepatitis B in health care workers dropped from 17,000 annually to 400 annually-and continue to drop. Transmission rate: 2-40% Hepatitis C Testing for hepatitis C after needlestick injuries was only recommended in 1998. It is a silent epidemic. There could be thousands and thousands of nurses with occupationally acquired hepatitis C who do not know it. Hepatitis C is the most frequent infection resulting from needlestick and sharps injuries. Of health care workers who become infected, 85% become chronic carriers. Chronic carriers have the potential to spread the disease to others, including their partners. Drugs that slow the progression of hepatitis C are available, but average $1,700 each month. Hepatitis C leads to liver failure, liver transplants and liver cancer. A liver transplant costs $500,000. At least 4 million Americans are infected with hepatitis C. Transmission rate: 2.7-10% HIV Human Immunodeficiency Virus (HIV) is the virus that causes AIDS, a fatal disease. Advances in treatment prolong the time before HIV becomes AIDS. The drug treatment can cost up to $6,000 per month. 16,000 of the 600,000 to one million needlestick injuries each year result in HIV exposure. There are over 54 documented cases of HCWs with occupationally acquired HIV and at least 133 cases of possible transmissions of HIV. There are 35 new cases each year. Transmission rate: .2-.4% More links related to needle stick injuries

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