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What are the best practices for preventing and managing needlestick injuries?

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Needlestick injuries are a serious occupational hazard for physicians and other health care workers. They can expose you to bloodborne pathogens such as hepatitis B, hepatitis C, and HIV, and cause anxiety, stress, and medical costs. Fortunately, there are some best practices you can follow to prevent and manage needlestick injuries effectively. Here are six tips to help you protect yourself and your patients from this risk.

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1 1. Follow standard precautions

Standard precautions are the basic infection prevention and control measures that you should apply to all patients, regardless of their suspected or confirmed infection status. They include hand hygiene, personal protective equipment, safe injection practices, environmental cleaning, and waste disposal. By following standard precautions, you can reduce the chance of coming into contact with potentially infectious blood or body fluids.

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2 2. Use safety-engineered devices

Safety-engineered devices are needles or syringes that have built-in features to prevent or minimize needlestick injuries. For example, some devices have retractable needles, shields, or blunting mechanisms that activate after use. You should always use safety-engineered devices whenever possible and appropriate for the procedure. You should also follow the manufacturer's instructions and dispose of the devices in a puncture-resistant container.

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3 3. Avoid recapping needles

Recapping needles is a common cause of needlestick injuries. It can be tempting to recap a needle after use, especially if you need to transport it to a disposal container. However, recapping can increase the risk of accidentally puncturing your fingers or hands. You should avoid recapping needles unless it is absolutely necessary and there is no alternative. If you must recap a needle, use a one-handed technique or a device designed for recapping.

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4 4. Report and document needlestick injuries

If you suffer a needlestick injury, you should report it immediately to your supervisor and the occupational health and safety department. You should also document the details of the injury, such as the type and source of the needle, the depth and location of the wound, and the exposure to blood or body fluids. Reporting and documenting needlestick injuries can help you access appropriate medical care, testing, and treatment. It can also help identify and address the factors that contributed to the injury and prevent future incidents.

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5 5. Seek medical evaluation and treatment

After a needlestick injury, you should seek medical evaluation and treatment as soon as possible. You may need to undergo baseline testing for bloodborne pathogens and receive post-exposure prophylaxis (PEP), which is a course of medication that can prevent or reduce the risk of infection. You may also need to have follow-up testing and counseling to monitor your health status and provide emotional support. You should follow the recommendations of your health care provider and the occupational health and safety department regarding your medical management.

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Helen Miller MD, MBA, CPE, CEM
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This is a real challenge in some Federal agencies who do not actually consider a needlestick to be an occupational injury. Quite different than other medical settings. You will need a plan for the baseline testing and PEP to be covered as their work comp will only cover if an actual infection results (not just an exposure). Not a new problem.

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6 6. Learn from needlestick injuries

Needlestick injuries are not only harmful to your health, but also to your morale and confidence. They can affect your performance, productivity, and well-being. Therefore, you should learn from your experience and take steps to prevent and manage needlestick injuries better in the future. You can do this by participating in infection prevention and control training, reviewing your work practices, seeking feedback, and sharing your knowledge and insights with your colleagues.

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7 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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Bassem Demian

Senior Attending at Ocean University Medical Center
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The practitioner must be responsible for themselves. In a office or clinical setting, when you take out a sharp instrument, scalpel, needle or anything that comes in contact with a patient, you are responsible for what happens to that instrument. Do not leave it for anyone else to dispose of it. No one else knows what procedure you performed. We all need to be conscientious and considerate of our colleagues. Assistants or cleaning staff are not trained nor are held to the same standards or responsibilities as the medical staff and are at a much higher risk of accidental injuries.

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What are the best practices for preventing and managing needlestick injuries?

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2

3

4

5

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1 1. Follow standard precautions

2 2. Use safety-engineered devices

3 3. Avoid recapping needles

4 4. Report and document needlestick injuries

5 5. Seek medical evaluation and treatment

6 6. Learn from needlestick injuries

7 Here’s what else to consider

Working with Physicians

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What are the best practices for preventing and managing needlestick injuries?

1

2

3

4

5

6

7

1 1. Follow standard precautions

2 2. Use safety-engineered devices

3 3. Avoid recapping needles

4 4. Report and document needlestick injuries

5 5. Seek medical evaluation and treatment

6 6. Learn from needlestick injuries

7 Here’s what else to consider

Working with Physicians

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