<b>Preventing Needlestick Injuries</b>

Abstract

Inadvertent puncture during use, disassembly, or disposal of needles or sharp devices (called collectively, "sharps") creates risk beyond a simple puncture. Sharps injury has always been a risk for health care workers, but emergence of certain blood-borne pathogens has intensified the need to act. Three- hepatitis B, hepatitis C, and HIV-are of utmost concern because they can cause significant morbidity or death. The incidence of sharps injury remains unacceptably high. Injury analysis at long-term care facilities and at the national level reveals several trends that can be used to shape policy and select interventions. Policy, practice, and training need to address new devices engineered to prevent sharps injuries, sharps disposal containers, and prophylaxis after percutaneous injury.

Knowledge and Practice of Health Care Workers regarding Needle Stick Injuries in a Tertiary Care Center of Nepal

“…Factors such as type and design of needle, recapping activity and method, handling or transferring specimens or sutures, cleaning activities, manipulation of needles or sutures, passing/handling devices or failure to dispose used needle in puncture proof containers have been implicated in the causation of NSI. [1][2][3][4][5] The global estimate of such accidental exposures is nearly 3.5 million individuals. 6 In our study, a very high prevalence of NSI was found (70.3%).…”

“…Avoiding recapping of needles as far as possible for disposal has been a prime emphasis in modern medical practice. 1,[8][9][10][11] Safety engineered needles and devices having features such as shields or retractable needles have proven efficacy for the prevention of these injuries. However inaccessibility and under use of such devices in the setting of Nepal may be a major contributing factor for NSI.…”

“…Three diseases -hepatitis B, hepatitis C, and HIV/AIDS are of greatest concern because of their morbidity, complications or death. 1 The risk of injury depends on two basic factors; the number of infectious patients and the universal precautions taken by the health care worker. Considering every patient to be infectious and following the universal discipline during handling of sharps remains to be the gold standard for the prevention of needle stick injuries.…”

Sharps Injuries

“…6 Today, over 20 blood borne pathogens have been identified as transmissible through sharps injuries, with HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) posing the highest risk of morbidity and mortality. 7 …”

“…However, the risk of seroconversion following needlestick injuries is much higher compared with HIV, estimated to be between 23–62%. 7,9 Furthermore, HBV can remain infective in dried blood for several days, and bodily fluids with high titers of hepatitis B antigen have the greatest risk for infectivity. 10 Finally, hepatitis C virus (HCV) transmission occurs through percutaneous or mucosal exposure, and infectivity depends on the viral load in the inoculum.…”