March 16, 2001

As a nurse working in the Infectious Disease Unit, Sharon Irvin, RN, is all too familiar with needlestick injuries. She knows firsthand how a clinician can accidentally get stuck with a needle during patient care. Even though she knows the proper procedures for handling such an incident, Irvin (pictured below) was so stunned when it happened to her six months ago that she wasn't sure what to do at first.

"I think I was in a state of confusion when it initially happened," she says. "I was giving an HIV patient a testosterone injection, and I accidentally stuck my middle finger with the needle. I didn't want to tell anyone at first. I've been a nurse for 17 years, and nothing like this has ever happened to me before."

After she composed herself, Irvin realized what she needed to do. She first told her supervisor and then called MGH Occupational Health Services (OHS) to report the incident.

According to June Carroll, RN, of OHS, Irvin's reaction is typical. "I think most employees are stunned when it first happens, but Sharon did the right thing," she says.

The first thing an employee should do if he or she gets stuck is to wash the area with soap and water, then tell a supervisor and call OHS. An OHS nurse practitioner will then evaluate the incident and the risk for the employee. If the exposure risk is considered high or the patient being treated at the time is not identified, the employee is offered preventive medications immediately. The patient's physician is contacted to see if the patient will consent to being tested for obvious infectious diseases such as hepatitis B, hepatitis C or HIV, that could be transmitted to the employee.

Fortunately, in Irvin's case, she knew about the patient's condition and was relatively sure that she would not test positive for HIV. She took medications for two weeks and went back to OHS for check-ups after one month and three months, then once more for a six-month follow-up.

"I'm fortunate that the incident didn't affect the way I do my job," says Irvin. "It affects some employees emotionally, but I work with patients with infectious diseases every day. I think this actually has helped me take better care of my patients. I can assure them that I know what it feels like to take these medications."

Injuries resulting from work-related needlesticks are estimated to be between 600,000 to 800,000 annually. However, about half of these go unreported. According to a recent study by the Centers for Disease Control and Prevention, an average of 385,000 needlestick injuries are reported annually in U.S. hospitals.

In 1991, the MGH established a task force to address work-related needlestick safety issues and to focus on providing safer sharp devices. These devices reduce the risk of exposure to blood and body fluids. The Needlestick Reduction Task Force has stepped up its efforts during the last year, and has made a series of evaluations and introductions of new products to help reduce the number of needlestick injuries.

"While practicing standard precautions is important, it is the combination of precautions and the use of safer devices that decrease the risk of being exposed to infectious diseases," says Susan Loomis, director of OHS. "We want to encourage employees to report any exposure promptly. Every report is reviewed to consider whether a safer sharp device could have prevented the incident. Reporting an incident not only helps the employee involved, but it also can help us provide a safer environment for all employees."

For more information, call OHS at 726-2217 or visit the Needlestick Safety web site at http://is.partners.org/nrtf/Needlestickhome.htm.