Needle Stick Injuries in Nursing: Causes and Prevention
This paper examines needle stick injuries (NSIs) in the healthcare setting, with particular focus on a documented incident involving a student nurse administering a heparin injection at a Sydney hospital. The paper identifies contributing factors — including lack of experience, inadequate supervision, stress, and long working hours — and reviews relevant literature on NSI prevalence, psychological consequences, financial costs, and prevention strategies. It concludes with outcome analysis and policy recommendations aimed at reducing NSIs among nursing students and healthcare professionals more broadly.
- Introduction to Needle Stick Injuries: Overview of NSIs, their prevalence, and health risks
- Incident Report: Student nurse NSI incident during heparin administration
- Contributing Factors: Fatigue, supervision gaps, stress, and inexperience as causes
- Literature Review: Research on NSI rates, costs, psychology, and prevention
- Outcome and Implications: Post-incident protocol and policy change recommendations
- Conclusion: Summary of key findings and prevention priorities
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What makes this paper effective
- The paper grounds its analysis in a concrete, real-world incident before moving into broader contributing factors and literature, creating a clear logical progression from specific to general.
- It draws on a diverse range of peer-reviewed sources to support each contributing factor, lending credibility and depth to the analysis.
- The outcome and implications section translates the analysis into actionable policy recommendations, demonstrating applied critical thinking rather than purely descriptive reporting.
Key academic technique demonstrated
The paper effectively uses an incident report as the analytical anchor for a literature-supported discussion. By first describing what happened and then systematically exploring why it happened through multiple contributing factors, the author demonstrates the ability to connect theoretical knowledge (from peer-reviewed studies) to a practical clinical scenario — a core skill in healthcare education writing.
Structure breakdown
The paper follows a clear five-part structure: (1) a general introduction to NSIs and their scope; (2) a specific incident report providing the case study; (3) a contributing factors analysis linking the incident to known risk variables; (4) a literature review surveying NSI research on prevalence, costs, psychology, and prevention; and (5) outcome and implications that recommend policy changes, followed by a brief conclusion.
Introduction to Needle Stick Injuries
A needle stick injury occurs when the skin is accidentally punctured during the use of a needle. As the name suggests, these injuries are common within the healthcare field. Needle stick injuries normally occur in large hospitals and are responsible for approximately 80% of HIV/AIDS cases among healthcare workers. In 2005, it was estimated that 64 healthcare professionals were affected with HIV each year due to needle stick injuries alone. Bloodborne infections such as Hepatitis B, Hepatitis C, and HIV/AIDS are spreading serious risks through the medical world today.
As would be expected, no patient presents for the first time with a label indicating which disease they carry. For this reason, healthcare professionals need to exercise great care when handling needles and related equipment. Tasks such as drawing blood or maintaining an IV line are generally the sole responsibility of nurses. Nursing professionals are trained to handle these tasks carefully and to prevent such injuries. It is crucial to counsel nurses about such incidents because diseases like HIV cannot be eradicated from the blood once contracted.
Even though the task of using needles is not inherently difficult, mistakes do happen. The following sections discuss certain factors that increase the likelihood of needle stick injuries. In order to maintain a healthy clinical environment, it is important to reduce the number of these injuries on a broad scale.
Incident Report
This incident took place during a morning shift at 08:30 hours in a Sydney hospital. The individual involved was a student nurse who was administering a heparin injection to a patient. Although the student was performing the task under the supervision of a registered nurse (RN), she experienced a needle prick to the index finger of her left hand while disposing of the used needle and syringe. The needle had pierced her latex glove and caused the finger to bleed. Following the injury, the student immediately washed her finger under running water.
As would be expected, the student was not aware of the patient's health status. Panicked, she informed the registered nurse, and an incident report was created at 09:40 hours. After the student had reported the incident, both the student and the patient were tested for Hepatitis B, Hepatitis C, and HIV/AIDS. The student was also provided with all up-to-date immunizations.
Contributing Factors
Adams (2012) identified many factors that contribute to needle stick injuries. These include the type of device used, the procedure followed by the nurse, lack of knowledge and training in needle handling, and insufficient awareness of the consequences of such an injury. Beyond these, factors such as inadequate supervision, stress, and long working hours also increase the incidence of needle stick injuries. Given that this incident occurred in the morning, it is possible that the student nurse had been working a late night shift. Extended working hours may have caused fatigue and reduced the student's alertness while performing clinical duties.
