Copyright 1999 Globe Newspaper Company
The Boston
Globe
April 6, 1999, Tuesday ,City Edition
SECTION: METRO/REGION; Pg. B1
LENGTH: 761 words
HEADLINE: A
nurse hopes her infection will spur action;
In lobbying for protection,
union head will disclose her needle-stick injury
BYLINE: By Richard A. Kno, Globe Staff
BODY:
Nurse Karen Daley was
shoving a used hypodermic needle into a disposal box at the Brigham and Women's
Hospital emergency room last July when she felt a sharp pain. A used needle
inside the box was pointing upward, and it stuck her gloved finger.
Months later she got the awful news: That accidental
needle-stick injury had infected her with the viruses that
cause AIDS and hepatitis C, a serious and often-fatal liver disease.
US
health-care workers report about 600,000 accidental injuries from needles and
other "sharps" each year, resulting in about 1,000 serious infections. What made
Daley's case unique is that she is president of the Massachusetts Nurses
Association. Ironically, the association was already preparing legislation that
would require hospitals to use the best available needle-stick prevention
technology.
To further that cause, the 46-year-old nurse plans to reveal
her infection publicly today in Beacon Hill testimony.
"She's one
amazing person," said Gloria Craven, the association's lobbyist. "She's saying,
'How can we turn this into something good?' "
Daley declined to speak
about her situation before her testimony, but colleagues say she is coping with
stoicism and determination. She reportedly suffers serious fatigue from her
infections.
Through June of last year, the US Centers for Disease
Control recorded 54 cases of documented HIV infection among health-care workers
and 133 possible cases. Nurses led the list of workers with occupationally
acquired HIV infection.
It is rare for victims of accidental needle
sticks to become infected with both hepatitis C and the human immunodeficiency
virus (HIV), which causes AIDS. Both are potentially fatal, and hepatitis C is
the leading cause of liver failure requiring transplantation.
The dual
infection complicates Daley's treatment, a nurse colleague said, and makes it
difficult to predict her course.
Although details of Daley's injury were
unavailable yesterday, it may have been impossible to identify the patient who
was the source of her infections. The disposal box presumably contained needles
from a variety of patients treated that day.
One of Daley's colleagues
called her injury "100 percent preventable" by such means as better-designed
disposal boxes, more frequent emptying of such receptacles, and needles that are
covered by a retractable plastic sheath except at the moment when they are in
contact with a patient's skin.
"Overall the health-care industry has not
seen fit to provide the devices that would make the work environment safer for
nurses and others," said Evelyn Bain, an occupational safety and health
specialist at the nurses association.
The costs of safer technology are
far outweighed, Bain said, by the costs of investigating needle-stick incidents
and providing prophylactic drugs costing $1,300 to
$1,800 per case, not to mention the future treatment costs and
human suffering if a health-care worker becomes infected. "One local hospital
that reduced needle-stick injuries by 50 percent with a prevention program still
recorded 101 injuries in 1997," she added. "That facility spent
$141,000 to follow the injured workers."
The proposed
legislation, which will be considered by the Legislature's Joint Health Care
Committee today, would set up a mechanism within the state health department
requiring health-care facilities to employ best-available prevention strategies.
"Facilities would have to do only three things: purchase the appropriate
equipment; look at how to prevent injury; and when an injury occurs, document it
and keep a log so we can use it for quality improvement," Craven said.
So far Oregon is the only state to pass such a law, she said.
Judy Glasser, a spokeswoman for the Massachusetts Hospital Association,
said hospitals generally support the proposal. "We believe it moves in the right
direction, and we believe we should do everything we can to protect our
employees and caregivers," Glasser said.
Staff members at the nurses
association said they learned only about a month ago about Daley's infections,
which the administration of prophylactic drugs had failed to prevent. "Most of
us haven't stopped crying yet," one said.
Daley's career may not be
over, but her 25 years of direct patient care may be at an end because of the
risk she may pose to patients. About 85 percent of individuals infected with the
hepatitis C virus become chronic carriers, and so far no treatment has been
shown to eliminate HIV from the tissues of infected individuals.
LOAD-DATE: April 06, 1999 
