EPINet OverviewEPINet Overview&&

RCN Surveillance ProjectRCN Surveillance Project

2005 Data2005 Data

EPINETEPINET

ExposureExposure PreventionPrevention Information Information NETworkNETwork

What does EPINet do?What does EPINet do?

Records occupational exposures to Blood & Body FluidsRecords occupational exposures to Blood & Body Fluids

Records occupationally acquired Sharps injuriesRecords occupationally acquired Sharps injuries

Tracks the results/consequences of these incidentsTracks the results/consequences of these incidents

How does EPINet do this?How does EPINet do this?

Uses 3 forms:Uses 3 forms:

1 Blood & Body Fluid Incident form1 Blood & Body Fluid Incident form

1 Needlestick & Sharp Object Incident form1 Needlestick & Sharp Object Incident form

1 Post Exposure form1 Post Exposure form

Blood & Body Fluid IncidentBlood & Body Fluid Incident

16 Questions16 Questions

Records exact details of exposures to Blood & Body Records exact details of exposures to Blood & Body fluids, including:fluids, including:

Which body fluids were involvedWhich body fluids were involved Where the exposure occurredWhere the exposure occurred Which part of the body was exposedWhich part of the body was exposed The length of time of the exposureThe length of time of the exposure The amount of fluid involved in the exposureThe amount of fluid involved in the exposure

Needlestick & Sharp object IncidentNeedlestick & Sharp object Incident

20 Questions20 Questions

Records exact details of Sharps injuries including:Records exact details of Sharps injuries including:

What type of device caused the injuryWhat type of device caused the injury The original user of the sharp itemThe original user of the sharp item The extent of the punctureThe extent of the puncture The location of the injury on the victimThe location of the injury on the victim A description of how the incident occurredA description of how the incident occurred

Post Exposure IncidentPost Exposure Incident

11 Questions11 Questions

Records details of the follow up to the incident, Records details of the follow up to the incident, including:including:

Results of testing for HCV, HBV, HIVResults of testing for HCV, HBV, HIV If the patient carried any BBVIf the patient carried any BBV

Treatment givenTreatment given

FeedbackFeedbackFeedback comes in 2 formatsFeedback comes in 2 formats

1.1. Reports:Reports:

Single Incident ReportSingle Incident Report Summary ReportSummary Report

2.2. Graphs:Graphs:

Variety of graphs from BBF and Needlestick Variety of graphs from BBF and Needlestick incidentsincidents

19 graphs to choose from19 graphs to choose from

Single Incident ReportSingle Incident Report

Available on all 3 formsAvailable on all 3 forms

Select the record you want to viewSelect the record you want to view

Report shows full details of incidentReport shows full details of incident

One page report One page report

Option to printOption to print

Single Incident Report: ExampleSingle Incident Report: Example

Summary ReportSummary Report

4 reports available in total4 reports available in total

Set criteria for data you want to viewSet criteria for data you want to view

EPINet generates summary reportEPINet generates summary report

Breaks down figures for easy analysisBreaks down figures for easy analysis

5 page printable report5 page printable report

Summary Report: ExampleSummary Report: Example

GraphsGraphs

19 graphs19 graphs

Available on BBF & Needlestick incidentsAvailable on BBF & Needlestick incidents

Allows for easy analysis of dataAllows for easy analysis of data

Graphs include:Graphs include: Job CategoryJob Category Original PurposeOriginal Purpose

Device (needlestick)Device (needlestick)

Where is EPINet used:Where is EPINet used:

6 Other European Countries run their own versions of 6 Other European Countries run their own versions of EPINetEPINet

60 Sites through out the UK60 Sites through out the UK

22 of which form the basis of the RCN surveillance 22 of which form the basis of the RCN surveillance project into NSI’sproject into NSI’s

Job DescriptionJob Description

10%

16%

1%

1%

2%

2%

3%3%

4%

4%9%

37%

8%

Consultant/ Registrar

SHO/HO

Professions Allied to Medicine(PAMS)

ODA/ ODP

Dentist

Sterile services

Dental hygienist/ Dental Nurse

Nursing Student

Phlebotomist/ IV Team

Domestic/ Porter

HCA/NA

Nurse

Other

Other: Ambulance/ Paramedic, Laundry, Physiotherapist, Clinical laboratory worker, Technician (non lab), Other attendant, Medical student

Where Injury OccurredWhere Injury Occurred

39%

3%6%2%

18%

4%

13%

1%

1%

3%

2%

2%

6%

Patient room

Outside patient room

A&E

ITU/ CCU

Theatre/ Recovery

OPD

Procedure room

Clinical Laboratories

Mortuary/ pathology

Service/ Utility

Labour/ delivery room

Home care

Other

Other: Day Centre, Blood bank, Venepuncture Centre, Dialysis facility

Source Patient IdentifiableSource Patient Identifiable

87%

10%1%2%

Yes

No

Unknown

N/A

Injured Worker was the Original User of Sharp ItemInjured Worker was the Original User of Sharp Item

