Needle Stick Injury in Pathology Laboratory, Hospitals industry and Its Management

 Needle Stick Injury in Pathology Laboratory, Hospitals industry and Its Management 

The majority of needle stick injuries occur during the use of the sharp devices, and after the use prior of disposal. Common causes of injuries attributable to improper work practices.

Needle-stick injury:

• An accidental needle stick injury can happen in an instant.  And if employee has a percutaneous needle stick, the employee shall be informed to supervisor or infection control officer for the following recommended actions :

 Bleed the puncture site freely by applying gently pressure up to the bleeding are not stops. After washing injured area by disinfectant soap and water.     

 The employee shall immediately notify his or her supervisor of the exposure, or in the  supervisor’s absence, Infection control officer  or Manager in the laboratory or Hospital. 

After the Post exposure prophylaxis: 

Every hospital and diagnostics center needs to be established a post exposure evaluation and treatment program that includes testing to determine whether infection with HIV of HBV has occurred, and includes follow-up treatment and counseling. Policy is that any employee having an occupational (workplace) exposure incident shall be offered the post-exposure program. This plan is prepared as per the NACO Guidelines.

Reporting of Exposure: 

Promptly report the exposure to the appropriate authority and condition must be treated as an emergency. the department supervisor/ Manager/hospital infection control officer on duty shall be notified immediately of the incident and shall:

1. Notify the human resources department and Centre Head as soon as practical of the incident.

2. Verify the employee has been directed to seek medical attention

When recommended, post exposure prophylaxis should be started as soon as possible, preferably within few hours. Initiating treatment after 72 hours of exposure is not of much use.

Testing and Counselling: 

The health care provider should be tested for HIV as per the following schedule:

Base-line HIV test - at time of exposure.        Repeat HIV test - at six weeks following exposure.        

2nd repeat HIV test - at twelve weeks following exposure.On all three occasions, HCW (health care workers) must be provided with a pre-test and post- test counselling. HIV testing should be carried out on three methods preparations. The HCW should be advised to avoid from donating blood, semen or organs/tissues and abstain from sexual intercourse.

According to the Occupational Safety and Health Administration (OSHA):

If a needle is confirmed to be contaminated with the hepatitis B virus, there is still only a 6 to 30% chance of infection for the injured person. However, in the United States, most medical institutions require vaccinations for hepatitis B, negating this concern.

If a needle is contaminated with HIV, there is a .3% of infection for the injured person.

If a needle is contaminated with the hepatitis C virus, the risk of infection from a contaminated needle is 1.8%.