Skyworth Needlestick Injury Management Procedure Guide PDF

Needlestick Injury Management Procedure Contents Page 1.0 Overview 2 1.1 Scope 2 1.2 Definitions and abbreviations 2 1.3 External documents to be used with this procedure 2 1.4 References 3 2.0 Immediate Care and Risk Assessment 4 2.1 Risk Assessment of bites 5 2.2 Risk Assessment of common injuries in children 5 3.0 Managing Significant Exposures 6 3.1 Assess the risk of transmission 6 3.2 Check the vaccination status of injured person 6 3.3 Take blood for storage 6 3.4 Follow-up testing 6 3.5 Source testing 7 3.6 Urgent BBV testing in NHS Lothian 8 4.0 Post-Exposure Prophylaxis (PEP) for HIV 8 4.1 Testing 8 4.2 Supplying HIV PEP 8 4.3 Starter Packs 9 4.4 Patient Information 9 4.5 Follow-up for HIV 9 5.0 Post-Exposure Prophylaxis (PEP) for Hepatitis B 10 5.1 HBV accelerated vaccination 10 5.2 Administering Hepatitis B immunoglobulin (HBIG) 10 5.3 Follow-up for HBV 10 6.0 Managing Healthcare Worker (HCW) injuries 10 6.1 Informing people the incident has occurred 10 6.2 Risk Assessment of HCWs 11 6.3 Follow-up of HCWs 12 7.0 Managing Third Sector workers and members of the public 12 7.1 Risk Assessment of Third Sector workers and members of the public 12 7.2 Follow-up of Third Sector workers and members of the public 12 8.0 Where to get expert advice 12 Document Owner:

NHS Lothian Occupational Health Service, Review date: April 2025

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Page 2 of 13, Needlestick Injury Management Procedure 1. Overview 1.1 Scope This document gives practical step by step guidance on what to do after potential exposure to blood-borne viruses (BBV) following a needle-stick or other exposure. It covers injuries sustained by: NHS health-care workers (HCW), Third sector workers in voluntary agencies providing BBV testing using dry blood spot tests Non-occupational injuries NB: The Occupational Health Service (OHS) ONLY deals with injuries of HCWs Individuals presenting after sexual exposure or assault should be assessed according to the Post-Exposure Prophylaxis for Sexual Exposure (PEPSE) and non-occupational exposure to Blood Borne Viruses.

1.2 Definitions and abbreviations Anti HBS Anti Hepatitis B Surface Antigen Antibody BBV Blood-Borne Virus CSHC Chalmers Sexual Health Centre GUM Genito-Urinary Medicine HBIG Hepatitis B Immunoglobulin HBV Hepatitis B Virus HCV Hepatitis C Virus HCW Health Care Worker HIV Human Immunodeficiency Virus ID Infectious Diseases OHS Occupational Health Service PCR Polymerase Chain Reaction PEP Post Exposure Prophylaxis RHCYP Royal Hospital for Children and Young People RIDU Regional Infectious Diseases Unit RIE Royal Infirmary of Edinburgh SJH St John’s Hospital WGH Western General Hospital 1.3 Documents to be used with this procedure Document Owner:

NHS Lothian Occupational Health Service, Review date: April 2025 Title Function Needlestick Injury Immediate Care and BBV Risk Assessment flowchart Recommendation for how to optimally manage a needlestick injury, including assessment for each BBV; also available in section 2.

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Page 3 of 13, Needlestick Injury Management Procedure 1.4 References Department of Health. HIV Post-exposure prophylaxis: Guidance from the UK Chief Medical Officers’ Expert Advisory Group on AIDS. Revised September 2008 & 2013 Department of Health, Green Book, Chapter 18, updated 2017 BMA: Needlestick injuries and blood borne viruses: decisions about testing adults who lack capacity Document Owner: NHS Lothian Occupational Health Service, Review date:

April 2025 BBV exposure risk assessment form To be filled out in every case, and forwarded to the relevant specialty in cases of significant exposure Blood Borne Viruses – Background information for Risk Assessment Allows you to calculate % chance a source is BBV positive, to perform a risk assessment Current recommended HIV Post-Exposure Prophylaxis (PEP) Current NHS Lothian recommended PEP medication Needlestick Injuries and Prevention of HIV Infection: A Factsheet for Patients Information about risk of contracting BBVs from needlestick, BBV testing and PEP Post Exposure Prophylaxis (PEP) Antiretroviral starter pack: Patient Information Leaflet PEP patient information leaflet.

Give to patients who are starting PEP Testing for Blood Borne Viruses, Information for Patients Can be handed to patients who are or are considering being tested for BBV

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Page 4 of 13, Needlestick Injury Management Procedure 2. Immediate Care and Risk Assessment Initial assessment of needlestick injuries should be conducted according to the above Document Owner: NHS Lothian Occupational Health Service, Review date: April 2025

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