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Sharps Injury

Definition

Sharp Injuries are skin penetrating stab wounds caused by sharp instruments and accidents in a medical setting. These instruments include needles, lancets, scalpels and broken glass.[1, 2]


Needlestick Injuries (NSIs) are defined as an accidental skin penetrating stab wound caused by hollow-bore needles such as hypodermic needles, blood-collection needles, IV catheter stylets, and needles used to connect parts of IV delivery system. [2, 3]

Risks

Healthcare workers (HCWs) face a high risk of an occupational exposure to blood and body fluids (BBF). This exposure can lead to the transmission of pathogens causing an infection and hazardous consequences for their health.2,3,4 The common high risk situations of such an occupational exposure involving the exchange of BBF are2:

1. Percutaneous injury
2. Mucous membrane contact
3. Non-intact skin contact

Percutaneous injuries represent the most dangerous situation for HCWs where safety products and measures haven’t already been established. Percutaneous injuries may be caused by objects like needles, surgical instruments or glass.2 Nearly 80% of all percutaneous sharps injuries are caused by a needlestick, with 56% attributed to hollow-bore needles (See Figure 1).1

Syringe needles, IV catheter stylets, and Butterfly needles represent nearly 65 % of all injuries from hollow-bore needles and are considered high-risk because they involve blood-filled needles. Nearly every 2nd hollow-bore needlestick also endangers the HCW to the risk of a blood exposure (See Figure 2).5

Figure 2: NSIs caused by different types of hollow-bore needles prior to the implementation of safety devices. Reference: 63 USA Hospitals participating in the EPINet surveillance program.
Regarding the group of HCWs most frequently affected by NSIs, nurses showed the highest percentage with up to 50% of all injuries sustained.1,5,6

Additionally physicians and laboratory staff had an explicit risk of NSIs with contaminated hollow-bore needles.1,6 In addition to HCWs directly working with medical devices, house keeping and laundry personnel are also susceptible to the hazardous consequences of NSIs (See Figure 3).1,6

References:

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1 Centers for Disease Control and Prevention. Workbook for Designing, Implementing and Evaluating a Sharps Injury Prevention Program. Update 2015

2 Riddell A, Kennedy I2, Tong CY3. Management of sharps injuries in the healthcare setting. BMJ. 2015 Jul 29;351:h3733. doi: 10.1136/bmj.h3733

3 Wicker S, Stirn AV, Rabenau HF, von Gierke L, Wutzler S, Stephan C. Needlestick injuries: causes, preventability and psychological impact. Infection. 2014 Jun;42(3):549-52

4 Yang L, Mullan B. Reducing needle stick injuries in healthcare occupations: an integrative review of the literature. ISRN Nurs. 2011;2011:315432. doi: 10.5402/2011/315432

5 Jagger J, Bentley MB. Injuries from vascular access devices: high risk and preventable. Collaborative EPINet Surveillance Group. J Intraven Nurs. 1997 Nov-Dec;20(6 Suppl):S33-9

6 Rapiti E, Prüss-Üstün A, Hutin Y. Sharps injuries - Assessing the burden of disease from sharps injuries to health-care workers at national and local levels. Environmental Burden of Disease Series, No. 11. WHO 2005

To read the abstract go to the literature page.

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