Needlestick injuries to health-care workers and other hospital employees is commonplace. It is estimated that over 800,000 needlestick injuries occur each year in United States hospitals. (Tan 2001) This section will review specific safety devices available to health-care workers to prevent such injuries. For further discussion of needlestick safety, as well as of occupational transmission of blood-borne diseases, please refer to the Universal Precautions section of the General Principles chapter.

 
Safety catheters

As mentioned in the Equipment section, there has been a proliferation in recent years of devices designed to prevent accidental needlestick injuries. Over 1000 patents have been issued in the United States since 1984 for such devices (Russo 1999); thus, it would be impossible to cover all such equipment in this forum. It is the clinician's responsibility to 1) be knowledgable of the equipment used in his/her environment, and 2) use that equipment in the appropriate manner.

 

The angiocathers used at our institution feature retracting needles and flash chambers that are activated with a touch a button.

 

Other safety devices that are commonly used include folding covers that securely snap onto needles after use. This devices should be activated immediatly after use to avoid risk of needlestick. Recapping of needles is strongly discouraged, and is in fact a violation of OSHA regulations. (NIOSH 1999).

 

All needles, including those that have safety devices that have been deployed, must be disposed of in approved, puncture resistant containers.

 
It should be noted that the highest risk needlestick is that which involves a hollow needle that has been in an artery or vein. The great majority of healthcare workers who have contracted HIV from occupational exposures occurred in this fashion. (Cardo 1997)
"Needle-less" Systems
In addition to safety catheters, many systems have been developed that obviate the need to use the sharp needles at all. Historically, it was standard practice for intravenous medicines to be administered into intravenous tubing via a sharp needle attached to a syringe. This practice should be discouraged, and a needleless system should be used if available. The use of such systems has been shown to decrease the incidence of needlestick injuries. However, their efficacy in reducing the transmission of blood-borne infectious diseases is unproven, mainly because the risk of disease transmission from needles that has not been exposed to blood is extremely low. (Russo 1999)
 
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Universal Precautions

Appropriate Universal Precautions should always be maintained to protect the patient, the person performing the procedure, and other individuals involved in all aspects of care (i.e. housekeeping staff who clean the room). This includes handwashing, the use of gloves and other protective barriers, proper sharps disposal and the correct usage of safety features. Please see the Universal Precautions section of the General Principles chapter for further discussion.

 

 

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