Needle Stick Injury (NSI), Risk of Blood-Borne Pathogen Transmission, Step-by-Step: What to Do After a Needle Stick Injury, Memory Aid – “W-H-A-R-M” for Needle Stick Protocol
.png)
🩸 NEEDLE STICK INJURY (NSI)
📌 Definition
A Needle Stick Injury (NSI) refers to:
"An accidental skin puncture wound caused by a needle or sharp object that may have been used on a patient or has come in contact with bodily fluids."
These injuries are a major occupational hazard in healthcare settings and pose serious risks of blood-borne infections.
🔍 Mechanism of Injury
Needle stick injuries occur when:
-
A needle pierces the skin.
-
The sharp is contaminated with blood or body fluids.
-
There’s a break in standard procedure or safety protocol.
Examples include:
-
During venipuncture
-
Administering injections
-
Recapping a used needle
-
Improper disposal of a used sharp
🦠 Risk of Blood-Borne Pathogen Transmission
| Pathogen | Risk of Transmission After NSI |
|---|---|
| Hepatitis B (HBV) | 6–30% (if unvaccinated) |
| Hepatitis C (HCV) | 1.8% |
| HIV | 0.3% |
🔴 Even though HIV has a lower transmission rate, it’s still life-threatening, so all exposures are treated seriously.
🧑⚕️ High-Risk Procedures
-
IV line insertions
-
Blood sample collections
-
Suturing wounds
-
Disposal of sharps
-
During emergencies or patient movement
📉 Contributing Factors
-
Fatigue or stress
-
Lack of training
-
Poor lighting
-
Overfilled sharps containers
-
Recapping of needles
-
Non-use of PPE (gloves, face shield)
📌 Step-by-Step: What to Do After a Needle Stick Injury
✅ ACT FAST – Every second matters!
1. First Aid
-
Immediately wash the wound with soap and running water
-
DO NOT squeeze the wound or scrub it
-
DO NOT use bleach, alcohol, or antiseptics directly
2. Report the Incident
-
Inform your immediate supervisor or infection control officer
-
Fill out an incident report
3. Medical Evaluation
-
Risk assessment of the source patient (if known)
-
Immediate baseline blood tests for:
-
HIV
-
HBV
-
HCV
-
4. Post-Exposure Prophylaxis (PEP)
-
HIV PEP should start within 1–2 hours and no later than 72 hours
-
Continue for 28 days
-
Follow-up testing at 6 weeks, 3 months, and 6 months
💉 Prevention Strategies
🔐 Universal Precautions:
-
Treat all blood and body fluids as potentially infectious
✅ Safe Injection Practices:
-
Use single-use, auto-disable syringes if available
-
Never recap needles
-
Use needleless IV systems when possible
✅ Sharps Disposal:
-
Dispose of needles immediately in puncture-proof sharps containers
-
Containers should be:
-
Easily accessible
-
Not overfilled (fill only to 3/4)
-
Closed when 3/4 full
-
✅ Personal Protective Equipment (PPE):
-
Gloves
-
Gowns
-
Eye protection (if risk of splashes)
💉 Vaccination Protocol for Healthcare Workers
✅ Hepatitis B Vaccination:
-
All healthcare workers should receive:
-
3 doses of HBV vaccine (0, 1, and 6 months)
-
A booster dose may be required later
-
-
Check anti-HBs antibody titer to confirm protection
📘 Laws & Guidelines
-
OSHA (Occupational Safety and Health Administration) guidelines
-
WHO guidelines on sharps safety
-
India: Bio-Medical Waste Management Rules 2016 emphasize sharp handling protocols
🧠 Memory Aid – “W-H-A-R-M” for Needle Stick Protocol
| Letter | Action |
|---|---|
| W | Wash with soap & water |
| H | Head to supervisor |
| A | Assess exposure risk |
| R | Report the incident |
| M | Medical follow-up/PEP |
🧾 Quick Case Study Example
Case: A 24-year-old nurse accidentally pricks her finger while injecting a diabetic patient. The needle had visible blood. She immediately washes the area but doesn’t report it until 3 hours later.
What went wrong?
-
Delay in reporting
-
No immediate evaluation of source
-
Possible delay in starting PEP
Correct Approach:
-
Wash → Report → Risk Assessment → Start PEP if needed
✅ Summary Checklist for Exams
-
🔲 Definition of NSI
-
🔲 Risks involved (HIV, HBV, HCV)
-
🔲 Causes of injury
-
🔲 First Aid steps
-
🔲 PEP guidelines
-
🔲 Prevention measures
-
🔲 Vaccination
-
🔲 Laws & regulations
Comments
Post a Comment