27.11.19
Needlestick; The harms and cost of an avoidable injury
Source: NHE Nov/Dec
Paul Butler, Associate Safety And Learning Lead At NHS Resolution
Sharps injuries are a well-known risk in the health and social care sector. Sharps contaminated with an infected patient’s blood can transmit more than 20 diseases, including hepatitis B, C and human immunodeficiency virus (HIV). Because of this transmission risk, sharps injuries can cause worry and stress to the many thousands who receive them.
The harm and cost associated with sharps injury are largely avoidable. Most sharps injuries can be prevented, and there are legal requirements on employers to take steps to prevent healthcare staff being exposed to infectious agents from sharps injuries.
What is the risk?
The main risk from a sharps injury is the potential exposure to infections such as blood-borne viruses (BBV). This can occur where the injury involves a sharp that is contaminated with blood or a bodily fluid from a patient. The blood-borne viruses of most concern are:
Hepatitis B (HBV)
Hepatitis C (HCV)
Human immunodeficiency virus (HIV)
The transmission of infection depends on a number of factors.
Who is at risk?
Workers and others in health and social care are at risk. This includes those who directly handle sharps but also includes workers who may inadvertently be put at risk when sharps are not stored or disposed of correctly.
There is a higher risk of infection from a sharps injury involving hollow-bore needles. Higher risk procedures include intra-vascular cannulation, venepuncture and injections and use of IV cannulae, winged steel-butterfly-needles, needles and syringes and phlebotomy needles.
What is the cost?
NHS Resolution manages claims submitted for injury to staff and patients and, in the case of needlestick, received 401 claims from staff between 2017 and 2019. Of these, 176 were successful and a 136 remain open. NHS Resolution paid out £361,150 in total damages to NHS staff on behalf of NHS trusts during this period.
The data shows that of the 176 staff involved in the claims, 94 of these were reported to be domestic, ancillary and cleaning staff.
There are hidden costs of harm and these include unpleasant and debilitating side effects of antiviral drugs which cause suffering to employees and their families; the cost of backfill for sickness as a result of the incident; and resources for investigations.
Common findings from claims cases include:
Inadequate disposal of clinical waste
Overfull sharps bins;
Not using safer sharps; and
Not using personal protective equipment.
Non-compliance with standard infection control precautions
NHS Resolution continue to support trust wide and national efforts to minimise harm and support organisations to learn from needlestick injury claims.
Dr Denise Chaffer, Director of Safety and Learning at NHS Resolution, said:
"A high number of our colleagues who keep our hospitals clean and provide support services are most at risk and we work with the national Safer Sharps Network to promote the use of safer sharps devices and the elimination of unnecessary risk; what is clear is that an organisation that fosters an open and honest safety culture can have a significant impact on reducing harm and supporting all health care staff to practice safely around sharps.”
"NHS Resolution provides safety and learning advice on its resources pages and recommends that NHS organisations consider these simple steps:
Review your organisation’s procurement of safer sharps versus conventional sharps
Consider why you are not using safer sharps, is this habit or lack of awareness?
Check training is implemented on the use of safer sharps.
Check training on correct disposal procedures is up to date.
Review your organisation’s claims for needlestick injuries, costs and hidden costs - any extra cost of safer sharps is likely to reduce harm and the cost of legal claims."