1. Needlestick injuries and the introduction of a safety cannulae in a Dublin Teaching Hospital Elaine Dunne Clinical Nurse Manager 2 Occupational Health Department Connolly hospital Blanchardstown.

2. Accidential blood exposures The occupational health department opened in July 2001. Prior to this staff who sustained an accidential blood exposure had to attend OH services off site. Initially reporting of NSI’s was slow. On average now we see 70 accidential blood exposures annually

3. Number of Needlestick injuries From July 2001- July 2003 101 accidential blood exposures reported 28 from cannulaes 27.7% of all accidential blood exposures were from cannulaes

4. Occupational Health Staff

5. Time spent on recipient Initial risk assessment Counselling Blood tests Vaccination PEP Follow up blood tests and counselling

6. Time spent on source Risk assessment of source patient Contacting team if hospital based. Organising urgent bloods Contacting hospital lab to arrange urgent transport Contacting VRL to arrange urgent testing

7. Time spent on source patient Following up source patients results and informing recipient Taking results after work hours on a regular basis. If patient from community, trying to find out GP and making contact to establish risk. Organising to have blood taken from patient in community has multiple complications.

8. Trialing safety cannulaes A/E had trialed numerous cannulaes over the years. Organised by the CNM3 who was safety conscious They particularly liked the vasofix safety cannulae

10. mechanism

11. Where we went from here Met with Infection control Team and Consultant Microbiologist Organised a trial for A/E and Theatre Post trial evaluation very positive Put proposal to finance for funding Legal case at time payout €8000 so no resistance from finance.

12. contd Exstensive training for medical and nursing staff. Another legal case so OHD used opportunity to put proposal for safety cannulae throughout hospital Proposal accepted.

13. Safety cannulae Introduced throughout the hospital September 2003. Training vitally important Very little resistance to new device 18 months post introduction we carried out an evaluation via questionnaire. Very positive feedback no problems identified.

14. 2 ½ years later Since introducing the safety cannulae in September 2003 we have had 1 needlestick injury.(from 28 in previous 2 years) This was were a doctor failed at cannulation and did not activate the device before removing from patient.

15. Things we learned It is hard work. Be persistent even if you are saying the same thing 100 times Initial training and ongoing training is vital and should be provided by the company Organisational commitment is key Involve staff at every stage it reduces resistance.