Understanding the Consequences of Injuries

By: Adeline Yi, Anzen Product Manager

The incident that causes an injury is the beginning of a long and costly journey. Sharps injuries present consequences to not only the injured individual but to the healthcare industry as a whole. Paperwork, substitute staff and treatment – sharps injuries cost time, money and peace of mind.

Sharps Injury – Course of Action
About 385,000 sharps-related injuries occur annually among healthcare workers in hospitals, however a majority of injuries go unreported. The main concern regarding a needlestick injury (NSI) is not characterized by the trauma itself, but by the percutaneous exposure to a patient’s blood and body fluids (BBF), which may carry infectious diseases such as HIV, hepatitis C and hepatitis B. In light of this, the subsequent steps that must be taken immediately following an injury are:

1) Provide care to the site by washing wound and skin
2) Seek evaluation and treatment for the injury from the ER or your employee health center
3) Report the incident to your supervisor and document it according to your employer policy, including the type and brand of device causing injury, department where the injury occurred, and explanation of incident.
4) Identify and document source patient who should be tested for HIV, hepatitis C and hepatitis B
5) Be tested for HIV, hepatitis C and hepatitis B
6) Get post-exposure prophylaxis (PEP) when source patient is unknown.
7) Get follow-up testing, counseling and monitoring of post-exposure prophylaxis toxicity.

Patients with an occupational exposure to a BBF should seek treatment as soon as possible, as studies have shown the efficacy of postexposure HIV prophylaxis is highest when initiated within the first 72 hours of exposure.

The Monetary Cost of an Injury
Sharps injuries can have a major and unnecessary impact on healthcare facility costs. Immediate and follow up treatment for exposed employees was reported to cost from $71 to $5,000 per case. The Massachusetts Sharps Injury Surveillance System, (SIC) determined approximately 1,000 percutaneous injuries per day in U.S. hospitals alone adds $1 billion in unnecessary annual costs. These costs go toward laboratory fees for testing exposed employees, associated labor and counseling and post-exposure follow-ups.

Indirect costs occur when time and compensation are shifted to receiving or providing care related to the injury. These costs include:

  • Lost productivity associated with the time required for reporting and receiving initial and follow up treatment for the injury
  • Healthcare provider time to evaluate and treat the employee
  • Healthcare provider time to evaluate and test the source patient, including obtaining informed consent for testing if applicable

The Impact on an Injury
Sharps injuries include so much more than the cost of treatment. It’s been found that the injured party can experience severe emotional and psychological effects. The injured worker faces uncertainty surrounding their infection status during the initial stages of the injury and then may have to face life-changing consequences if they’ve developed a disease. In a study on the economic impact of needlestick injuries it was found that 29 out of 110 nurses participated in emotional counseling following their needlestick injury. In a separate study, Costigliola et al (2012) questioned 634 nurses from western Europe and Russia who had experienced an NSI associated with diabetes injections. They identified emotional responses following such an injury, including depression, crying spells, tension in the family, relationship issues, panic attacks, excessive anxiety and inability to work.

Conclusion
It is difficult to know the true nature of the problem as many sharps injuries go unreported each year. However, given the reported cases each year, we know that their impact is widespread and costly. In the next post, “Putting Two and Two Together: How Sharps Safety Saves You Money,” we will review why safety scalpel adoption is important and how it can save healthcare institutions and personnel money.

 


1 http://www.cdc.gov/sharpssafety/pdf/sharpsworkbook_2008.pdf
2 http://www.bbraun.nl/documents/Sharps_Injury.pdf
3 http://www.nursingworld.org/DocumentVault/OccupationalEnvironment/Needles/7-Responses.pdf
4 http://emedicine.medscape.com/article/784812-treatment
5 http://www.beckershospitalreview.com/quality/needlestick-injuries-cost-u-s-hospitals-1b.html
6 https://www.cdc.gov/sharpssafety/appendixe.html
7 http://www.leeject.com/Download/LeEject_Appendix3.pdf
8 BD, Needlestick and sharps injuries: practice update, 2012