Needle stick injury most commonly occurs during which of the following procedures?

RML 2023

Fundamental of Nursing

Easy

Appeared in: RML 2023

Explanation

Recapping needles is the most frequent cause of needlestick injuries among healthcare workers.
This practice is strongly discouraged by all major health and safety organizations, including OSHA.
The act of recapping, especially with two hands, creates a direct path for the needle to miss the cap and puncture the hand holding it.
Safe disposal in a sharps container immediately after use is the correct protocol.

Option A: While an injury can occur during an IM injection (e.g., due to sudden patient movement), it is far less common than injuries that happen after the procedure, such as during recapping or disposal.
Option C: Similar to IM injections, injuries during the administration of an IV injection are less common than post-procedure handling errors. The risk is higher after the needle is withdrawn.
Option D: Needles should not be manually crushed. They should be disposed of in a puncture-proof sharps container. Some facilities use needle-destroying devices, but injuries from these are not the most common type of needlestick injury overall. The primary method of disposal is the sharps bin.

Clinical Relevance

Nursing practice connection: Knowing Causes and prevention of needlestick injuries in healthcare settings helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Adherence to the 'no-recap' policy is a fundamental patient and worker safety principle. It is a non-negotiable standard of practice.
Immediate and correct post-exposure management is critical. Nurses must know the first aid steps and the protocol for reporting the injury without delay to receive timely post-exposure prophylaxis (PEP).
The risk of transmission varies by pathogen: HBV risk is highest (up to 30%), followed by HCV (approx. 1.8%), and HIV (approx. 0.3%) from a single percutaneous exposure.

How to Approach the Question

First, identify the core of the question: it asks for the most common cause of needlestick injuries.
Evaluate each option based on standard safety protocols taught in nursing.
Recall that giving injections (IM or IV) is the intended use of a needle, and while risks exist, safety measures are in place. The highest risk often comes from handling the contaminated sharp after its intended use.
Consider the action of 'recapping'. This is a universally discouraged practice precisely because it is a leading cause of injury. The needle is exposed, sharp, and contaminated.
Eliminate 'crushing the needle' as it's not a standard procedure; disposal in a sharps container is the correct method.
Conclude that recapping is the most cited and well-documented cause of accidental needlestick injuries.

Concept Tested & Keywords

Concept Tested: Causes and prevention of needlestick injuries in healthcare settings.
Stem keywords: Needle stick injury, most commonly occurs, procedures
Lead-in keywords: which of the following
Negative lead-in flag: false

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