NursingWorld Home
NursingInsider: The Latest news for Nurses
NursingMall: One Stop Shopping for Nurses


Join/Renew ANA

FAQs

E-mail Lists: Sign up for lists from ANA
Sitemap
Help
About ANA
Contact Us

ANA*NET
For ANA and CMA staff members only

NursingInsider: The Latest news for Nurses
NursingMall: One Stop Shopping for Nurses

The American Journal of Nursing
AJN Table of Contents2001 AJN Table of Contents
AJN Home PageAJN Home Page
Other ANA ColumnsOther ANA Columns this Month:
Washington Watch|Issues Update|Health & Safety| Workplace Rights

Health & Safety
line
American Journal of Nursing - March, 2001 - Volume 101, Issue 3

You've Been Stuck
What do you do?

By Karen Worthington, RN

Q. What should I do if I sustain a needlestick injury while on the job?

A.In November 2000 the Needlestick Safety and Prevention Act became law, requiring health care facilities to use safer devices to protect against sharps injuries. Although the number of needlestick injuries is expected to decrease as a result of this law, some will continue to occur because safety devices haven’t been developed for every type of venous access procedure. Because post-exposure prophylaxis has been proven to reduce the chance of HIV infection, it’s more important than ever to seek treatment immediately after exposure.

Under the Occupational Safety and Health Administration’s (OSHA) Bloodborne Pathogens Standard, employers must evaluate and treat health care workers in accordance with the latest postexposure assessment, prophylaxis, and treatment guidelines published by the Centers for Disease Control and Prevention (CDC). Separate guidelines address HIV, hepatitis B, and hepatitis C. These guidelines and documents are readily available on the Web (see Resources).

Before an exposure occurs, make sure your employer is able to provide:

  • immediate evaluation and risk assessment of needlestick injuries—many hospitals have implemented hotlines for this purpose.
  • confidential testing for HIV, hepatitis B, and hepatitis C.
  • access to postexposure treatment and prophylactic medications within two hours of exposure.
  • counseling, education, and follow-up testing for up to one year after exposure. If you sustain a needlestick injury, take the following actions immediately:
  • Wash the wound with soap and water.
  • Alert your supervisor and initiate the injury reporting system used in your workplace.
  • Identify the source patient, who may need to be tested for HIV, hepatitis B, or hepatitis C infections.
  • Report to employee health services, the emergency department, or other designated treatment facility.
  • Get tested immediately and confidentially for HIV, hepatitis B, and hepatitis C infections.
  • Document the exposure in detail, for your own records as well as for the employer. Under the new needlestick law, employers must maintain a confidential sharps injury log that contains, at a minimum, the type and brand of device involved in the incident, the department or work area where the exposure incident occurred, and an explanation of how the incident occurred.
  • When the source patient is unknown or tests positive for HIV, hepatitis B, or hepatitis C infection, get postexposure prophylaxis (PEP) in accordance with CDC guidelines. If the patient has HIV, start prophylaxis within two hours of exposure. For possible hepatitis C exposure, no treatment is currently recommended, but you may want to talk to a specialist about experimental postexposure prophylaxis.
  • Make sure to follow up with postexposure testing at six weeks, three months, and six months, and depending on the risk, at one year. If PEP is prescribed, you should be monitored regularly for signs and symptoms of toxicity. Take precautions (especially by practicing safe sex) to prevent exposing others until follow-up testing is complete.
  • Don’t be afraid to seek additional information or a referral to an infectious disease specialist if you have any questions. Also, consider counseling—a needlestick injury can be traumatic, regardless of the outcome.

Resources