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Group 5 Go Beyond !

Recapping of Needles: The Davao Doctors College BSN 4 Student Nurses Experiences
Group 5-13B

Chapter 1 Introduction
Recapping of needles has turned out to be hazardous over these years. Some studies in the global setting support the fact that it leads to accidental injuries to any healthcare nurse. These needle stick injuries(NSIs) result into infection, thus putting anyone life at risk(Blackwell,et al,2007) Considering these facts, we researchers therefore attempt to explore further the experiences of teh student nurses of Davao Doctors College on recapping the needles and propose intervention scheme to address or alleviate this concern.

Theoretical framework 
Neuman system model  Flexible Line of Defense(FLD)  Normal Line of Defense(NLD)  Line of Resistance (LOR)

Variables
-physiologic -psychologic -developmental -sociocultural -Spiritual

Conceptual framework
Input Output

Experiences DDC BSN students recapping needles

of 4 on of

Proposed Intervention Scheme

Purpose of the study:
The purpose of the study is to describe how varied the experiences are of the BSN 4 students in recapping of needles. Also the study envisions to discover the extent of the knowledge, attitude and practice of these participants in recapping of needles. The following research questions guide the study: How do the participants describe their experiences in recapping of needles What do they know about the risk which they can acquire from their needle stick injuries? What actions do they propose to address their concerns on the risk?

Significance of the study:
College of nursing Administration: sound basis for policy formulation Clinical instructors : provide our clinical instructor baseline information instructions Student nurses: provide our fellow student nurses relevant data Future researcher : provide future researcher some baseline date which they could use for support

to develop

Limitation of the study:
Focus: describing the experiences of our student participants on recapping of needles

Participants : BSN 4 students enrolled in RLE 2nd semester S.Y. 2009-2010

Chapter 2 Methodolgy
Design : Qualitative Method Phenomenology Sampling: Purposive sampling-BSN 4 RLE students in S. Y 20092010 ( atleast 10) Measures: Materials  Interview guide with open ended question  FGD(atleast 10)  KII ( atleast 10)  Treatment: Conformability

Chapter 3 Results and discussion
Description of experiences in recapping of needles:
Input
KII (key-informant-interview) natural nervous and fear (factor CI s presence ) threw the syringe with out recapping Shakiness in performing Forgetfulness to fishhook FGD(focus group discussion) nervousness (factor CI s presence) Shakiness of hands Painful ( got pricked) natural and confident in perform

Feelings during the time of recapping:

KII (key-informant-interview) 
Feel panic Fearful and stressful during rd Shivering during rd Fear of pain and infection Easy

FGD(focus group discussion) 
Nervousness because of cis presence Painfull(got pricked Confident Confused  Easy

Knowledge of the BSN 4 participants on the risk they may possibly exposed in recapping of needles:

FGD(focus group discussion) KII (key-informant-interview) 
All 17 participants are aware of the risk that they may acquire(eg HIV, hepa B and C;aids) All 16 participants are aware about the risk they can acquire ,however pt 16 emphasizes the pain of the needle prick injury than the disease acquired

Knowledge of BSN 4 participants on what to do after getting pricked:

KII (key-informant-interview) 
Wash hands in running water soap and apply alcohol afterwards Report the incident to CI

FGD(focus group discussion) 
Wash wound and soap and water Report to CI Failed to perform proper recapping procedure

Suggestion of bsn 4 particpants on recapping of needles:
FGD(focus group discussion) KII (key-informant-interview) 
Proper procedure must observed Be careful when performing report to CI any healthcare team when injured Follow the guide lines on what to do when accidentally injured Avoid washing hands after procedure to prevent muscle spasm Listen to ci during rd Practice recapping several times Focus and presence of mind..

Chapter 4 Summary
Purpose: 
described how varied the experiences were BSN 4 students in recapping of needles envisioned to discover the extent of the knowledge attitude and practices of these participants in the recapping of needles

Research question: 
How do the participants describe their experiences in recapping of needles?  What do they know about the risk which they can acquire from their needle stick injuries? what actions do they propose to address their concerns on the risk?

Method Qualitative Research-Phenomenology 
FGD(focus group discussion) KII (key-informant-interview)

Participants purposively selected: 
BSN 4 students in RLE 2nd sem. S. Y 2009-2010 at DDC Finding of the study

Findings of the study: 
experiences varied because of the pressure which most of them across under a circumstances  different in attitude towards recapping of needles  Knowledge about possible disease or blood borne pathogens that they may acquire.  knowledge about the measures or steps on what to do when injured by a needle during recapping from reading the guidelines posted in the hospital

Conclusion:
We concluded that the difference of our participants in experiences which were indicated in their knowledge , attitudes and practices during and after recapping procedure was ascribed to the kind of training which their clinical instructor provided foe them in rd. However most of them confessed that their CIs had not taught them of the proper steps or action to do when an incident of needles injury occurred .Some would not like to report about the injury Both from the KII and FGD had some ideas on how to address the problem incurred from recapping procedure

Recommendation:
To college of nursing administration: sound basis for policy formulation To clinical instructor : 
Provide students with adequate knowledge of the prevalence of risk to caution them to perform recapping of needles Must educate in mind of the students the urgency of reporting the injury when injured

To student nurses:  must seek assistance from CI s whenever they are doubtful in performing recapping

Proposed Intervention Scheme:
Our findings had shown that Return Demonstration greatly influences the BSN-4 experiences' in recapping of needles. Most of them failed to do the standard procedure due to some circumstances, factors, and moreover because of lack of emphasis during lecture and return demonstration. Thus, researchers proposed the following interventions to increase awareness, skills and compliance to prevent needle stick injury to nursing students of Davao Doctors College. In lecture and return demonstration, we would like to add emphasis on the proper procedure on recapping of needles under the concept on administration of therapeutic agents (e.g. Intramuscular (IM) injection, Intradermal (ID) injection, and Subcutaneous (SC) injection). The following techniques are proposed to be included and focused during Lecture Demonstration in injection (IM, ID and SC) and Related Learning Experience NCM 101:

One-hand Recapping ( Scoop ) Technique

Many accidental needlesticks occur when staff recap needles. Recapping is a dangerous practice: If at all possible, dispose of needles immediately without recapping them. If it is necessary to recap a needle (for example, to avoid carrying an unprotected sharp when immediate disposal is not possible), do not bend or break the needle or remove the needle from the syringe by hand. To safely recap needles use the one-hand technique:

Step 1: Place the cap on a flat surface, then remove your hand from the cap. Step 2: With one hand, hold the syringe and use the needle to scoop up the cap. Step 3: When the cap covers the needle completely, use the other hand to secure the cap on the needle hub. Be careful to handle the cap at the bottom only (near the hub).

Hands-free Technique for Passing Sharps Health care personnel can accidentally stick each other when passing sharps during a procedure particularly in Operating Theater. Always pass sharps in such a way that the surgeon and assistant are never touching the item at the same time. This is known as the hands-free technique. To use the hands-free technique: The assistant puts the sharp in a sterile kidney basin or other safe zone in the sterile field. The assistant tells the service provider that the sharp is in the safe zone. The provider picks up the sharp item, uses it, and returns it to the safe zone.

Group 5 God bless ..