Needle Stick Injury & Spill Management

Welcome
“NEEDLE STICK INJURY”
&
“SPILL MANAGEMENT”
What are “sharps”?
Sharps are devices that are intentionally sharp

to puncture or cut skin (needles, scalpels, etc.),
or become sharp due to accident, such as
broken glass tubes.
-- Hypodermic needles
-- Scalpels
-- IV devices
-- Capillary tubes
-- Glass containers
-- Pipettes
-- Others
7/12/11
Who is at risk for sharps injuries?
 Any worker who may come in contact with

contaminated sharps is at risk, including
nursing staff, lab workers, doctors and
housekeepers.
 The main issue is contamination from blood

or other potentially infectious materials
(“OPIM”).
7/12/11
What infections can be caused by
sharps injuries?
 Any injury sustained as a result of the skin being
pierced by sharp used for patients
- has potentials to cause infection.
 The pathogens that pose the most serious health

risks are--
-- Hepatitis B virus (HBV) (30%)
-- Hepatitis C virus (HCV) (3%)
-- Human immunodeficiency virus (HIV) the virus
that causes AIDS (0.3%)
Quick FACT:
 HBV vaccination is recommended for all

healthcare workers (unless they are immune
because of previous exposure).
 HBV vaccine is highly effective in preventing
infection in workers exposed to HBV.
 However, no vaccine exists to prevent HCV or
HIV infection.
 HBV vaccinations of all HCW who at risk
should be done & records to be maintained.
7/12/11
Causes of Needle Stick Injuries-
- Unsafe Injection Practices
- During mutilation
- During recapping of needles
- During suturing
- Movement of Patient
- Collection and Transportation of Biomedical
Waste.
- Through accidental prick from needles fallen
on floor.
Good Practice For the Safe Handling And
Disposal Of Sharps:
• ALWAYS dispose of your own sharps.
• NEVER pass used sharps from one person to
another.
• NEVER recap, bend or break disposable
needles.
• After use, place needles and syringes in a rigid
container.
• Locate sharps disposal containers close to the
point of use, e.g. in patient's room, on the
medicine trolley and in treatment room etc.
• Protect fingers from injury by using forceps
instead of fingers for guiding suturing.
DO’S
- Pass syringes and needles in a tray. Preferably

cut it with needle Cutters.
- Put needle and syringes in 1% hypochlorite

solution if needle clutter is not available.
- Remove cap of needle near the site of use.
- Pick up open needle from tray / drum with forceps.

DONT’S
- Never pass syringe and needle directly to next

person.
- Do not bent/or break used needle with hands.
- Never test the fineness of the needle’s tip before

use with bare or gloved hand.
- Never pick up open needle by hand.
- Never dispose it off by breaking it with hammer /

stone.
Steps to be followed after the prick
(First Aid)
DOs--
- Remove the offending needle immediately
- Wash the part with running water immediately
- Wash the skin with soap and water
- Irrigate with water or saline if eyes or mouth
exposed (in case of blood & body fluid)
DON'Ts--
- Do not panic
- Do not put pricked finger in mouth
- Do not squeeze the finger or part to bleed it
- Do not use antiseptics on the wound
RESPONSIBILITY
- Microbiologist
- Infection Control Nurse
- Nurse Incharge
- EMO on Duty
- Physician (if needed)
Cont….
• The above mentioned steps are to be followed

for all the cases.
• Further if the needle was used for a patient

inform immediately to shift Incharge and during
routine hours directly to ICN/ Nursing Supervisor.
Action Taken in cases of needle stick injury:
 The health care provider is tested for HIV, HBsAg and HCV
at the time of exposure
 These tests are repeated if source is positive or unknown
i) Base linetest - at time of exposure
ii) Repeat test - at 6 weeks following exposure
iii) 2nd repeat test - at 12 weeks following exposure
iv) 3rd repeat test (in case of HCV) - at 6 months following

exposure
HCW is provided with a pre-test and post –test counseling.

