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

Elaine DunneClinical Nurse Manager 2

Occupational Health DepartmentConnolly hospital Blanchardstown.

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

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

Occupational Health Staff

Time spent on recipient

Initial risk assessment Counselling Blood tests Vaccination PEP Follow up blood tests and

counselling

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

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.

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

mechanism

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.

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.

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.

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.

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.