HEALTH AND SAF E T Y


explaining how they would deploy the safety guard on e.g., the hollow bore needles.


l Lack of consistency in reporting sharps injuries to the organisations’ own internal occupational health services.6


A study undertaken in 2000, at a large teaching hospital Trust in the UK, found knowledge of risks among anaesthetists to be poor. This is surprising, considering how high risk the specialty workforce is, given that repeated handling of needles, peripheral IV cannulation, insertion of central venous catheters and arterial cannulations are all high risk procedures.7


COVID-19 has raised awareness of the occupational hazards for healthcare workers and indeed the HSE has reported a sharp increase in 2022 of injuries to workers in general.8


Reporting the incident is an integral part of the Regulations with duties expected of the employer to record the exact details of the incident, where and when it occurred, and the type of sharp that was involved.


Not specific to healthcare nor to needlestick injuries but generally to work- related ill-health, they report an increase of 5.8% year-on-year, which is a worrying trend.


Prevention and management Examples of good practice identified by the Health and Safety Executive inspections9 showed that infection control teams working closely with health and safety staff, and using occupational health at a strategic level, is an ideal model for maintaining continuous improvement in the prevention and management of sharps injuries. Procurement had a role to play in ensuring that traditional sharps were not stored alongside safety devices, as this caused confusion and inconsistency for staff. Where it was shown that there was no suitable safer sharps device available and non-safety devices had to be continued to be used, these should be stored in the relevant area together with the risk assessment and procedure for working with those devices. Learning points from analyses of


incidents was included in the training, as well as highlighting high risk areas from internal data and having systems in place to audit these areas. Training should always be part of providing a comprehensive risk management strategy. The training should cover the biological agents that staff are exposed to, as well as the precautions they should use to protect themselves, including the use of PPE and safe methods of disposal. In addition, it is essential that staff know what procedures to follow in the event of an injury. How to report incidents and what follow up to expect from the organisation should also be included in the training. Reporting the incident is an integral part


of the Regulations, with duties expected of the employer to record the exact details of the incident, where and when it occurred, and the type of sharp that was involved. The employees’ training must be clear to highlight the responsibility for them to notify the incident and on any other processes to be followed, particularly if the person works away from the employer’s premises. The extent of the accident investigation will depend on the potential severity of the incident. Injuries with a contaminated device or sharp will require further detailed investigation compared with a clean needle or sharp.


The purpose of the investigation is to highlight whether the risk control measures are sufficiently adequate. It should look at


underlying and root causes, as well as the immediate factors which led to the accident. Any lessons learned should be applied across an organisation and not just the location or department where the incident happened. If the incident reported has a


contaminated sharp involved, especially if this exposes them to a blood borne virus (the patient status needs to be known) then the employee needs to have immediate access to medical advice, be offered post-exposure prophylaxis and the employer must consider whether counselling would be appropriate for the employee.


Conclusion


Needlestick injuries are common healthcare workplace hazards. Many injuries that occur to workers go unreported which is of considerable concern as the seriousness of the consequences, if ignored, are high risk to the individual.


The reasons for lack of reporting are generally not the focus of research and are often underestimated by the healthcare professionals. The risks of seroconversion are low but none-the-less do occur with considerable impact to the individual. The law exists for a purpose; it is bizarre that health professionals – who know better – ignore their own health protection.


CSJ


References 1 Worldwide Prevalence of Occupational Exposure to Needle Stick Injury among Healthcare Workers: A Systematic Review and Meta-Analysis. - Abstract - Europe PMC


2 Health and Safety (Sharp Instruments in Healthcare) Regulations 2013: A guide for employers and employees HSIS7 (hse.gov.uk)


3 Hosseinipalangi Z. et al 2022 Global, regional and national incidence and causes of needlestick injuries: a systematic review and meta- analysis 1020-3397-2022-2803-233-241-eng.pdf (who.int)


4 Ibid 5 Health & Safety Executive 2016 Prevention and management of sharps injuries: Inspection of NHS Organisations (hse.gov.uk)


6 Ibid 7 Diprose P, Deakin CD, Smedley J. 2000 Ignorance of post-exposure prophylaxis guidelines following HIV needlestick injury may increase the risk of seroconversion (sciencedirectassets.com)


8 HSE statistics 2022 reveal a sharp rise in worker injuries (worknest.com)


9 Ibid 20 l WWW.CLINICALSERVICESJOURNAL.COM JANUARY 2023


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68