Setting Up a Needlestick Protocol: 5 Best Practices for Facilities

Needlesticks are a common healthcare hazard, with an annual average of 385,000 injury occurrences among hospital-based workers. To minimize risk and establish a culture of safety in your facility, setting up a needlestick protocol is crucial. It not only informs staff of the necessary welfare steps following a percutaneous injury, but can also ensure that clinicians feel supported in coming forward about a needlestick incident.

In this article, we’ll give a brief overview of the issue and dive into some best practices for developing needlestick injuries protocols. Curious about how it may look before getting into the details? Here’s a downloadable template that you can use as a guide when creating your facility protocol:

Common Types of Accidental Needlesticks

Handling needles is often unavoidable in clinical care. They’re a necessary tool for tasks like suturing, and drawing up and delivering medications. Here are the six devices that account for the largest majority of injuries:

Of those, disposable syringes and suture needles have the highest rate of needlestick occurrences. Handling sharps devices like these can often become so routine for clinicians that they may forget to follow needle injury prevention measures. In high pressure situations, rushing through tasks may also risk sharps-related injuries. Needlestick injuries can occur during:

• Needle insertion, manipulation, or withdrawal from the patient.
• IV line access.
• Transit to disposal or during cleanup.
• Collisions between staff members handling needles.
• Accidental exposure due to left-behind or forgotten needles.

Why is Needle Safety a Healthcare Priority?

At a minimum, accidental sharps exposure can be costly for institutions as affected employees will have to leave their shift to receive follow-up care. This leaves a unit or department liable for the cost of the incident in addition to the costs associated with overtime — and any additional staff coverage that’s needed — as well as potential fines for workplace safety violations.

However, the true risk is the safety and wellbeing of the staff member. Exposure to a contaminated sharp has the potential to transmit as many as 20 bloodborne pathogens. The ones with the most clinical significance are classically considered to be hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). All of these have the potential to greatly alter life expectancy and incur ongoing treatment. After any accidental needlestick, diseases, or their threat of contraction, can also affect mental health and availability for continued work.

How to Set Up a Needlestick Protocol: 5 Best Practices

Given the risks to employee welfare following the misuse of a needle, stick-related percutaneous injuries must be treated quickly. Yet as many as half of all needlestick exposures go unreported. Combat this troubling statistic and ensure the safety of your staff through a well-crafted (and informed by the CDC) needlestick protocol. Here are some best practices to guide yours.

1. Prioritize Quick Responses

Accidental, contaminated needlesticks risk infection and ongoing harm to employee health. Handwashing and quick follow-up care measures are critical aspects of a safety-minded needlestick protocol.

Tips:

• Highlight first aid measures as the first follow-up step.
• Include necessary communication and notification to ensure proper reporting.

2. Ensure Medical Follow-Up

Some exposure incidences are considered medical emergencies. Healthcare staff are known for putting off self-care and placing the job’s needs first — but after an exposure incident, it’s critical that they seek care as quickly as possible.

Tips:

• Mandate expedient evaluation for the employee and ensure that participation from source-individual is requested.
• Detail pertinent diagnostic measures to reinforce the necessity of thorough care.

3. Standardize Associated Documentation

Utilizing a standard incident form and a well-established sharps injury log can help streamline documentation processes and maintain regulatory compliance. For example, the Needlestick Safety and Prevention Act requires the specification of all involved devices, injury location, and event details.

Tips:

• Specify what documentation is required and which templates (such as an incident form) must be used.
• Include minimum timeframes for documentation to ensure accuracy and completion.

4. Follow Reporting Guidelines

Some regulations require documentation to be completed and maintained on-site where others require prompt external notification. The latter may go beyond OSHA’s national reporting standards to include certain state health departments, such as Texas’s. Including the necessary reporting guidelines adds clarity in a situation that can quickly become overwhelming.

Tips:

• Denote all reporting obligations to ensure compliance after an incident.
• Check your local state health board reporting requirements and include them in the protocol.

5. Evaluate Outcomes and Educate

Avoid another injury occurrence by provisioning follow-up evaluations that may inform future training and staff education. Investigating the root cause of an incident could identify important information like a faulty device, which would then need to be reported to protect other vulnerable workers.

Tips:

• Ensure employee (or occupational) health is involved in the follow-up plan.
• Include a post-event meeting to review the incident and assess the employee’s wellbeing and needs.

Needlestick-Related Injuries in Healthcare: FAQ

Having a protocol in place reinforces the imperative of needle safety and can help engage your staff in further protection measures. Before you reform your existing program or roll-out a new one, here are a few key questions to consider regarding needlesticks in healthcare.

Is the patient contaminant source notified or involved in the protocol implementation?

To establish the extent of the exposure and better manage future needlestick injury symptoms, the source patient must be notified so that informed consent can be given to acquire necessary laboratories. Having this participation is crucial, which is why it belongs in needlestick protocols. Some states, like Maine, may even allow courts to intervene if a source-individual refuses to comply with follow-up measures.

Is there a healthcare role that is more at risk than others?

Data indicates that inpatient units and operating rooms experience higher levels of blood and body fluid exposures — like from needlesticks — than other work settings. The same study identified that nurses (followed by doctors) experience the highest rates of exposure incidences. However, all healthcare employees are at risk in facilities where sharps are used, and standard precautions should be maintained by all.

How can facilities prevent needlestick related injuries?

Needlestick injury prevention begins with establishing a culture that celebrates transparency, productive communication, and safety. Consistently encouraging near-miss reporting and prioritizing honesty are excellent methods to improve current practices and education. Other prevention considerations include:

• Educating and training staff on sharps safety policies and procedures.
• Eliminating sharps use where possible
• Enforcing the requirement of safety devices for all needles via purchasing power.
• Following OSHA recommendations for safe disposal practices.
• Encouraging open dialogue and team participation in needle safety program revisions.

Does recapping needles or any other post-use blunting measure help reduce risk?

Though injuries occur during the disposal and cleanup process, recapping is generally viewed as very high risk and is typically not recommended unless required by certain procedures. Unless absolutely necessary, clinicians should never recap, bend, or remove needles from a contaminated sharp.

How can healthcare leaders best support injured staff?

Exposure risks and complications following a percutaneous injury may lead to occupational stress, anxiety, and even depression. Leadership can show support for affected staff members by immediately addressing any fears associated with potential reprisal, and providing for the team’s emotional needs. Accomplish this by establishing and reinforcing trust, encouraging mentorship programs for struggling individuals, and providing access to emotional support resources as needed.

Continue Prioritizing Your Commitment to Staff Safety

With a needlestick protocol in place, your team is better protected against one of healthcare’s common hazards. Make more strides with your goals to improve staff wellbeing through IntelyCare’s robust array of beneficial outcome strategies and facility guides for developing your ideal workplace environment.