Sustaining a needlestick injury or other type of exposure is scary. According to the CDC, there is an average of 385,000 sharps-related injuries annually among healthcare workers. Healthcare workers are at risk for contracting diseases such as Hepatitis B or C as well as HIV – which can be terrifying. Despite legislation for needlestick prevention and safety measures in place, accidents do happen, and nurses need to know what to do in case of an exposure. Show
The actions taken after exposure depend on the type of exposure. For sharps/needlestick injuries, nurses should immediately wash the area with soap and water and "milk" the area to encourage bleeding. Viruses begin to multiply rapidly once in the bloodstream, so preventing entry into the bloodstream in the first place is extremely important. For splash exposures, nurses should scrub the area thoroughly with soap and water. For splash exposures involving mucous membranes (eyes, nose, mouth), irrigate the area well with water. RELATED: Accident/Error and Incident Prevention: NCLEX-RN Nurses should immediately report exposures to a supervisor. This is one of the largest problems; nurses are extremely busy and sometimes choose not to report right away. They may not want to "dump" their work on others and sometimes they are afraid of discipline for reporting a sharps injury. Some are even embarrassed, or are too frightened to face the possibility of contracting a disease or too much in shock to report. However, reporting should not be delayed – treatment should begin immediately to help prevent transmission of bloodborne pathogens. Once reported to the provider, several things may happen at once. In some cases, the patient is contacted and blood work ordered to check Hepatitis B and C status as well as HIV. This is only if it is known where the exposure came from. Also, the patient must give consent to check blood work. Concurrently, the nurse would also get baseline lab work done. A Hepatitis B vaccine may also be indicated, and the nurse may choose the option of starting post-exposure prophylaxis (PEP) to reduce the transmission of HIV. Subsequent blood work (for at least six months) to monitor conversion status may also be indicated. Learn more about the role of HIV/AIDS RNs. RELATED: How Do Nurses Protect Themselves from Highly Infectious Patients? Nurses may also benefit from counseling services. As stated earlier, an exposure can be very stressful and scary, affecting not just the patient and nurse but the nurse's family as well. Some nurses feel like they "failed" by experiencing a needlestick or other type of exposure, playing the scenario back to find out how things could have been done differently. Unfortunately, needlestick and other types of exposures happen. Nurses can reduce their risk by following safety measures and using needleless systems (when possible) and activating the safety device on sharps. Proper use of personal protective equipment (PPE) when performing a procedure or task that has a high risk of exposure to body fluids is also critical. Nurses should also avoid rushing and "cutting corners" as it could result in an accidental exposure. RELATED: How Do Psychiatric Nurses / NPs Stay Safe on the Job? For more information on what to do following an exposure, please visit the CDC website. Featured Nursing Programs
Amanda Bucceri Androus, RN, BSN Amanda Bucceri Androus is a Registered Nurse from Sacramento, California. She graduated from California State University, Sacramento in 2000 with a bachelor's degree in nursing. She began her career working night shifts on a pediatric/ med-surg unit for six years, later transferring to a telemetry unit where she worked for four more years. She currently works as a charge nurse in a busy outpatient primary care department. In her spare time she likes to read, travel, write, and spend time with her husband and two children.  Related Articles
Per the CDC, a sharps injury is a penetrating stab wound from a needle, scalpel, or another sharp object that may result in exposure to blood or other body fluids. This can include scalpels, razors, needles, lancets, blades, broken glass or any other sharp implement. The CDC knows there are many needle sticks and sharps injuries that occur during a year in hospitals and healthcare facilities, with over half of them unreported. Most happen innocently, like when nurses are caring for patients, or when a needle is being recapped with two hands. What risks do these injuries pose, and what's the best way to treat and avoid them? What to Do If You Experience a Sharps InjuryFirst, don't panic. Know that it's OK. Most needlesticks, splashes, and sharps injuries do not result in the transmission of any worrisome infections, so take a deep breath. This situation usually turns out just fine if you follow up, as needed, with a medical provider. There were 58 known workplace transmission of HIV and 150 suspected cases of HIV due to workplace exposures. It's important to follow up with medical care immediately if there has been an exposure. If you have just had a needlestick or a sharps injury:
If you've been splashed with blood or a body fluid:
