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Preventing Needlestick Injuries

2.00 Contact Hours:
A score of 80% correct answers on a test is required to successfully complete any course and attain a certificate of completion.
Authors:    Kelley Madick (MSN/ED, PMHNP) , Julia Tortorice (RN, MBA, MSN, NEA-BC, CPHQ)

Purpose/Goals

The purpose of this course is to provide the most recent evidence based practice to avoid needlestick injuries and provide post-exposure prophylaxis and procedure.

Objectives

After completing the course the learner will be able to:

  1. Identify methods to reduce needlestick injuries
  2. Recognize the transmission risk of contracting of HIV, HBV and HCV,
  3. Discuss the post-exposure prophylaxis and procedure
  4. Discuss Federal laws pertaining to health care facilities
  5. Identify the desirable characteristics of safety devices.

Introduction

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally, at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance  with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values that are creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998, more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance  with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance  with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values that are creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance  with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 
 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance  with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance  with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values that are creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance  with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance  with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values that are creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance  with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine months later and after being tested several times for symptoms she believed were that of HIV, her test was positive. Upon subsequent testing she learned that she was also positive for hepatitis C. Lisa has used her experience to educate other about the importance of needlestick prevention and post exposure protocols (Healthcare workers are at serious risk of injury on the job, 2011).

Karen Daley, past President of the American Nurses Association, is not only an advocate for needle stick injury prevention but she is also a victim. She contracted HIV and hepatitis C from a needle that was protruding through a sharps container. Dr. Daley was instrumental in getting the 2000 Needlestick Prevention Act enacted. She has campaigned to help nurses be safe in their work environment. She emphasizes that nurses need to recognize unsafe procedures and be willing to fight for their safety in the work place (ANA, 2010).

     A hero is an ordinary individual who finds the strength to persevere and endure in spite of overwhelming obstacles.

     Christopher Reeve

Approximately half of nurses working in a clinical setting will sustain at least one needle stick in their career (Daley, 2014). The World Health Organization estimates that needle sticks are responsible for 37.6% of health care workers contracting Hepatitis B, 39% contracting Hepatitis C, and 4.4 % contracting HIV/AIDS (Nagandla et al, 2015). The CDC (2010) estimates that 384,325 percutaneous injuries occur each year in U.S. hospitals. However, it is also reported that 40-70% of needle stick injuries are not reported (CDC, 2010). Several professional organizations including the ANA, CDC, OSHA and Association of periOperative Nurses (AORN) have produced policies and standards of practice to reduce the number of needle stick injuries (NSI). This includes the Needlestick Safety and Prevention Act of 2000 that mandate employers provide safer medical devices and requirement for NSI reports (U.S. Department of Labor, 2011) and the Stop Stick Campaign developed by the National Institute of Occupational Safety and Health (NIOSH) to raise awareness of a safety need. Although the rate of needlestick injuries has dropped 31.6 percent in non-surgical areas, these injuries are still prevalent in surgical area and for new nurses (Akridge, 2013).

Needlestick injuries (NSI) are defined as injuries sustained by hypodermic needles, blood collection needles, intravenous stylets and needles connecting intravenous systems (Kuhar et al., 2013).  Although NSI are a serious concern for nurses and other medical professions, it is believed that most NSI go unreported and fewer are actually documented (Sayami & Tamrakar, 2013). In fact, a study by Adhikari et al reported that half of nursing student studied had a needle stick injury that they did not report. Furthermore, these students stated that they were aware that HIV and HBV were commonly transmitted via needle stick injuries (Adhikari, 2008). Not following proper procedures is a main cause for continued exposure at all nursing levels and areas. Studies are abundant that report nurses are often in a hurry, stressed or forget to follow protocols for needle disposal and other sharps objects (Ford, 2013; Gounder, Beers, Bornschlegel, interland,& Balter,2013; Jain, Dogra, Mishra, Thakur,& Loomba, 2012). These studies also report that most needle stick injuries are preventable.

It is estimated that 1 in 10 health care workers sustain a needle stick injury yearly by sharps and needlestick injuries (Henderson, 2012). Thus exposing themselves to over 20 pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), human T lymphotrophic retroviruses (HTLV I & II), hepatitis D virus (delta agent activated by HBV), cytomegalovirus, Epstein-Bar virus, parvoviris B19, transfusion transmitted virus, West Nile virus, marlarial parasites and prion agents (spongiform encepholopathies) (Elseviers, Arian-Gullen, Gorke & Arens, 2014). Risk of actual infection depends upon the strength of pathogen in the patient’s blood and the transmission rate. The average risk of HIV transmission is about 1 in every 325 or about 0.3% documented exposures (Henderson, 2012; CDC, 2013). However, the infection rate of HBV is much more likely and is estimated at 6% to 30% and the risk for contracting HCV is about 1.8%  (CDC, 2013). The World Health Organization estimates that 16,000 cases of hepatitis C, 66,000 cases of hepatitis B and 1000 cases of HIV occurred due to occupational exposure in 2000 worldwide (Adib & Lotfi, 2013).

