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Attitude And Practice Of Standard Precautions Among Healthcare Workers
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1.7 SHARP INJURIES (SI) :
SI are defined as “an exposure
to event occurring when any sharp penetrates the skin†(CDC, 2012).
These include needles, scalpels, broken glass, and other sharps. This
term is interchangeable with percutaneous injury. It is considered a
serious hazard in hospitals because it may allow the contaminated blood
that has pathogen to be in contact with nurses. SI and NSI lead to
infection. They expose nurses to blood- borne pathogens which mean â€
pathogenic microorganisms that are present in human blood and can cause
disease in humans. These pathogens include, but are not limited to,
hepatitis B virus†(CDC, 2012). SI and NSI are considered a major source
of Hepatitis C Virus ( HCV ) infection among HCWs. Nearly (39%) of
cases of HCV that occurred worldwide happened among HCWs, while
hepatitis B virus (HBV) formed (37%) (Goniewicz et al., 2012).
Furthermore, needle stick injuries can transmit more than twenty types
of infections such as malaria, syphilis and herpes (Elizabeth 2012).
SI
and NSI are challenges that threaten health workers especially nurses
and form a significant risk in professional nursing. This is due to
their daily activities which may expose nurses to NSI and SI. These
activities or procedures include the following: recapping needle,
suturing, placing intravenous line, drawing blood, failing to get rid of
used needles in puncture-resistant sharps containers, using needles or
glass equipment to transfer body fluid between containers, disassembling
needle or sharp device, giving injections to patients, filling
injection, opening the lid of the injection and many others (CDC, 2012;
CDC, 2013). These tasks and activities of nurses in daily work may
expose them to SI or NSI. Therefore, to prevent transmission of blood
borne pathogens to nurses after being exposed to such injuries, they
should quickly wash the wound with water and soap. On the other hand,
squeezing the wounds is not recommended as this will not reduce the risk
of blood- borne pathogen. In case of the splash of blood or body fluid
touches the nose or the mouth or the skin, they must flush these
splashes with water and in case of blood or body fluid comes in contact
with the eye, they should irrigate eyes with clean water or saline. Then
they should inform the supervisor about injury to begin a reporting
system (incidence report). At the same time, they should test the source
patient for hepatitis B, hepatitis C and AIDS. After that, infected
nurses should receive the appropriate treatment, and post exposure
prophylaxes (PEP) should be taken if the source patient was unknown or
the source patients’ test was positive (CDC, 2007; NHMRA, 2010).
Sharp
injuries and needle stick injuries are costly; these injuries have
direct and indirect cost at the same time. The direct cost includes the
cost of laboratory test of exposed nurses and source patient, in
addition to the cost of treatment that may be required or post exposure
prophylaxis. On the other hand, the indirect cost includes loss of
nurses, loss of productivity, loss of time during reporting or taking of
treatments and cost for replacing the infected nurses (NIOSH, 2011).
According to CDC’s estimation, there were nearly (385,000) SI cases
yearly among HCWs, and most reported cases occurred among nursing staff,
but laboratory staff, physicians and other HCWs were also injured
(NIOSH, 2011). Nearly half of SI were not reported; this was due to many
reasons: lack of time to report, lack of knowledge of the reporting
procedure, possibility of getting in trouble for having the exposure,
belief the source patient was low for hepatitis B or hepatitis C or
AIDS,and underestimation of the importance of reporting
1.8 SHARP DISPOSAL CONTAINERS (OR BOX):
Sharp
objects must be disposed in separate containers in every hospital to
prevent risk of transmission of infection. These containers are called
sharp disposal containers and they must be puncture-resistant, liquid
–proof, closed when not used and sealed and when (75%) of them are
filled. They should be put nearby work place and close to place where
sharp is used. This would reduce the occurrence of recapping needles and
needle-stick injuries that are associated with recapping (OSHA,
2011;WHO,2012).
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