Splashes to intact skin should be washed off, but without splashing mucus membranes (mouth, nose, eyes, etc.) or non-intact skin (cuts, abrasions, sores, burns). This probably poses no risk for major blood-borne illnesses, but please follow safety protocols where you work and check with a medical professional about any exposures. Why Do You Need to Immediately Seek Medical Treatment?There are certain diseases like HIV, Hepatitis B, and Hepatitis C that can spread through blood exposure and it's important to take any steps immediately to reduce the risk of transmission. Post-exposure prophylaxis refers to medication or other interventions that can reduce the chance of developing a disease after being exposed to an infection. This can mean a daily medication for HIV, or a vaccination and immunoglobulin injection for Hepatitis B. For HIV exposure, these drugs only need to be taken for 4 weeks (28 days). But it's important that this daily treatment is started as soon as possible. You need to start the drugs within 72 hours, but better yet within the first 24 hours of being stuck. Medical clinicians in the US can call the Clinicians' Post Exposure Prophylaxis (PEP) Line at 1-888-448-4911for help. Post-exposure prophylaxis can also be used after someone has been exposed to the infection through rape or through consensual sexual activity. Do All Splashes and Needlesticks Need Treatment?Always wash away any body fluids and clean any needlesticks or other injuries, but talk to your healthcare provider about whether you actually need treatment. If the needle or sharp has not been used on anyone else, it won't, of course, transmit any infections from anyone else. An injury though can always become infected like any other injury so it's important to keep any injury clean. If, on the other hand, the needle to sharp had been used on someone else, the source patient (whose blood was on the needle) could transmit infection. But if the person does not have any infections that you might be concerned about, you may not be at risk for anything in particular. This is something you should talk about with a healthcare professional to help understand what risks you may or may not face. If you're a healthcare provider, you may know whether the patient had HIV, Hep B, or Hep C. Depending on the laws and regulations, there may be a way to quickly find out if the source patient is infected with any of these viruses. This will depend on where you are and what the exposure was. Please talk to your healthcare provider about this. Likewise, not all body fluids transmit all infections. HIV is transmitted by:
HIV can also be transmitted by fluids that would only be reached by a needle or scalpel during a medical procedure:
However, other fluids would normally have to have blood present to transmit HIV. The risk of HIV transmission is very low, without blood, from:
This means that being spit on is not a risk factor for HIV. Likewise, being scratched also doesn't spread HIV if there is no contact with HIV+ blood. HIV is also not spread through swimming, the air, mosquitoes, hugging, sharing toilets, sharing food or drinks. Likewise, although Hepatitis B virus can be found in saliva and spit, it is not believed to be spread through kissing or sharing utensils, per the CDC. Also, the good news is that needles do not remain infectious for long. An old needle, long abandoned on the street, is unlikely to be a risk, but do talk to your healthcare provider about each exposure. Are Only Nurses at Risk?Most Needlesticks and Sharps Injuries affect nurses and doctors. However, some injuries affect those who are not medical professionals. It's important to always stay safe when there are needles, scalpels, or blades around. A child may try to reach into an overfilled sharps box to pick up a shiny needle. A groundskeeper in a park may be pricked by a needle left on the ground. A police officer or a corrections officer may be injured by someone with a bloody needle or knife. Someone else may worry about their risk because their spouse is a nurse who has had a needlestick. Similar exposures can occur in the home with razors, blades, and even a needle used for a splinter. This can also happen, in rare cases, if a tattoo parlor or a nail salon does not follow necessary safety regulations. There are lots of ways that these sorts of injuries can affect all of us, so seek medical advice if there's any concern for exposure. In some places, health facilities are not in line with Infection Prevention and Control. This is one reason for the spread of Hepatitis C worldwide. There are times when needles are reused. Sometimes IV fluids or IV tubing are reused. Other times reusable devices are not fully decontaminated between usages. In other cases, needles are used after patient use to obtain more medications from a shared reusable medicine container. Reuse of needles in any form after use in a patient can lead to spreading infections. What You Can Do to Prevent Needlesticks or Sharps InjuriesIt's about being prepared.
Just to be on the safe side, don't use needles unless you know what you're doing and you need to. There's a risk in using a needle. Every time you use one it can risk a needlestick. It can also create more risks for the patient (who can always get an infection and pain at the site of the injection). In general, only use needles when well trained to do so and when it's necessary. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
By Megan Coffee, MD Thanks for your feedback! Which actions by a nurse are reportable to the state Board of Nursing?Complaints received by the Board of Registered Nursing are reviewed to determine if the Board has the authority to investigate the complaint.. gross negligence or incompetence.. unprofessional conduct.. license application fraud.. misrepresentation.. substance abuse.. mental illness.. unlicensed activity.. Which client in the emergency department should the nurse see first?Which client does the nurse prioritize to see first? A client experiencing chest pain and diaphoresis would be classified as emergent and would be triaged immediately to a treatment room in the ED. The other clients are more stable. A nurse is triaging clients in the emergency department.
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The nurse accidentally sticks him/herself in the finger with a clients contaminated needle
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