Needlestick injury in dental practice — ORE Part 1 MCQ

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HardDental Public Health, Ethics, Law and Infection ControlNeedlestick injury in dental practiceORE Part 1

A dental nurse sustains a needlestick injury from a used local anaesthetic needle after treating a patient of unknown blood-borne virus status. The wound bleeds slightly. The practice has an occupational exposure policy and access to urgent medical advice. What is the most appropriate immediate investigation?

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Correct answer: D — Urgent occupational health blood-borne virus risk assessment

The correct answer is D. UK occupational health guidance (SDCEP, NHS Scotland, NHS England) mandates that following a needlestick injury with potential blood-borne virus exposure, the injured worker must report immediately to Occupational Health Services for urgent risk assessment and advice. A risk assessment determines the actual transmission risk based on mechanism, patient factors (if known), and worker immune status, and guides decisions on post-exposure prophylaxis (PEP) initiation—which must occur within hours for maximum effectiveness. A (needle culture) is not a standard diagnostic tool and adds no clinical value. B (patch testing) addresses latex allergy, not BBV exposure. C (delayed review) is dangerous and contradicts the imperative for immediate assessment and timely PEP. D (radiograph) is irrelevant. Risk assessment by occupational health is the only correct first step.

Reference: Right Decisions (NHS Scotland) and SDCEP Practice Support Manual: occupational health risk assessment for healthcare workers following needlestick injury. https://www.rightdecisions.scot.nhs.uk/infectious-diseases/needlesticks-peppepse/occupational-needlestick-injury/occupational-needlestick-injury-management-procedure/managing-healthcare-worker-hcw-injuries/