Quality and Patient Safety Articles-Percutaneous Sharp Injuries: Primary Prevention

Percutaneous Sharp Injuries: Primary Prevention

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Percutaneous sharp injuries, such as needlestick injuries, are a risk for healthcare workers. While the rate of blood-born pathogen seroconversion has decreased, there are still associated stress and costs. Primary prevention strategies should be prioritized to decrease the risk of these injuries.  <br />Factors that affect the likelihood of seroconversion following a sharps injury include the viral load of the patient, immunocompromised state of the healthcare worker, depth of injury, and the use of gloves by the healthcare worker. The use of gloves during the procedure correlates with a decreased risk of seroconversion. HBV has the highest risk of seroconversion due to its high concentration of viral particles, but the risk is nearly eliminated after full vaccination. The risk for seroconversion from an HIV or HCV infected source is around 0.3% and 0.2% respectively.  <br />A survey among electromyography (EMG) physicians found that 64% had experienced a percutaneous sharp injury while performing needle EMG, with 14% of those indicating the source patient had HIV, HBV, or HCV. However, percutaneous sharp injuries during EMG are lower risk in nature due to smaller gauge and solid bore needles. 73% of respondents always wore gloves during needle EMG. The AANEM recommends wearing gloves during the procedure and avoiding recapping needles. Used needles should be disposed of according to OSHA requirements.  <br />Overall, healthcare workers should prioritize primary prevention strategies such as using gloves and avoiding recapping needles to decrease the risk of percutaneous sharp injuries and seroconversion.

Keywords

Percutaneous sharp injuries

needlestick injuries

healthcare workers

primary prevention strategies

viral load of the patient

immunocompromised state

use of gloves

HBV seroconversion risk

HIV seroconversion risk

HCV seroconversion risk