POST EXPOSURE PROPHYLAXIS (PEP)
 PEP Recommendation is done by calculating Source

Code (SC) & Exposure Code (EC)
 If needed- PEP is done with
- Zidovudine
- Lamivudine
- Indinavir
7/12/11
SPILL MANAGEMENT
7/12/11
Objectives
 Become familiar with applicable regulatory standards

 Demonstrate an understanding of potential hazards
and appropriate responses
 Spill kits to be ready for use.
7/12/11
Spill Kit
 Why Do We Need Spill Kits?

- Because Accidents Happen!!
- Potential hazards must be recognized.
- YOU need to know the safest response.
 Located in each unit-
- Contains gloves, absorbent pads, sheets, goggles,
aprons & disposal bags.
- Periodically check the spill kit to see if supplies
need to be replenished.
7/12/11
Spill Kit
7/12/11
SPOT CLEANING
 Wipe spot immediately with a damp cloth, tissue or

paper towel.
 An alcohol wipe may be used
 Discard contaminated material
 Wash hands.
7/12/11
SMALL SPILLS (Up to 10cms)
 Collect Spill Kit. Wear disposable cleaning gloves.

 Wipe up spill immediately with absorbent material
(e.g. paper/ hand towel).
 Place contaminated absorbent material into plastic
bag (Yellow) for disposal.
 Put 1% Sodium Hypo covering entire area for 20
mins
 Clean the area with soap and water
 Discard contaminated materials
(absorbent,disposable gloves and plastic apron)
 Wash hands
LARGE SPILLS (> than 10cm diameter)
 Isolate and confine the spill area

 Collect Spill Kit
 Wear disposable cleaning gloves, eye wear and
plastic apron should be worn if there is a chance
of splashing occurring.
 Cover area of the spill with paper towel, blotting
paper, newspaper and allow it to absorb.
 Cover area of the spill with 1% Sod Hypo. for
20 min
 Discard contaminated materials (absorbent
towelling, cleaning cloths, disposable gloves and
plastic apron) in infectious waste bag which
should be incinerated.
 Use cleaning materials to mop area with water
and detergent.
 Clean and disinfect bucket and mop, dry and
store appropriately
 Reusable eye-wear should be cleaned and
disinfected before use
 Wash hands
Mercury Spill
 Call Hazmat Team by calling HK Number

 Confine the area
 Keep the heat <20C and ventilate the area
 Put face mask to prevent breathing of mercury
vapour
 Remove all jewels to prevent amalgamation
 The containers with mercury to be sent to HK
Manager and then sent for final disposal
7/12/11
Remember--
 All disinfectant solution containers should be dated

when opened.
 All solutions should be used and discarded

according to the manufacturer’s recommendations
Thank You

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Welcome

“NEEDLE STICK INJURY”

Sharps are devices that are intentionally sharp

 Any worker who may come in contact with

 The main issue is contamination from blood

 The pathogens that pose the most serious health

 HBV vaccination is recommended for all

- Pass syringes and needles in a tray. Preferably

- Put needle and syringes in 1% hypochlorite

- Remove cap of needle near the site of use.

- Pick up open needle from tray / drum with forceps.

- Never pass syringe and needle directly to next

- Do not bent/or break used needle with hands.

- Never test the fineness of the needle’s tip before

- Never pick up open needle by hand.

- Never dispose it off by breaking it with hammer /

• The above mentioned steps are to be followed

• Further if the needle was used for a patient

 These tests are repeated if source is positive or unknown

i) Base linetest - at time of exposure

ii) Repeat test - at 6 weeks following exposure

iii) 2nd repeat test - at 12 weeks following exposure

iv) 3rd repeat test (in case of HCV) - at 6 months following

HCW is provided with a pre-test and post –test counseling.

 PEP Recommendation is done by calculating Source

 Become familiar with applicable regulatory standards

 Why Do We Need Spill Kits?

 Wipe spot immediately with a damp cloth, tissue or

 Collect Spill Kit. Wear disposable cleaning gloves.

 Isolate and confine the spill area

 Call Hazmat Team by calling HK Number

 All disinfectant solution containers should be dated

 All solutions should be used and discarded

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