Definition
A needle stick (NSI) injury can be defined as an accidental skin penetration wound caused by a suture needle or a hallow bore needle. A sharps injury (SI) is a skin penetrating wound caused by a sharp device like a scalpel, trocar, scissors, drill bit, broken glass or a saw blade. Blood and body fluid exposure occurs when a splash of these fluids comes into contact with skin or mucous membranes. Operating room nurses are continuously at risk for a needle stick or sharps injuries and blood or body fluid splashes as a result of the nature of the work they do.
When do they occur?
Needle stick and sharps injuries have occurred before use during use, after use but before disposal, during or after disposal. The majority (46%) occur after use but before disposal and the minority (2%) occur before use. Operating room practioner’s can experience needle stick or sharps injuries when giving injections, recapping needles, assisting a surgeon during surgery, cleaning instruments during surgery and cleaning instruments or medical devices after surgery. 44.7% of injuries occurred when passing and receiving instruments from the surgeon and 12.1% occurred whilst cleaning instruments after surgery.
In Thailand the operating room personal sustained the most percentage of injuries from suture needles (36.1%), however they were also injured by hallow-bore needles, scalpel blades (only 15,3% of the time), wires, trocars and scissors.
Risk of infection
A needle stick or sharp’s injury exposes our operating room personnel to blood and body fluids which increase the risk of infection from bloodborne pathogens like hepatitis B, hepatitis C and HIV. Care workers have been known to show signs of anxiety, anger and even feelings of guilt when sustaining a needle stick injury. They also show significantly higher levels of depression. As expected the anxiety level is usually reduced when care workers are informed that the test was negative, however they usually remain anxious about the accuracy of the test result.
Some personal adopt active coping strategies like seeking first aid and reporting the incident when sustaining a needle stick injury. Others adopt passive coping methods which include avoidance of reporting the event and expectancy that there will be no problems. If the psychological discomfort is not managed it can develop into a chronic condition like post-traumatic stress disorder.
Jeong, JS. Et al. 2016. Qualitative content analysis of psychologic discomfort and coping process after needlestick injuries among health care workers
Katsatpibal, N. et al. 2016. Prevalence and risk factors of needlestick injuries, sharps injuries, and blood and body fluid exposures among operating room nurses in Thailand. American Journal of Infection Control, 44, 85-90
Ogg, MJ. AORN, Clinical Issues AORN January 2014, Vol. 99, No. 1.