There appears to be an organizational factor of culture and structure that is connected with decreases in NSI. Magnet hospitals, for example, have shown a decrease in NSI between 20-34% (Cho, et al 2013). Factors attributed to this decrease in NSI are adequate staffing, a work environment that uses precautions and an organization that provides resources for nurses.  This is opposed to nurses who work in an unorganized, understaffed and stressful environment (Valent, et al, 2016).  In fact, a study done by Wicker et al (2014) revealed that 48.3% of NSI were related to stress and 36.6% were related to tiredness. The nurse that is educated on needle stick prevention and understands the impact of factors with in an organization will be best equipped to prevent needle stick injuries for themselves and for others.

There are many incidences where NSI can occur. The Stop Sticks Campaign reports that 48 % of injuries occur during use and another 30% occur during activities after use and prior to disposal (2011). Furthermore, there are certain devices that seem to be closely related to NSI. Devices with the highest number of NSI are disposable syringes (31%), suture needles (24%) and winged steel needles (5%) (Stop Sticks Campaign, 2011). Several studies also reported that hollow-bore needles account for approximately 38% of NSI (Hanafi, Mohamed Kassem & Shawki, 2011; Adams, 2012). Health care organizations can implement several strategies to decrease needle sticks. Following legislation and guideline using safe work practices and correct devices is a system wide example. Also, educating those on the frontline on proper use of potential NSI devices and policy for exposure is needed. Unfortunately, several studies show that compliance is with guidelines is not the norm in most facilities (Adib, Mohsen & Mohammad, 2013). One strategy is at the staff level and is focused on shared values. That is creating an organizational culture of safety.

One of the most important ways in which needle sticks injuries can be prevented is to develop an organizational culture of safety (Zacharias, 2014). Employees and management must all commit to using safety protocols every time a needle is used. The commitment by all the staff provides a culture of safe practice and motivation for individuals (Zacharias, 2014). The culture of an organization should take on a personal perspective for staff.  Leaders can promote shared values to influence attitudes and shapes perceptions for of what is normal in the organization as well as provide motivation to practice safely (Weaver, et al, 2013). Some interventions to promote a culture of safety are team training, executive walk arounds and shared outcome identification (Weaver, et al, 2013). However, there are also mandates that need to be followed and should be included when promoting a culture of safety in the organization.

Legislation to reduce occupational transmission of bloodborne pathogens began with the Bloodborne Pathogen Standard Act in 1991 by OSHA, which was enacted to limit the exposure of health care workers to bloodborne pathogens (Perry, Jagger, Parker, Phillips, & Gomaa, 2012). This act required employers to implement universal precautions and provide Personal Protective Equipment to employees. Furthermore, standards were set forth and required to prevent needlesticks, splashing, packing of bodily fluid specimens and disposal of sharps. However, recommendations for prevention of needlestick injuries were first promoted by the CDC in 1983 then became part of the Universal Precaution recommendations in 1987 and 1988 (Perry, Jagger, Parker, Phillips & Gomaa, 2012).

Then in 1993 The Food and Drug Administration issues guidelines for sharps disposal containers. This emphasized the importance of safe containers for needle and sharps disposal that was stated in the 1991 OSHA regulations. Again in 1998 more regulation focused on sharps containers. The National Institute for Occupational Safety and Health issued Selecting, Evaluating and Using Sharps Containers. This guide was set forth to make sure health care facilities had sharps containers that were functional, accessible to staff, visible by staff, and accommodating for staff (Perry, Jagger, Parker, Phillips & Gonna, 2012). Finally in 2000, with the help of nurses, the U.S. Congress passed the Needlestick Safety and Prevention Act (HR5178). This law regarding needlesticks, required health care employers identify, evaluate, and use of effective and safe medical devices (Needlestick Safety and Prevention Act of 2000, Public Law 106-430, 114 Statute 1901, 2000)

 
 

In October of 1997, a nurse by the name of Lisa Black was assigned to work with several patients on night shift including a patient with active AIDS. While attempting to remove a blood clot from the patient’s IV line, the patient startled. His arm jerked, and the needle that was inserted in the IV punctured Lisa’s palm. She immediately was treated prophylactically. Although she returned to working on the floor, she was fired for making several errors on the job. She had difficulty remembering things and paying attention was equally difficult. She was again fired from a second hospital for similar issues. Finally at her three-month post-exposure blood work session she was declared negative and free from HIV. However, nine