2007 U.S.

EPINet Needlestick and Sharp-Object Injury Report

International Healthcare Worker Safety Center, University of Virginia

Total Cases: 951 Average Daily Census: 3400 9 Teaching facilities (average daily census = 2317; total injuries = 789) 20 Non-teaching facilities (average daily census = 1083; total injuries = 181)

Job category 1 Doctor (attending.staff) List specialty 2 Doctor (intern/resident/fellow) List specialty 3 Medical Student 4 Nurse 5 Nursing Student 6 Respiratory Therapist 7 Surgery Attendant 8 Other Attendant 9 Phlebotomist/ Venipuncture/ IV Team 10 Clinical Laboratory Worker 11 Technologist (non lab) 13 Dental Hygienist 14 Housekeeper 15 Other, describe 16 Paramedic 17 Other Student 18 CNA/HHA 19 Laundry Worker 20 Security Total Records: 950

137 171 9 322 6 19 59 15 44 12 39 1 14 64 8 15 12 2 1

14.4% 18.0% 0.9% 33.9% 0.6% 2.0% 6.2% 1.6% 4.6% 1.3% 4.1% 0.1% 1.5% 6.7% 0.8% 1.6% 1.3% 0.2% 0.1%

Where did the injury occur? 1 Patient Room/Ward 2 Outside Patient Room 3 Emergency Department 4 Intensive/Critical Care Unit 5 Operating Room/Recovery 6 Outpatient Clinic/Office 8 Venipuncture Center 9 Dialysis Facility 10 Procedure Room 221 10 82 82 341 61 2 8 39 23.3% 1.1% 8.6% 8.6% 35.9% 6.4% 0.2% 0.8% 4.1%

11 Clinical Laboratories 12 Autopsy/Pathology 13 Service/Utility Area 14 Other, describe 16 Labor and Delivery Room 17 Home-care Total Records: 950

6 10 8 46 32 2

0.6% 1.1% 0.8% 4.8% 3.4% 0.2%

Was the source patient identifiable? 1 Yes 2 No 3 Unknown 4 N/A Total Records: 947 901 36 9 1 95.1% 3.8% 1.0% 0.1%

Was the injured worker the original user of the sharp item? 1 Yes 642 2 No 279 3 Unknown 10 4 N/A 14 Total Records: 945

67.9% 29.5% 1.1% 1.5%

Was the sharp item contaminated? 1 Contaminated 2 Uncontaminated 3 Unknown Total Records: 941 873 10 58 92.8% 1.1% 6.2%

What was the original purpose of the sharp item? 1 Unknown/not applicable 49 2 Injection, intramuscular/subcutaneous 224 3 Heparin or saline flush 4 4 Other injection into IV injection site or port 12 5 To connect IV line 1 6 To start IV or setup heparin lock 35 7 To draw a venous blood sample 109 8 To draw an arterial blood sample 18 9 To obtain a body fluid or tissue sample 17 10 Fingerstick/heel stick 10 11 Suturing 228 12 Cutting 80 13 Electrocautery 12

5.2% 23.6% 0.4% 1.3% 0.1% 3.7% 11.5% 1.9% 1.8% 1.1% 24.0% 8.4% 1.3%

14 To contain a specimen or pharmaceutical 15 Other, describe 16 To place an arterial/central line 17 Drilling Total Records: 949

5 122 16 7

0.5% 12.9% 1.7% 0.7%

When did the injury occur? 2 During use of item 3 Between steps of a multi-step procedure 4 Disassembling device or equipment 5 In preparation for reuse of reusable instruments 6 While recapping a used needle 7 Withdrawing a needle from rubber or other resistance 8 Other after use, before disposal 9 From item left on or near disposal container 10 While putting the item into the disposal container 11 After disposal, stuck by item protruding from disposal 12 Item pierced side of disposal container 13 After disposal, item protruding from trash bag or inapp 14 Other, describe 15 Restraining patient 16 Device left on floor, table, bed or other inappropriate Total Records: 947

450 134 23 12 32 15 99 2 38 10 1 6 69 6 50

47.5% 14.1% 2.4% 1.3% 3.4% 1.6% 10.5% 0.2% 4.0% 1.1% 0.1% 0.6% 7.3% 0.6% 5.3%

Type of device causing injury: 1 Syringe, disposable 2 Syringe, prefilled cartridge 3 Syringe, blood gas 4 Syringe, other type 5 Needle on IV tubing 6 Needle, Winged steel 7 IV catheter 8 Needle/holder vacuum tube blood collection 9 Needle, spinal or epidural 10 Needle, unattached hypodermic 11 Needle, arterial catheter introducer 12 Needle, central line catheter introducer 13 Needle, drum catheter 15 Needle, other non vascular catheter 28 Needle, unknown type 29 Needle, describe 30 Lancet 31 Suture Needle 32 Scalpel, reusable 33 Razor 289 27 12 3 1 52 27 16 5 4 9 7 2 3 16 42 12 224 35 1 30.8% 2.9% 1.3% 0.3% 0.1% 5.5% 2.9% 1.7% 0.5% 0.4% 1.0% 0.7% 0.2% 0.3% 1.7% 4.5% 1.3% 23.9% 3.7% 0.1%

34 Pipette, plastic 35 Scissors 36 Electrocautery Device 37 Bone cutter 39 Towel clip 41 Trocar 44 Fingernails/teeth 45 Scalpel, disposable 46 Retractors, skin/bone hooks 47 Staples, steel sutures 48 Wire 49 Pin 50 Drill bit 51 Pickup/forceps/hemostats 58 Sharp item, not sure what kind 59 Other sharp item (please describe) 60 Medication ampule 61 Medication vial 63 Pipette, glass 78 Glass item, unknown type 79 Glass item, other Total Records: 938

1 4 14 6 2 1 5 35 7 1 7 5 7 3 10 31 2 1 1 2 6

0.1% 0.4% 1.5% 0.6% 0.2% 0.1% 0.5% 3.7% 0.7% 0.1% 0.7% 0.5% 0.7% 0.3% 1.1% 3.3% 0.2% 0.1% 0.1% 0.2% 0.6%

If injury was caused by a needle, was it a "safety design"? 1 Yes 341 2 No 529 3 Unknown 42 Total Records: 912 A. If yes, was safety mechanism activated? 1 Yes, fully 2 Yes, partially 3 No Total Records: 319 B. If yes, did the injury happen? 1 Before activation 2 During activation 3 After activation Total Records: 308

37.4% 58.0% 4.6%

38 55 226

11.9% 17.2% 70.8%

204 65 39

66.2% 21.1% 12.7%

Location of injury as selected from list Arm Face/Head 29 1 3.1% 0.1%

Foot Front Hand, left Hand, right Leg Total Records: 943

6 2 574 324 7

0.6% 0.2% 60.9% 34.4% 0.7%

Depth of the injury Superficial-little or no bleeding Moderate-skin punctured, some bleeding Severe-deep stick/cut, profuse bleeding Total Records: 940 651 257 32 69.3% 27.3% 3.4%

Did the sharp item penetrate? 1 Single pair of gloves 2 Double pair of gloves 3 No gloves Total Records: 911 627 176 108 68.8% 19.3% 11.9%

Handedness of injured worker 1 Right-handed 2 Left-handed Total Records: 930 874 56 94.0% 6.0%