Needlestick injuries and the introduction of a safety cannulae in a Dublin Teaching Hospital

1. Needlestick injuries and the introduction of a safety cannulae in a Dublin Teaching Hospital Elaine Dunne Clinical Nurse Manager 2 Occupational Health Department Connolly hospital Blanchardstown.

2. Accidential blood exposures • The occupational health department opened in July 2001. • Prior to this staff who sustained an accidential blood exposure had to attend OH services off site. • Initially reporting of NSI’s was slow. • On average now we see 70 accidential blood exposures annually

3. Number of Needlestick injuries • From July 2001- July 2003 • 101 accidential blood exposures reported • 28 from cannulaes • 27.7% of all accidential blood exposures were from cannulaes

4. Occupational Health Staff

5. Time spent on recipient • Initial risk assessment • Counselling • Blood tests • Vaccination • PEP • Follow up blood tests and counselling

6. Time spent on source • Risk assessment of source patient • Contacting team if hospital based. • Organising urgent bloods • Contacting hospital lab to arrange urgent transport • Contacting VRL to arrange urgent testing

7. Time spent on source patient • Following up source patients results and informing recipient • Taking results after work hours on a regular basis. • If patient from community, trying to find out GP and making contact to establish risk. • Organising to have blood taken from patient in community has multiple complications.

8. Trialing safety cannulaes • A/E had trialed numerous cannulaes over the years. • Organised by the CNM3 who was safety conscious • They particularly liked the vasofix safety cannulae

10. mechanism

11. Where we went from here • Met with Infection control Team and Consultant Microbiologist • Organised a trial for A/E and Theatre • Post trial evaluation very positive • Put proposal to finance for funding • Legal case at time payout €8000 so no resistance from finance.

12. contd • Exstensive training for medical and nursing staff. • Another legal case so OHD used opportunity to put proposal for safety cannulae throughout hospital • Proposal accepted.

13. Safety cannulae • Introduced throughout the hospital September 2003. • Training vitally important • Very little resistance to new device • 18 months post introduction we carried out an evaluation via questionnaire. • Very positive feedback no problems identified.

14. 2 ½ years later • Since introducing the safety cannulae in September 2003 we have had 1 needlestick injury.(from 28 in previous 2 years) • This was were a doctor failed at cannulation and did not activate the device before removing from patient.

15. Things we learned • It is hard work. • Be persistent even if you are saying the same thing 100 times • Initial training and ongoing training is vital and should be provided by the company • Organisational commitment is key • Involve staff at every stage it reduces resistance.