Transcript:

What Are the Exact Steps Following a Needlestick or Accidental Exposure?

If someone in your office got stuck with a needle today, would they actually know what to do next?

Not what the manual says. I mean, in that moment—would they know where to go, who to tell, what paperwork needs to be completed, and where they’re supposed to go for medical evaluation?

Because once an exposure happens, that's not the time to start looking for your Exposure Control Plan.

I'm Kelli Ngariki with Healthcare Compliance Associates, and we've helped hundreds of Oregon healthcare practices prepare for situations just like this.

So, I want to walk you through the five steps your team should know before a needlestick or accidental exposure occurs.

And I'll also cover a few mistakes I've seen practices make that can turn an already stressful situation into a much bigger problem.

STEP 1: TAKE CARE OF THE EXPOSURE FIRST

First things first: take care of the exposed area.

For a needlestick or cut, wash the area with soap and water.

If blood or other potentially infectious material gets into the eyes, nose, or mouth, immediately flush the area with plenty of clean water or saline.

This sounds obvious, but when people panic, they sometimes jump ahead. They're thinking, Who do I tell? Where's the form? What do I do?

Start with first aid.

And one thing I want to make really clear: don't aggressively scrub the wound or try to squeeze blood out of it.

Wash the area, then move on to the next step.

And remember, washing the area is not a substitute for medical evaluation. It's simply your immediate first response.

STEP 2: TELL SOMEONE RIGHT AWAY

Next, report the exposure immediately.

Your employees should already know exactly who they're supposed to notify. Maybe that's your office manager, safety officer, supervisor, or another designated person.

And this is an area where I've seen practices run into trouble.

An employee gets poked and doesn't say anything.

Maybe they're embarrassed. Maybe they think, It barely broke the skin, so it's probably fine. Or they don't want to make a big deal out of it.

Sometimes they simply didn't realize they were supposed to report it.

That's why I tell practices: don't just have a reporting procedure on paper. Make sure your employees actually know it.

They should be able to answer three questions:

1. What needs to be reported?
2. Who do I report it to?
3. And how quickly do I need to do it?

The answer to that last one is easy: right away.

Some post-exposure decisions can be time-sensitive. You don't want an employee waiting until the end of the shift—or until tomorrow—to mention what happened.

STEP 3: ADDRESS SOURCE TESTING

Once the exposure has been reported, you'll also need to address source testing when it's appropriate.

This is one of those areas where I don't want employees improvising.

Your practice should have a procedure for what happens next, including how you handle the source patient and how you obtain consent when testing is appropriate.

Generally, you're asking the source patient for voluntary consent for relevant bloodborne pathogen testing based on the exposure and applicable requirements.

And yes, the patient may decline.

If they do, document that.

But here's the really important part:

Don't let what's happening with the source patient delay care for your employee.

The exposed employee still needs prompt, confidential medical evaluation.

The healthcare professional evaluating that employee can look at the circumstances of the exposure, the information that's available, the employee's vaccination history, and determine what testing, treatment, or follow-up is appropriate.

Your job at the practice level is to have the process ready so nobody is trying to figure it out after the exposure has already happened.

STEP 4: DOCUMENT WHAT HAPPENED

Next comes documentation.

And I know paperwork probably feels secondary when you're dealing with an exposure, but this is an important part of the process.

Document what actually happened while the details are still fresh.

1.  When did it happen?
2. Where did it happen?
3. What was the employee doing?
4. What needle, instrument, or device was involved?
5. How did the exposure occur?
6. What did the employee do immediately afterward?
7. Who was notified?

Your Exposure Control Plan should tell you what documentation your practice needs to complete.

And depending on the incident and your practice, there may be additional recordkeeping requirements, including your Sharps Injury Log.

But here's the part I really want practice owners and managers to think about:

Don't document the incident and then stick the paperwork in a file and forget about it.

Ask: Is there something we can learn from this?

Maybe an instrument was being passed in a way that created unnecessary risk.

Maybe a sharps container wasn't located where the team really needed it.

Maybe there's a safer device or a workflow that should be evaluated.

Or maybe the employee simply wasn't trained on the procedure.

That's where documentation becomes more than paperwork. You're using the incident to look for an opportunity to prevent the next one.

STEP 5: GET THE EMPLOYEE MEDICALLY EVALUATED

Finally, the exposed employee needs prompt, confidential medical evaluation and follow-up.

And please don't wait until an exposure happens to Google, Where do we send somebody for a needlestick?

Figure that out now.

Your practice should already know where an employee will go.

That might be occupational health, an urgent care clinic, employee health services, or another healthcare provider you've designated for post-exposure evaluation.

Make sure your managers know where that is.

Make sure they know how to contact them.

And make sure you have a backup plan if an exposure happens late in the day or when your usual provider isn't available.

The evaluating healthcare professional will determine the appropriate medical next steps based on the actual exposure.

Your responsibility is to make sure the employee can get there without unnecessary confusion or delay.

FIVE THINGS I DON'T WANT YOU TO DO

Now that you know the five steps, let me give you five things I don't want to see happen after an exposure.

Number one: Don't brush it off.

Even if the employee thinks, It's probably nothing, follow your exposure procedure.

Number two: Don't wait to report it.

This isn't something to mention tomorrow morning. Report it right away.

Number three: Don't aggressively squeeze or scrub the wound.

Wash it with soap and water and follow your exposure procedure.

Number four: Don't forget the documentation.

Document what happened, complete the required records, and then look at whether anything needs to change.

And number five—and this is probably the biggest one—don't assume your employees already know all of this.

Having an Exposure Control Plan in a binder doesn't mean your team knows what to do.

They need training.

They need to know where that plan is.

And they need to understand exactly what happens in your office if an exposure occurs.

QUICK REVIEW

So, if you remember nothing else from this video, remember these five steps:

One: Wash or flush the exposed area immediately.

Two: Report the incident immediately.

Three: Address source testing when appropriate without delaying care for your employee.

Four: Document what happened and evaluate whether anything needs to change.

Five: Get the exposed employee prompt medical evaluation and follow-up.

That's your basic roadmap.

And the goal isn't to make employees memorize regulations.

The goal is that if something happens on a Tuesday afternoon in the middle of a busy schedule, your team doesn't panic.

They know what to do.

Here's what I'd like you to do after this video.

At your next safety meeting, ask your team one question:

"If you had a needlestick right now, what would you do?"

And let them answer.

Can they tell you where they would wash the exposure?

Who they would report it to?

Where your Exposure Control Plan is?

And where they would go for medical evaluation?

If they can't answer those questions, you've just identified a really useful training opportunity before someone gets hurt.

We've also created a simple infographic with these five steps that you can download and post in a staff-only area as a quick reminder for your team.

And if you're an Oregon healthcare practice and you're not sure whether your Exposure Control Plan or post-exposure procedures are where they should be, you can schedule a free Compliance Risk Review with Healthcare Compliance Associates. We'll help you take a practical look at what you already have in place and where you may have gaps.

Because when an exposure happens, your employees shouldn't have to figure out what to do.

The plan should already be there.

If this was helpful, subscribe for more practical, Oregon-specific compliance guidance.

Thanks for watching, and I'll see you in the next video.

Full Length Video Here: https://youtu.be/MQgiQx9tMFQ