Needle Stick Injury Awareness Quiz

Needle Stick Injury

• A needle stick injury is when the skin is accidentally punctured by a used needle.
• Blood-borne diseases, including HIV, hepatitis B (HBV), and hepatitis C (HCV), can be transmitted via a needle stick injury.
• HBV has a 30% risk of transmission after a needle stick injury.
• HCV has a 3% risk of transmission after a needle stick injury.
• HIV has a 0.3% risk of transmission after a needle stick injury.

Learning Objectives

• Identify diseases transmitted by needle sticks.
• Understand postexposure prophylaxis measures (PEP).
• Differentiate between different PEP measures.
• Recognize hazards of needle stick injury.

Case Study

• Amani, a head nurse, experienced a needle stick injury while assisting a patient.
• She chose to wash her hands with soap and water instead of proper protocol.
• She neglected to notify her supervisor, failing to follow established procedures.
• The case highlights the importance of immediate response and meticulous reporting.
• This case discussion prompts critical reflection on proper procedures and potential consequences.

Management of Needle Stick Injury:

• Immediately clean the wound by encouraging bleeding, flushing with running water, and applying soap.
• Report the incident immediately to a supervisor or designated medical professional.
• Treat the injury. Determine HIV, Hep B, and Hep C status of the patient and seek the appropriate treatment.

Hepatitis B Post-Exposure Prophylaxis (PEP)

• If the injured health worker is unvaccinated, initiate and complete the hepatitis B vaccination series, including hepatitis B immune globulin (HBIG).
• Vaccination completion is required even if the source of exposure is hepatitis B negative.
• Monitor for antibody formation, testing 1-2 months after vaccination , if HBIG was not used in conjunction .

Hepatitis C Post-Exposure Prophylaxis

• Hepatitis C (HCV) is less commonly transmitted than HBV through needle stick.
• Baseline testing for antibodies and alanine aminotransferase (ALT).
• Retest for antibodies and ALT between 4-6 months after exposure.
• Viral RNA testing for early detection 4-6 weeks post-exposure.
• If antibodies are positive, ELISA supplemental testing may be required.
• Referral to a specialist is advised if infection is confirmed.

HIV Post-Exposure Prophylaxis (PEP)

• HIV can survive in dried blood at room temperature for up to three days.
• Properly refer the exposed person for medical evaluation, risk assessment, and prescription of PEP.
• PEP (post-exposure prophylaxis) involves medication to prevent HIV.
• Decisions on PEP should be informed by adherence and potential adverse reactions to antiretroviral drugs.
• Administer the antiretroviral drugs promptly within 72 hours of exposure/ ideally within 4 hours.
• Continuously track the PEP regimen for 28 days.
• Periodic (6 weeks,3 months,6 months) HIV antibody testing for confirmation.
• If seroconversion occurs (positive HIV test), refer the person to a specialist for treatment, care, and support.

Risk Reduction for Needle Stick Injuries

• Health workers exposed to blood or body fluids should receive routine hepatitis B vaccination.
• Adhere to all workplace safety procedures, including regular safety refresher courses.
• Minimize needle usage.
• Do not recap used needles.
• Dispose used needles in properly labeled, puncture-resistant sharps containers.

Assessment Questions

• Question 1: Of the blood-borne pathogens, which has the highest risk for transmission from a needle stick injury? Hepatitis B
• Question 2: How long can HIV survive in dried blood at room temperature? Three days.
• Question 3: Explain the post-needle stick injury management protocol? This protocol should include immediate cleaning of the wound, reporting to the proper authority, and testing for critical blood borne pathogens (HIV, Hepatitis B, and C).