Averting needle sticks

Nursing,  Aug 1999  by Jagger, Janine,  Perry, Jane

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TWO NURSES, BOTH OCCUPATIONALLY INFECTED WITH HIV AND HCV: WHAT HAVE THEIR INJURIES TAUGHT US?

LISA BLACK, RN, A 26-YEAR-OLD mother of two, worked in a small hospital in Sparks, Nev. While caring for a patient with advanced AIDS, Lisa noticed that his I.V. line had become occluded. She prepared to irrigate the line and noted that it wasn't equipped with the needleless I.V. system the hospital had made available to prevent needle-stick injuries.

As she attempted to flush the line, the patient's arm jerked, dislodging the needle she'd inserted into the injection port of his I.V. line. The needle punctured her left palm. Nine months later, she tested positive for HIV; two months after that, she tested positive for hepatitis C virus (HCV).

What can we learn from this terrible tragedy? Needle-based I.V. access systems must be eliminated from all hospitals. More than a third of U.S. hospitals still haven't heeded a 1992 safety alert from the Food and Drug Administration warning about the risk of needle sticks from unnecessary needles on I.V. lines. In some facilities, needleless I.V. systems are used side by side with needle-based ones. This situation permits hospitals to blame injured workers for choosing the wrong system.

Hidden hazards

For 22 years, Karen Daley, RN, MPH, worked in the ED of Brigham & Women's Hospital in Boston, Mass. Her passion for nursing led to her being elected president of the Massachusetts Nurses Association. One day in July 1998, as she was dropping a used butterfly needle into a sharps container, she felt a sting. Another needle wedged in the disposal box flap had stuck her. Six months later, she found out she'd contracted both HIV and HCV from the needle stick.

We can learn two important lessons from Karen's needle stick: First, it wouldn't have happened if the needle that stuck her had had a protective feature that covered the sharp after use. Realizing this, Karen spearheaded a campaign to pass safety needle legislation in her state.

Second, facilities need to provide sharps containers appropriate for the setting. Containers suited to one clinical setting may be unsafe in another setting. Containers must be continually monitored to provide the best level of protection.

A small price to pay

The expense of converting to protective devices is insignificant compared with the cost of treating needle sticks-particularly if the worker becomes infected with a bloodborne pathogen. Lisa's and Karen's treatment costs over the course of their lifetimes will be enormous.

To ensure that your facility is using the safest possible equipment, get involved in product evaluation or risk-management committees. Offer to review available safety products with vendors. Send your facility the message that you care about safety issues and want something done now-not later.

BY JANINE JAGGER, MPH, PhD

Director

JANE PERRY, MA

Director of Communications

International Healthcare Worker Safety Center University of Virginia Charlottesville, Va.

Copyright Springhouse Corporation Aug 1999
Provided by ProQuest Information and Learning Company. All rights Reserved