How do nurses handle sharps, hazardous drugs, radiation and chemicals safely?
NCLEX-RN topic: Hazardous and infectious materials
- Needlestick: wash with soap and water, report now, get evaluated.
- Never shear or break needles; drop them right away into a sharps container.
- Hazardous-drug excreta need PPE for 48 hours: double gloves and a gown.
- Radiation safety: limit time, increase distance, use shielding.
- SDS sections: 2 hazards, 4 first aid, 6 spills, 8 PPE.
Key facts
- Needlestick or cut: wash with soap and water; splash to nose, mouth or skin: flush with water; eyes: irrigate with clean water, saline or sterile irrigant.
- Report every exposure immediately and seek medical care right away; OSHA requires a confidential post-exposure evaluation at no cost to the worker.
- Contaminated needles are never sheared or broken and are not recapped, bent or removed unless no alternative exists, and then only with a one-handed technique or a mechanical device.
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- Hazardous-drug excreta stay hazardous for 48 hours after a dose; wear PPE (double gloves, gown, face protection if splashing is possible).
- Hazardous drug on the skin: wash with soap and water; in the eye: flood for at least 15 minutes.
- Radiation protection is time, distance and shielding: as little time as the job needs and as much distance as possible.
- Safety data sheets must be readily accessible every shift; section 2 lists hazards, 4 first aid, 6 spills and 8 protective equipment.
Quick check1 question · 2 more at the end
A nurse is stuck with a used needle after giving an injection. The nurse has just washed the puncture with soap and water. What should the nurse do next?
Correct answer: A.
After cleaning the site, the nurse reports the exposure to the supervisor immediately and seeks medical care right away to judge the risk and the need for preventive treatment. OSHA requires the employer to make a confidential evaluation and follow-up available immediately after an exposure is reported.
A Correct: report the incident at once and seek medical care right away to determine the risk.
B Reporting is immediate, not delayed until the end of the shift.
C The evaluation, including testing of the source client, starts after the report; it is not a reason to delay reporting.
D Medical evaluation is sought immediately, not left for later.
Full lesson
Each part starts with its main idea. Open a part when you want the details.
The short answer: After a needlestick, wash the wound with soap and water, report it immediately and get a confidential medical evaluation at no cost. Wear double gloves and a gown for hazardous drugs and their excreta for 48 hours. Limit time and increase distance near radiation sources, and check the safety data sheet for chemical hazards, first aid and spills.
1 What should you do right after a needlestick or splash?Clean the exposed area at once, then report the exposure and get evaluated right away. 1 min
Clean the exposed area at once, then report the exposure and get evaluated right away. Hepatitis B, hepatitis C and HIV can all spread through blood, so do not wait.
- Clean: wash a needlestick or cut with soap and water. Flush splashes to the nose, mouth or skin with water. Irrigate the eyes with clean water, saline or a sterile irrigant.
- Report: tell your supervisor immediately and complete an incident report.
- Get care: seek medical evaluation right away to judge your risk and the need for preventive treatment.
Under the OSHA Bloodborne Pathogens Standard, the employer must offer a confidential medical evaluation and follow-up at no cost to you. It documents how the exposure happened and tests the source client's blood as soon as feasible after consent. The hepatitis B vaccine must also be offered at no cost within 10 working days of starting a job with exposure risk.
2 How do you prevent sharps injuries?Safety devices and a few firm habits protect you from sharps injuries. 1 min
Safety devices and a few firm habits protect you from sharps injuries. Contaminated needles are never sheared or broken. They are not bent, recapped or removed unless no alternative exists, and then only with a one-handed technique or a mechanical device.
Drop a used sharp right away into a puncture-resistant container close to where it was used. Use safety-engineered devices, such as needleless IV connectors, whenever they are available.
3 How do you handle hazardous drugs?Treat hazardous drugs, such as many cancer drugs, and the client's body fluids as exposure sources. 1 min
Treat hazardous drugs, such as many cancer drugs, and the client's body fluids as exposure sources. These drugs can enter your body through the skin, the eyes or by breathing in dust or droplets.
| Situation | What to do |
|---|---|
| Giving the drug | Gown and two pairs of gloves; face and eye protection if splashing is possible |
| Urine, stool, vomit within 48 hours of a dose | Same PPE as giving the drug |
| Drug on the skin | Wash right away with soap and water |
| Drug in the eye | Flood the eye at an eyewash station for at least 15 minutes |
| Spill | Trained staff use the spill kit; post a warning sign |
Never eat, drink or apply makeup where hazardous drugs are handled.
4 How do you stay safe around radiation sources?Radiation safety comes down to time, distance and shielding. 1 min
Radiation safety comes down to time, distance and shielding. Spend only the time the job needs near a source, keep as far away as you can, and use shielding when it is available.
A client with a temporary brachytherapy implant may stay in a private room. Nurses give all needed care but work quickly, may stand at a distance and may talk from the doorway. Visits are short (about 30 minutes or less a day), and pregnant visitors and children younger than 1 year do not visit. After a temporary implant is removed, no radiation remains in the body.
5 What does a safety data sheet tell you about a chemical?A safety data sheet (SDS) is the first place to look before you handle or clean up a chemical. 1 min
A safety data sheet (SDS) is the first place to look before you handle or clean up a chemical. OSHA requires an SDS for each hazardous chemical, readily accessible to workers on every shift. Every SDS uses the same 16 numbered sections.
| Question | SDS section |
|---|---|
| What are the hazards and warnings? | 2, Hazard(s) identification |
| What first aid is needed after exposure? | 4, First-aid measures |
| How is a spill or leak cleaned up? | 6, Accidental release measures |
| How should it be stored? | 7, Handling and storage |
| What PPE protects me? | 8, Exposure controls/personal protection |
Common mistakes
The traps students fall into most. Read these before you practice.
Watch out: Report a needlestick right away, not at the end of the shift or after the source client's results return.
Watch out: Hepatitis B vaccine is offered within 10 working days of starting a job with exposure risk, not only after an exposure.
Watch out: A sealed implant still gives off radiation while it is in place; after a temporary implant is removed, the client is no longer radioactive.
Watch out: Section 4 of the SDS is first aid, not personal protective equipment, which is section 8.
How to remember it
Use the three-word habit "clean, report, evaluate" after any exposure. For radiation, add "less time, more distance." For chemicals, look for the numbers 2-4-6-8: hazards, first aid, spills, PPE.
Self-check:
- Say the first three things you do after a needlestick.
- Name the PPE for emptying a urinal 20 hours after a hazardous-drug dose.
- Name the SDS section you would open to find the gloves to wear.