From the Guidelines
I would choose option B, report the manager, as it is crucial to ensure the nurse receives proper care and follow-up after a needlestick injury, and the manager can address any underlying issues preventing the nurse from reporting the incident. When a nurse experiences a needlestick injury and refuses to report it to infection control, this creates a serious safety issue that requires intervention. As a healthcare professional, I have an obligation to ensure proper protocols are followed for everyone's protection. By reporting to the manager, I ensure the situation receives appropriate attention from someone with authority to address it. The manager can then implement necessary steps including counseling the nurse about the importance of reporting, arranging post-exposure prophylaxis if needed, and ensuring proper testing occurs, as outlined in the guidelines for management of occupational exposures to bloodborne pathogens 1.
This approach protects the injured nurse, potential patients, and maintains institutional safety standards. Needlestick injuries carry risks of bloodborne pathogen transmission including HIV, Hepatitis B, and Hepatitis C, making proper reporting and follow-up essential for both individual and public health reasons. The manager can also address any underlying reasons for the nurse's reluctance to report, such as fear of repercussions or lack of understanding about reporting procedures. According to the updated U.S. public health service guidelines for the management of occupational exposures to HBV, HCV, and HIV, immediate care to the exposure site, determination of risk associated with exposure, and evaluation of the exposure source are critical steps in managing occupational blood exposures 1.
Furthermore, the guidelines emphasize the importance of providing post-exposure prophylaxis (PEP) for exposures posing a risk of infection transmission, and the need for follow-up testing, monitoring, and counseling of exposed healthcare personnel (HCP) 1. By reporting the incident to the manager, I can ensure that these guidelines are followed, and the nurse receives the necessary care and support to prevent potential complications.
Some key steps in managing the exposure include:
- Washing the needle-stick site or cut with soap and water
- Reporting the incident to the supervisor and seeking medical treatment immediately
- Documenting the type of injury, including the involvement of blood, and the source of the blood
- Determining the status of the source patient and the immunity of the employee
- Considering prophylaxis against HIV and hepatitis B, as recommended by the guidelines 1.
Overall, reporting the manager is the most appropriate course of action to ensure the nurse's safety and well-being, as well as to maintain institutional safety standards and prevent potential complications.
From the Research
Response to Accidental Needle Prick
In the event of a nurse experiencing an accidental needle prick and refusing to report the incident to infection control, the following steps can be considered:
- Incident Report: Filing an incident report is crucial in such situations to document the event and ensure that proper protocols are followed for the safety of the nurse and others involved 2, 3.
- Report to Manager: Informing the manager or supervisor about the incident is essential, as they can provide guidance on the next steps to take and ensure that the nurse receives the necessary support and care 4, 5.
- Request Viral Marker for the Patient: If the needle prick occurred while attending to a patient, it may be necessary to request viral marker testing for the patient to determine the risk of transmission 6.
Considerations
When dealing with an accidental needle prick, it is vital to prioritize the safety and well-being of the nurse and others involved. This includes:
- Following established protocols for reporting and managing needlestick injuries
- Providing support and care to the affected nurse
- Taking steps to prevent similar incidents in the future
Available Options
The available options for responding to the situation are:
- a. Incident report
- b. Report the manager
- c. Nothing to do
- d. Request viral marker for the patient
It is clear that options a and b are the most appropriate courses of action, as they prioritize the safety and well-being of the nurse and others involved. Options c and d are not suitable responses, as they do not address the situation adequately.