62%

33%

3% 2%

Yes

No

Unknown

N/A

Was the sharp Item ContaminatedWas the sharp Item Contaminated

84%

2%

14%

Contaminated

Uncontaminated

Unknown

Purpose of the Sharp ItemPurpose of the Sharp Item8%

23%

1%

1%

8%

15%2%

3%

4%

11%

6%

1%

1%

3%

13%

Unknown/ N/A

Injection, intramuscular/ subcutaneous or other injection through the skin (syringe)

Other injection into (or aspiration form) IV injection site or IV port (syringe)

To connect to IV line(intermittent IV/ piggyback/ IV infusion/ other IV line connection)

Cannulate IV or set up heparin lock (IV catheter or winged set-type needle)

To draw venous blood sample

To draw arterial blood sample

To obtain a body fluid or tissue sample

Finger stick/ heel stick

Suturing

Cutting

To place an arterial/ central line

Drilling

Subcutaneous infusion (fluid/ medication)

Other

Other: Heparin/ Saline IV Flush, Electrocautery, To contain a specimen or pharmaceutical (glass item)

When did the Injury OccurWhen did the Injury Occur

1%

32%

7%

6%2%

2%

1%

23%

2%

7%

3%

0%

2%6%

1%5%

Before use of item (item/ broke/ slipped, assembling deviceetc)

During use of item (item slipped, patient jarred item etc)

Betw een steps of a multi-step procedure (betw eenincremental injections,passing instruments etc)

Disassembling device or equipment

Inpreparation for reuse of reusable intrucment (sorting,disinfecting, sterilising etc)

While recapping used needle

Withdraw ing a needle from rubber or other resistantmaterial (rubber stopper, IV port etc)

Other after use (before disposale - intransit to w aste,cleaning, sorting etc)

From item left on or near disposal container

While putting item into disposal container

After disposal, stuck by item protruding from opening ofdisposal container

Item pierced side of disposal container

After disposal, item proturded from w aste beg orinappropriate w aste container

Other after use (before disposale - intransit to w aste,cleaning, sorting etc)

Restraining patient

Device left on f loor, table, bed or other inappropriate place

Type of Device Causing InjuryType of Device Causing Injury

24%

4%

1%

1%

3%

7%

5%8%2%

6%

10%

3%

8%

3%1%1%1%

2%

10%

1%

Disposable syringe with needle

Pre-filled cartridge syringe

Blood gas syringe

Syringe, other type

Needle on IV line

Winged steel needle

IV catheter stylet

Vacuum tube blood collection holder/ needle

Unattached hypodermic needle

Needle, not sure what kind

Other needle

Lancet (finger or heel stick)

Suture needle

Scalpel, reusable

Electro-cautery device

Trocar

Fingernails/ teeth

Scalpel, disposable

Wire (suture/ fixation/ guide wire)

Other

Other glass item, Specimen/ test tube, Forceps/ Clamps, Non-vascular catheter needle,Other vascular catherter needle, Central line catheter, Arterial introducer, Spinal or epidural needle, Scissors, Razor, Microtome blade, Towel chip, Bone cutter, Staples, Retractors, Other Sharp item, Drill bit/ bur, Pin, Other sharp item

Depth of InjuryDepth of Injury

46%

51%

3%

Superficial (little or no bleeding)

Moderate (skin puncture, somebleeding)

Severe (deep stick/ cut, orprofuse bleeding)

Glove PenetrationGlove Penetration

59%

5%

36%

Single pair of gloves

Double pair of gloves

No gloves

Average NSI per 100 Beds = 14.8

Site number Number of beds Total needle sticks NSI / 100 beds103 340 47 13.82106 1014 88 8.68111 446 71 15.92116 520 78 15.00121 1472 181 12.30124 1168 151 12.93125 364 76 20.88129 744 145 19.49134 439 49 11.16135 1200 165 13.75136 550 56 10.18138 950 194 20.42150 589 85 14.43194 532 95 17.86195 687 87 12.66196 656 133 20.27197 973 128 13.16198 225 43 19.11199 460 107 23.26

NSI AVERAGE YEAR ON YEARNSI AVERAGE YEAR ON YEAR

• Year 1 AverageYear 1 Average 11.311.3• Year 2 Average Year 2 Average 11.611.6• Year 3 AverageYear 3 Average 14.114.1• Year 4 Average Year 4 Average 14.514.5• Year 5 AverageYear 5 Average 14.814.8

RequirementsRequirements

• 1 strict requirement1 strict requirement

• MS Access 2000 or XPMS Access 2000 or XP

• EPINet is a file which uses database features of EPINet is a file which uses database features of AccessAccess