In 2006, a young nurse, Junie Xaviour freshly passed out from a renowned Nursing college in Kerala came to work in a super-speciality hospital in Kolkata. Motivated by Florence Nightingale, she was eager to be a part of the patient care process.
One month into her duty in CCU, she got a deep needle prick from a hypodermic needle while withdrawing after administering an injection to a patient. Not knowing what to do, she casually approached her supervisor Lily. “Madam, I got a prick from a used needle and its bleeding”, said Junie. “Junie you should not take this casually at all. This prick can act as the entry of deadly organisms and lead to diseases like HIV, Hepatitis B or C”, exclaimed supervisor Lily.
“Madam, I am scared. What should I do now? Said a bit startled Junie. “Listen Junie, Meet the Emergency Medical Officer.” Junie met with the EMO, Dr Jatin. Dr Jatin asked, “You are quite careless? Were you not taught in Nursing school how to give injections? Junie replied nervously “Sir, I have accidentally pricked myself with a used needle”.
Dr Jatin replied quite apathetically, “I will give you first aid. I will take your blood samples.” Go and get the billing done with this prescription. Get me the patient’s sample also.”
Junie ran all the way panic-stricken to her supervisor to get the patient details. Ms Lily mentioned, how can we ask the patient for the sample? Who will bear the cost?” Junie replied in a trembling voice “Madam, I will bear all the cost.” Lily replied “Go and convince the patient and draw the sample.” Junie had a tough time explaining to the patient to get the sample. She bore the cost herself, deposited the samples with the laboratory and went back to Dr Tarak. “Do I need to do anything else”, Junie asked. Dr Jatin mentioned “we will inform you”. Junie waited for a week but no one got back.
She approached a relative of her who was a nurse in the School of Tropical Medicine, Kolkata who guided her through the next course of action.
“That incident totally shook me up. Fortunately for me the follow ups were negative. I decided, I will not let this happen to anyone in the future”’ recalls Junie. She changed her career path and shifted to Nursing administration. She undertook the Infection Control course from TISS and joined Apollo Gleneagles Hospital Limited, Kolkata, a multidisciplinary tertiary care JCI accredited hospital in 2010 in infection control.
Over the years Junie worked hard with support from Hospital management and Quality Cell to build a robust process of Needle stick injury and other sharps related injury preventions. From as high as an average of 6/month NSI has been reduced to “zero” in current months.
According to Junie “Through team efforts, we have achieved what we wanted in our hospital. But, we have miles to go before we sleep. We need to strengthen our National Policies and bring in mandates to protect staffs from Occupational Exposures to Blood borne pathogen like abroad.” Junie’s initiative still continues to touch the lives of many.
Lessons Learned
- Lack of policies and defined processes on prevention of exposure to blood borne pathogens and what protocols to follow following a needle stick injury
- Lack of training and awareness among staffs policies and processes, use of PPEs, Biomedical waste management, safe injection practices and NSI protocols
- Lack of a robust mechanism of tracking and follow up of each injury
- Lack of availability engineered safety devices and personal protective devices.