Procedure after Sharps Injury

What is it?

Sharps injuries, also known as needlestick injuries, are among the leading causes of occupational hazards for healthcare workers, including HIV, HBV (hepatitis B), and HCV (hepatitis C). Healthcare workers risk injury from needles and other sharp instruments during many routine procedures. Injuries often occur after use and before disposal of a sharp device but can occur during use and disposal.

To minimise the risk of spread of infection, all blood and body substances should be treated as potentially infectious. Accidental exposure may still occur through puncture by a used needle or any sharp object.

Guidelines for treatment

 

First aid

If blood has contaminated the skin, but no cut or puncture is evident, wash the area thoroughly with soap and water. Check the skin with an alcohol solution to ensure skin is not broken in any way

If exposure has occurred from a sharp object (e.g., laceration or puncture from a needle or other sharp instrument), wash the area thoroughly with soap and water. Apply a waterproof occlusive dressing to the site. DO NOT squeeze or bleed the site

Remove any contaminated clothing and shower if necessary

Report the incident

Any employee who sustains a sharps injury must report the matter immediately to their supervisor, no matter how trivial.

Supervisor's action

The supervisor must immediately refer the employee to the person in charge.

Manager or charge person action

Assess the nature of the incident and ensure proper first aid measures have been carried out. Ascertain employee's hepatitis B vaccination status.

Refer serious exposures immediately to the nearest hospital or medical centre for assessment and counselling. In high-risk exposures involving infectious or potentially infectious body fluid, post-exposure prophylaxis efficacy is greater if administered within 1 or 2 hours of exposure. Prophylaxis can be commenced up to 72 hours post-exposure.

Less serious exposures can be followed up at the nearest hospital or medical centre as soon as practicable after the incident.

Ensure the affected employee is relieved from duty as soon as practicable and transported promptly to the nearest hospital or medical centre.

All medical consultations and blood tests will be done at the aged care facility's expense.

NSW, VIC & QLD Health Departments provide a 24 hour a day Blood and Body Fluid Exposure Phoneline which provides confidential advice and counselling. 

For information phone: 1800 804 823 (NSW & VIC) 1800 633 353 (QLD).

Complete an incident form

An incident form must always be completed as soon as possible and forwarded to the manager or nominated charge person. If the source is a resident, include the medical record number and HIV or HBV and HCV status (if known), and the name of the resident's Doctor.

The reason for the sharps injury will be discussed with the employee involved to establish that there was no breach of facility policy and address any possible preventative or remedial actions.

Hepatitis B and HIV status of source resident

If the source resident is known and testing is required, the resident's Doctor is to be contacted to organise counselling for the resident and obtain the resident's informed consent to test. Where the resident is unable to give consent, refer to guardianship requirements.

For comprehensive information regarding occupational exposure to blood and body substances, refer to NHMRC (2019) Australian Guidelines for Infection Prevention and Control in Healthcare or Starship's Guidelines on Needlestick Injuries.