Ethico-legal aspects of the protocol for needlestick injuries.
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The objective of the present study was to assess the incidence of sharps/needlestick injuries among dental health care workers (DHCWs) at Armed Forces Hospital Riyadh. A questionnaire was distributed among all dental staff, including dentists, hygienists, and dental surgery assistants. Results show that 65 individuals (58%) had sharps/needlestick injuries, and of these, more than half did not report these injuries to the appropriate department. At the time of injury, the majority of the DHCWs were vaccinated or immune, but a few of them were not vaccinated against hepatitis B virus. This study concludes that every DHCW should be immunized against hepatitis B virus to avoid cross-infection from sharps/needlestick injuries, which are quite common in a dental practice. The high frequency of these injuries could be reduced by simple interventions.
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Exposure to contaminated sharp objects is one of the inherent hazards of working in a clinical setting. Today, primarily due to concerns about possible HIV infection, a "terror-factor" strikes mortal fear, whether imagined or real, in the heart of individuals who suffer a subcutaneous sharp object injury. The psychological effects of sustaining a sharp object injury and the actual danger of contracting a potentially lethal viral infection following such an occurrence are discussed. Methods of avoiding a sharp object injury and possible treatment options are also considered.
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You might be out of compliance with a directive from OSHA, which instructs inspectors to cite hospitals for failure to evaluate and purchase safer needle devices. You are at risk for fines of $7,000 for serious violations and $70,000 for willful violations if you aren't evaluating and purchasing safer needle devices. A new federal law requires the use of safer devices, and that employers solicit input on new devices from employees. More than 250 federally approved safer needle devices are available. Designate senior employees to train less experienced staff when new devices are used.
It's 11:30 PM on a Saturday night, and you just stuck yourself with a contaminated needle. Suddenly, you have a problem. You remember that you have to act fast and you need a form, and the source has to be tested, but the details are somehow lacking. Now what do you do and where do you go? Where are those forms that you need? And didn't that procedure change last year? Now imagine being able to get all your questions answered and finding your forms with a few clicks of a mouse....
During the course of a year, there are many healthcare workers nationwide who sustain sharps injuries whilst carrying out their duties. Staff who work in the Accident and Emergency (A & E) units are no different from anyone else in this respect. The emotional cost of such an accident cannot be calculated, whereas the financial costs can. This article aims to show how the cost of an injury to a member of staff can be calculated, thus allowing a manager to assess the financial implications of sharps injuries to their department. In the absence of access to an Occupational Health (OH) department, most A & E units have to respond to sharps injuries to healthcare workers in the hospital. This task must be attended to by the medical staff as well as the nursing staff of the A & E unit. Within the following text the appropriate responses and methods to ensure uniformity of response are discussed. The tables and the calculation figures shown are taken directly from the information held in the St James's University Hospital Trust's OH department. All calculations are based on the middle band of the salary scale for each discipline. Accurate costings for each member of staff injured cannot be shown in this article, but the general principle is laid down and can be easily followed for any situation.
The risk of transmitting contagious diseases by accidental needle-stick injury has raised a considerable amount of concern among hospital staff. Before generalized vaccination in the early 80s, there was a high risk of hepatitis B transmission. More recently, the development of reliable techniques of detecting serum markers has made it possible to precisely evaluate the risk for hepatitis C. The risk of contamination by the hepatitis C virus by accidental needle-stick injury can be estimated at 0 to 3%, and can only reach a maximum of 10% when the patient is positive for hepatitis C RNA. The risk is thus less than for hepatitis B virus (7 to 30%). The low rate of transmission probably results from the quantity of viral material in blood and secretions. In populations of health personnel exposed to a risk of septic needle-stick injury, the prevalence of anti-hepatitis C virus antibodies has been observed in several studies at rates between 0 and 2%. This is similar to non-exposed populations and would be an argument suggesting that there is a low risk of hepatitis C virus transmission. Nevertheless, because hospital staff is frequently exposed to blood and because a significant number of patients are positive for anti-hepatitis C virus antibodies, adequate preventive measures must be taken. The Immunization Practice Advisory Committee (USA) recommends injection of polyvalent gammaglobulins when stick injury occurs with a needle used for a hepatitis C virus antibody positive patient, but the effectiveness of this protocol has not been demonstrated. Several preliminary studies suggest that treatment of hepatitis C in the acute phase could significantly reduce the rate of chronicity. When interferon has been authorized for this indication, and if effectiveness is confirmed, treatment might be recommended for health personnel with acute needle-stick transmitted HCV infection. Infected needle-stick victims might be followed by having their transaminases checked 4-12 weeks later. In case of positive results, early interferon therapy might be started.