Advocate for safety

Having achieved what she set out to do after she was infected with HIV and the hepatitis C virus through an occupational needlestick injury in 1997, Lisa Black, a registered nurse from Reno, has moved on with her life.

For about five years, the center of her life revolved around extensive public speaking about her experience among nursing groups, physician groups, general healthcare workers, infectious disease conferences, lawmakers in the United States,Asia and Europe.

She also worked to pass national and state needle safety and worker's compensation legislations.

"I chose to go public with it because it was important to do so," says Black, who was 26 at the time and a single mom of two daughters.

"It isn't just about numbers.What happened to me was not common.

To my knowledge, there had never been a case of that happening in the state of Nevada.

But when it does happen, it's very important."

Black, now 35, has since gone back to school and completed her master's degree.

For her master's thesis, she researched on patients' perceptions of healthcare workers with HIV/HCV.

Today, while teaching fulltime at the University of Nevada Reno's nursing program, she is also pursuing a doctorate on health policy.

"I do consider it an opportunity to be able to work with nursing students, as they are learning and to be able to teach them about safety," she says.

Black also works a couple of days a month at Washoe Medical Center.

And last month, South Jordon,Utah-based International Sharps Injury Prevention Society, the first international needlestick prevention group, honored her for her efforts.

"It's really a nice recognition,"Black says."I think the work I've done has made a lot of difference for a lot of people.

I hope it has."

She speaks occasionally to health groups but the need to do so is not as pressing as when she chose to put a public face to the issue of dealing with workers infected with needlestick injuries and the urgent need to adopt safety devices.

Most of the industry, she points out, has responded to the need to prevent the injuries.

Black was one of the prominent figures who worked hard, traveling constantly to Washington,D.C., despite her health failing many times, on the passage of the Needlestick Safety and Prevention Act of 2000.

She is happy to see the progress that's been made but says there is still some way to go to make it completely safe.

She sees some reluctance specifically among surgeons, among whom there tends to be a culture of not wanting to use the safer needles that are available.

"They tend to think 'That won't happen to me, I'm careful.'My message to them would be: I was careful too and it happened to me."

A recent unpublished study of the Exposure Prevention Information Network comparing percutaneous injury rates in 1999 before the passage of the act and 2003 found that there was a 33 and 45 percent decrease in teaching and non-teaching hospitals respectively.

In a more in-depth study in 2003 that was published in Advances in Exposure Prevention data was only taken from teaching hospitals it was found that, overall, there was a 51 percent decrease in sharp injury rates to nurses.

And the same study found major declines in injury rates in most device categories such as three hollow-bore needle categories, phlebotomy needles and also for catheters and butterflies, says Jane Perry, director of communications of the International Healthcare Worker Safety Center at the University of Virginia, Charlottesville.

"The one device category in which we did not see a really significant decrease was suture needles, which only had 5 percent decline in injuries,"Perry adds.

Black subsequently worked on Presumptive Compensability Legislation in Nevada, which was successfully passed in 2002.

This legislation requires workers compensation benefits to healthcare workers who develop an infectious disease after exposure to blood and body fluids and infectious air in their workplace.

"It was very courageous, just because it's very difficult, given her personal situation, to go public," says Assemblywoman Sheila Leslie, D-Reno."She was a tireless advocate and helped me on the issue.

By putting a face on the issue, she made it impossible to ignore at the legislature and really was the key person that ensured its passage."

Northern Nevada nurses, Leslie says, tell her they feel a huge sense of relief to have their safety improved because of this legislation.

Black says she's gratified to see the change in attitudes in the health industry.Where healthcare worker exposed to needlestick injury once were told, "You need to be more careful," they now hear,"If the exposures are happening we need to look at changing the existing practices."

One of her biggest compliments, she says, came from a nurse who had once actually worked with her at the time when she went public.

"Every time I have a needle in my hand I think of you," the nurse had told her."That was probably it.

That was it."