Aziz et al. (2009) stated that practice deficiencies can be identified through proper observation of staff. In particular, the waste management practices of staff should be assessed carefully. Lack of supervision and control is a plausible contributing factor in this incident. Although the registered nurse was present, the student may not have followed the most reliable procedure. As Blenkharn (2009) noted, one reliable way to ensure staff are managing waste safely is to examine their clothing and the external surfaces of equipment. This incident therefore signals the need to review other potential hazards that may be going unaddressed.
It should be noted that not all nurses are experienced with all types of devices. Lack of familiarity with a specific device is a plausible contributing factor to the NSI that occurred in this case. Stress is yet another factor that may prevent a nurse from managing a given task properly — both before and after a needle stick injury occurs.
Deisenhammer et al. (2006) identified lack of dexterity in handling needle-syringe devices and limited knowledge of the consequences of NSIs as major contributing factors. Interestingly, stress arising from awareness of those consequences can itself contribute to the occurrence of an injury. In this scenario, however, the opposite may be true: as a student nurse, the individual concerned may not have been sufficiently aware of the consequences of a needle stick injury. It is known that Hepatitis B can survive outside the body for up to one week, while Hepatitis C can persist for up to two days.
Conclusion
Overall, the central challenge is identifying the contributing factors for needle stick injuries. Once these factors are clearly understood, staff must work to counsel personnel and implement measures to reduce such injuries. The most important step is to prevent this hazard and reduce the number of needle stick injuries in future clinical practice.
References
Adams, D. 2012. Needle stick and sharps injuries: implications for practice. Nursing Standard, 26(37), pp. 49–57.
Aziz, A.M., Ashton, H., Pagett, A., Mathieson, K., Jones, S., and Mullin, B. 2009. Sharps management in hospital: an audit of equipment, practice and awareness. British Journal of Nursing, 18(2), pp. 92–98.
Blenkharn, J. 2009. Sharps management and the disposal of clinical waste. British Journal of Nursing, 18(14).
Blenkharn, J. 2009. Blood and body fluid exposures in clinical waste handlers. Waste Management.
Chow, J., Wong, J., Jefferys, A., and Suranyi, M. 2009. Needle-stick injury: a novel intervention to reduce the occupational health and safety risk in the haemodialysis setting. Journal of Renal Care, 35(3), pp. 120–126.
Costigliola, V., Frid, A., Letondeur, C., and Strauss, K. 2012. Needlestick injuries in European nurses in diabetes. Diabetes and Metabolism, 38(1), pp. S9–S14.
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Doebbeling, B.N., Vaughn, T.E., and McCoy, K.D. et al. 2003. Percutaneous injury, blood exposure, and adherence to standard precautions: are hospital-based health care providers still at risk? Clinical Infectious Diseases, 37, pp. 1006–1013.
Ford, J. and Phillips, P. 2011. An evaluation of sharp safety hypodermic needle devices. Nursing Standard, 25(35), pp. 39–44.
Glenngard, A. and Persson, U. 2009. Costs associated with sharps injuries in the Swedish health care setting and potential cost savings from needle-stick prevention devices with needle and syringe. Scandinavian Journal of Infectious Diseases, 41, pp. 296–302.
Jagger, J., Hunt, E.H., Brand-Elnaggar, J., and Pearson, R.D. 1988. Rates of needle-stick injury caused by various devices in a university hospital. New England Journal of Medicine, 319(5), pp. 284–288.
Molen, H.F., Zwinderman, K.A.H., Sluiter, J.K., and Frings-Dresen, M.H.W. 2011. Better effect of the use of a needle safety device in combination with an interactive workshop to prevent needlestick injuries. Safety Science, 49(8–9), pp. 1180–1186.
Small, L., Pretorius, L., and Walters, A. 2012. A surveillance of needle-stick injuries amongst student nurses at [University]. Health SA Gesondheid, 16(1).
Whitby, R.M. and McLaws, M.L. 2002. Hollow-bore needlestick injuries in a tertiary teaching hospital: epidemiology, education and engineering. Medical Journal of Australia, 177, pp. 418–422.
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