The Cost of a Needlestick Injury

In November 2000 when the Needlestick Safety and Prevention Act was bought into the United States during the Clinton administration, there was renewed focus and clinical discipline given to the prevention of needlestick injuries. With the bill requiring healthcare facilities to review and make available safety-engineered sharps products, a rise in SED adoption saw needlestick injury rates fall 38% percent within twelve months. It was genuinely believed that within 5 years of the bill being passed, we would all but eliminate sharps injuries.

Fast forward two decades, and we are seeing sharps injuries trending only slightly lower than in 2001 with an estimate of 2.4 injuries occurring per 100 full time equivalent staff. Per the 2017 EXPO-STOP results, over 50% of needlestick injuries occur in perioperative services, primarily in operating rooms. The majority of OR incidents result inbetween use of a sharp item – either in the passing of a sharp between members of the surgical team or in the placement or disposal of an item. Over 70% of the exposures involve suture needles or disposable syringes, and the victims are most commonly physicians and nurses. 

What is the cost?

The exposure risk of needlestick injuries is far greater than is commonly reported. While Aids, Hepatitis B, and Hepatitis C are amongst the more severe diseases that can be contracted via sharps penetration, there are in fact more than 60 bloodborne pathogens that can be contracted as a result of a sharps injury.

In the US, the estimated cost of a single Needlestick Injury (NSI) treatment ranges between US$500 to US$4,000 (CAD$640 to CAD$5,100).^1,4 Leveraging these costs, the annual economic burden of NSIs in the US was estimated to be between US$118 million and US$591 million (CAD$151 million and CAD$757 million) based on national occurrence of 236,000 cases.² For the more serious cases, however, the costs can far exceed the average. According to the American Hospital Association, one case of serious infection by bloodborne pathogens can cost US$1 million (CAD$1.3 million) or more in expenditures for testing, follow up tests, lost time, and disability payments.³

Despite being staggeringly high, these costs are underestimated in that they do not account for long-term treatment costs associated with illness contracted from the injury or litigation and compensation costs.¹ They also do not account for the “harder to monetize” human impact that is experienced by the healthcare workers affected. 

The emotional toll of a needlestick injury

There is no “convenient time” for a sharps injury to occur and, especially within the OR, many practitioners report a certain stigmatism against reporting a stick. When a needlestick injury occurs, there is a natural disruption that follows. In the OR the exposed healthcare worker must scrub out and be replaced, and further time is taken up in the drawing of blood from the patient and follow-up investigation into patient records; this process naturally creates an environment where the victim feels they have done something wrong. 

A common narrative from needlestick injury survivors is that the time waiting for blood draw results is their most emotionally unsettling memory of being stuck. Beyond the pressure that they feel having left their team a staff member short, they are now in a state of psychological unrest waiting to find out whether they have contracted a life-threatening illness.

Every needlestick injury has an individual impact 

Every needlestick injury incurs a significant consequence for the person exposed and their loved ones, especially if it was a high-risk exposure or the patient chooses not to consent to having their blood drawn. If the victim acquires a communicable disease, the implications are life altering. In the case of a person accidently sticking a colleague, there is often a high degree of trauma and physiological distress that the team member has to endure.

Eliminating sharps injuries relies on many factors – safer devices, safer sharps containers, leadership focus, and safety process adoption. See our article on needlestick injury prevention here for further insight. However overall, as an industry and as a group of people committed to improving safety for healthcare workers, it requires a collaborative effort ensure that everyone; healthcare practitioners, EVS staff and patients, get home safely at the end of the day. 

¹ Centers for Disease Control and Prevention. Workbook for designing, implementing, and evaluating a sharps injury prevention program. 2004. Available at: www.cdc.gov/sharpssafety/index.html.

² Department of Health and Ageing. The Australian Immunisation Handbook 9th Edition. Available at: http://www.healthgov.au/internet/immunise/publishing.nsf/content/handbookhepatitisb.

³ Pugliese G and Salahuddin M. Sharps injury prevention program: a step-by-step guide. Chicago: American Hospital Association. 1999

4Lee JM, Botteman MF, Xanthakos N, Nicklasson L. Needlestick injuries in the United States: epidemiologic, economic, and quality of life issues. American Association of Occupational Health Nurses Journal. 2005. 53(3):117-33