From the Guidelines
Immediately after a sharps injury, a healthcare worker should wash the needle-stick site or cut with soap and water, and report the incident to their supervisor and immediately seek medical treatment. The first step is to clean the affected area to reduce the risk of infection. According to the guidelines outlined in 1, the exposed employee should immediately follow these steps: wash the needle-stick site or cut with soap and water, and if splashes to the nose, mouth, or skin occur, flush the involved area with water.
The worker must then report the incident to their supervisor and occupational health department, documenting details of the incident including the source patient if known. A blood sample should be collected from both the injured worker and source patient (with consent) for testing of bloodborne pathogens including HIV, Hepatitis B, and Hepatitis C. Post-exposure prophylaxis (PEP) may be necessary depending on the risk assessment.
For HIV exposure, PEP typically includes a course of antiretroviral medications, and for Hepatitis B, HBIG (Hepatitis B Immune Globulin) and/or vaccination may be indicated depending on the worker's vaccination status, as outlined in 1. Prompt action is crucial as PEP effectiveness decreases with time, and proper wound care reduces infection risk by removing potentially infectious material from the injury site.
Some key points to consider after a sharps injury include:
- Washing the affected area with soap and water
- Reporting the incident to the supervisor and occupational health department
- Documenting details of the incident, including the source patient if known
- Collecting blood samples for testing of bloodborne pathogens
- Considering post-exposure prophylaxis (PEP) depending on the risk assessment
- Following up with medical treatment and testing as necessary, as recommended in 1.
From the Research
Immediate Steps After a Sharps Injury
The immediate steps for a healthcare worker after a sharps injury are crucial in preventing the transmission of blood-borne pathogens. According to the available evidence, the following steps should be taken:
- Report the incident immediately to the supervisor or the infection control department 2, 3, 4
- Wash the affected area with soap and water 5
- Seek medical attention as soon as possible to assess the risk of transmission and to receive post-exposure prophylaxis (PEP) if necessary 5, 6
- Cooperate with the healthcare facility's procedures for reporting and managing sharps injuries, including providing information about the incident and the source patient 2, 3, 4
Importance of Reporting Sharps Injuries
Reporting sharps injuries is essential for healthcare worker occupational safety, as it allows for the identification of high-risk areas and the implementation of measures to prevent future incidents 2, 3, 4. However, underreporting of sharps injuries is a significant problem, with many healthcare workers failing to report incidents due to fear of peer perception, lack of knowledge about reporting systems, or the belief that the exposure has low risk of infection 2, 4.
Prevention of Sharps Injuries
Prevention of sharps injuries is critical in reducing the risk of transmission of blood-borne pathogens. Strategies to prevent sharps injuries include:
- Identifying the risk of blood exposure and creating policies to minimize the risk 4
- Educating and training healthcare workers on safe practices and the use of safety-engineered sharps devices 4
- Implementing a simplified reporting process to encourage reporting of sharps injuries 2
- Using double-gloving and safety-engineered sharps devices to reduce the risk of injury 4