Ouch! What to Do About Needlesticks and Sharps Injuries
Accidents involving needlesticks or sharps injuries (NSI) are very common in the dermatology field. In fact, next to surgeons, dermatologists have the highest rate of injury among medical specialties. The high rates of needlestick and sharps injuries in dermatology not only applies to physicians, but also to nurses, physician assistants, nurse practitioners, and technicians.
A recent review looked at preventative techniques and post-exposure protocols for sharps injuries encountered in dermatologic practice. The study categorized major types of sharps injuries that occur in the dermatologic surgery setting and summarized the appropriate preventative techniques that apply to each type of sharps injury. Relevant post-exposure protocols in the event of a sharps injury are also reviewed. Most NSIs in the dermatologic setting occur during skin surgery; physicians are typically injured while using the sharp object, while nurses or technician are mostly at risk during passage or disassembly of the sharp. Suture needles, scalpel blades, and syringes, are the most common instruments that cause NSIs. For all of these instruments the authors suggest the following general precautions can reduce or eliminate the majority of injures:
- Avoid hand to hand passage of sharps
- Maintain a consistently organized surgical tray
- Position surgical table at appropriate height and position surgical tray/instruments in a convenient and easily accessible location
- Avoid unnecessary bending or straining
- Avoid over-sized surgical gloves
- Utilize cotton-tip applicators for counter traction
- Always utilize eye and mucus membrane protection
For post-exposure protocols the authors note that in addition to the high rate of injuries, there are also high rates of NSIs that go unreported. One study found that around 65% of dermatologists indicated having an unreported NSI. The authors emphasize that lack of reporting puts both the surgeon at risk of contracting a blood-borne disease (BBD), and puts future patients at risk if the surgeon does contract a BBD unknowingly. The article outlines specific best practices for HIV, HBV, and HCV, while offering general guidelines such as immediately reporting the injury and/or going to the ER for further care.
The authors conclude that conscientious adoption of the discussed methods, techniques, practices, and attire can result in the elimination of the vast majority of dermatologic sharps injuries.
Byline: Martha L. Sikes, MS, RPh, PA-C
Posted: February 20, 2017
Adapted from the original article.