Preventing Needlesticks

and Other Sharps

Injuries
Everything You Need to Know
Part I:
Background

 Part I: Background
Part II: Safer Sharps Devices
Part III: Safe Work Practices

The Problem
CDC estimates ~385,000 sharps injuries
annually among hospital-based healthcare
personnel (>1,000 injuries/day)
Many more in other healthcare settings (e.g., emergency
services, home care, nursing homes)

Increased risk for bloodborne virus transmission

Costly to personnel and healthcare system

Risks of Seroconversion due to Sharps Injury

from a known positive source

Virus
HBV
HCV
HIV

Risk (Range)
6-30%*
~ 2%
0.3%

(*Risk for HBV applies if not HB vaccinated)

What is the Risk for HIV Alone?

Percutaneous

0.3%

Mucous membrane

0.1%

Non-intact skin

<0.1%

Occupational HIV Transmission among U.S.

Healthcare Personnel, 1985-2004

57 documented cases
i.e., HIV negative at time of exposure and
became HIV positive during follow-up period

137 other cases

i.e., No documented exposure and no
known risk factor for HIV infection

Occupational HIV Transmission

Documented Cases (n=57)

50 (88%) involved percutaneous exposures

45 caused by hollow-bore needles, half of
which were used in a vein or artery

5 mucocutaneous exposures
2 exposure route unknown

Costs of Sharps Injuries

Baseline and follow-up laboratory testing
Treatment of exposed personnel
$71-~$5,000 depending on treatment provided
Lost productivity
Time to complete paperwork
Loss of income / loss of career
Emotional costs
Societal costs
OMalley, et. al. Costs of Management of Occupational Exposure to Blood and Body Fluids.
ICHE, July 2007, v 28, No. 7.

Preventing
Sharps Injuries
is Our Goal!

How Do Sharps Injuries Happen?

Who gets injured?
Where do they happen?
When do injuries occur?
What devices are involved?
How can they be prevented?

Data Sources
National Surveillance System
for Healthcare Workers
(NaSH)
Exposure Prevention
Information Network
(EPINet)

Who Gets Injured?

Occupational Groups
of Healthcare
Personnel Exposed to
Blood/Body Fluids,
NaSH June 1995
December 2003
(n=23,197)

Where Do Sharps Injuries Occur?

Patient Room
(Inpatient: Medical ICUs )
Operating Room
Outpatient
ER
Laboratory
Other
Source: NaSH, June 1995December 2003

39%
27%
8%
8%
5%
13%

When Do Sharps Injuries Occur?

During use

41%

After use/before disposal

40%

During and after disposal

15%

Other

4%
Source: NaSH, June 1995December 2003

What Devices are Involved in Sharps Injuries?

Six Devices Account for 78% of All Injuries

Disposable Syringes

30%

Suture Needles

20%

Winged-Steel Needles

12%

Intravenous Catheter Stylets

5%

Phlebotomy Needles

3%

Scalpels

8%

Source: NaSH, June 1995December 2003

Devices that Require Manipulation after Use

are Associated with an Increased Rate of Injury

Jagger, et al. Rates of needle-stick injury caused by various devices in a university hospital.
NEJM. 1988;319.

How Do Injuries Occur With Hollow-Bore Needles?

Circumstances Associated with Hollow-Bore Needle
Injuries NaSH June 1995December 2003 (n=10,239)

Disposal
Related:
35%

Sharps Injuries Are Preventable

Preventability of Needlesticks in 78 NaSH Hospitals,
June 1995--December 2004 (n=11,625)

Preventing Sharps Injuries is a National Priority!

Federal and state laws increase enforcement

of sharps injury prevention
Needlestick Safety and Prevention Act, 2000
OSHA enforcement of needlestick prevention increasing
21 states with laws/regulations

CDC: targets needlesticks for elimination

Sharps Injuries at ______Hospital (period of time)

Last year _____ sharps injuries were reported by our

employees/staff
The occupations most affected were _____
The devices most commonly involved were _____
The most common ways sharps injuries occurred were
_____

What are Strategies to Eliminate Sharps Injuries?

Eliminate or reduce the use of needles and

other sharps
Use devices with safety features to isolate
sharps
Use safer practices to minimize risk for
remaining hazards

 Part II: Safer Sharps Devices

Part III: Safe Work Practices