The New York State Nurses Association is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This course has been awarded 2.4 contact hours.

Nurses and other healthcare workers who use or may be exposed to needles and other sharps are at increased risk of needlestick and other percutaneous injuries. Such injuries put the worker at risk for infection from multiple pathogens and can lead to serious or fatal infections with bloodborne pathogens such as hepatitis B virus, hepatitis C virus or human immunodeficiency virus (HIV), among others.

There are more than 8 million healthcare workers in the United States. Although data are not available on the precise national number of needlestick and other percutaneous injuries among healthcare workers annually, estimates indicate that 600,000 to 1 million such injuries occur (NIOSH, 1999; NYSPEF, 2002; ANA, 2004). Many of these injuries go unreported. It is approximated that in the average hospital, workers incur 30 needlestick injuries per 100 beds per year (NIOSH, 1999). The annual frequency of sharps injuries resulting in serious injury varies. The low estimate is that approximately 1,000 healthcare workers receive sharps injuries annually (ANA, 2004); the high estimate is that about 2,500 sharps injury victims develop either hepatitis B or C, or contract HIV (NAPPSI, 2004). Over 100 healthcare workers receive infections that lead to death annually (NYSPEF, 2002).

Nurses are the largest group of healthcare workers; nurses are also the professional discipline that administers medication. Clearly, nurses are at greatest risk among healthcare workers for needlestick injuries and indeed, most reported needlestick injuries have involved nurses (NIOSH, 1999), however laboratory staff, physicians, housekeepers and other healthcare workers are also injured.

Throughout the history of nursing, there have been fluctuations in supply and demand of nurses. Nurses have withstood nursing shortages in the past. Our current nursing shortage is requiring that nurses work longer hours and care for more patients than is often safe. One of the results of this situation is that nurses experience increased fatigue while at work, and also are likely to attempt to hurry in order to care for the numbers of patients needing nursing care. This situation is ripe for an increase in needlestick injuries. An anonymous nurse (Hospital Infection Control, 1996) described her momentary distraction, at the end of a 16 hour day, in which she incurred a needlestick injury and subsequently contracted HCV. Given the current shortage of nurses throughout healthcare, this is a situation that can occur repeatedly.

Exposure to needlestick injury increases the risk of acquiring serious or fatal infections. More than 20 infections, other than HIV, HVB, and HVC, can be transmitted through needlesticks, including: tuberculosis, syphilis, malaria and herpes (ANA, 2004). The ramifications of such an injury touch every aspect of a person's life, physically, emotionally, professionally, socially, and spiritually.

Needlestick injuries can be prevented. According to the American Nurses Association (2004), over 80% of needlestick injuries could be prevented with the use of safer needle devices. Unfortunately, they also report that only 15% of US hospitals use safer needles and devices (ANA, 2004).

There is some good news, however. According to the New York State Public Employees Federation (NYSPEF) Occupational Health and Safety Program (2002), since 1984 manufacturers have filed more than 1,000 patents for safer medical devices, including those that prevent needlesticks, and the Food and Drug Administration (FDA) has approved over 250 of them (ANA, 2004). Safer medical devices continue to be developed and are becoming easier to use than early models.

This course will focus on needlestick injuries, although other sharps injuries will also be addressed. The areas that will be covered include: identification of the risk of exposure to needlestick injury and other percutaneous injuries; legal protections; strategies to prevent or decrease the risk of exposure on individual and systems levels; and post-exposure treatment.

© 2004 NYSNA All rights reserved.

Course Objectives

After studying this self study module the learner should be able to:

• Discuss the prevalence of needlestick injuries and other percutaneous injuries among healthcare workers.

• Identify factors that contribute to occupational needlestick injuries and other sharps injuries.

• Discuss the risk of infection with hepatitis B, hepatitis C or Human Immunodeficiency Virus after an occupational exposure due to a needlestick injury.

• Describe the impact of needlestick injury on the healthcare worker.

• State the federal regulations that help to reduce occupational exposure to needlestick injury.

• State factors to be considered when selecting and evaluating devices with safety features.

• State the procedure for evaluation of sharps disposal containers.

• Discuss employer responsibilities in protecting healthcare workers from needlestick injury and other percutaneous injuries.