Abstract
Healthcare workers put themselves at risk every day in ways that rarely make headlines. Among the quieter occupational hazards is the needlestick injury (NSI), a small puncture that can carry enormous consequences, including exposure to hepatitis B, hepatitis C, and HIV. When I learned that interventional radiologists, who routinely handle long, fine needles during image-guided biopsies, report NSI rates between 86 and 91 percent over the course of a career, I was struck not only by how common this risk is, but by how normalized it has become. My thesis work, encompassing both the technical project and my STS research paper, grew out of a shared question: why, despite decades of regulation and device innovation, do these injuries persist at such alarming rates?
The technical project addresses the problem at its most immediate source: the Chiba Needle itself. This standard interventional radiology tool requires clinicians to repeatedly reinsert a stylet or catheter after each tissue sample, forcing direct contact with an exposed, contaminated sharp in a cramped, high-stakes workspace. My team's goal was to redesign this device so that reinsertion, the single most hazardous step in the procedure, is eliminated entirely. Our proposed design introduces a sheath-protected, self-retracting stylet mechanism that automatically encloses the sharp tip upon withdrawal. This allows the needle to remain in place for additional sampling passes without requiring the clinician to handle the exposed sharp. The design also prioritizes reusability, addressing both cost and sustainability concerns that often discourage hospitals from adopting newer safety equipment. Development will follow a user-centered, iterative prototyping process in collaboration with interventional radiologists at the University of Virginia Health System, with target benchmarks of a 95 to 100 percent reduction in simulated NSI events across at least 15 safe reactivation cycles.
My STS research paper asks a harder question: even if a safer device exists, what determines whether it actually gets used? Using Actor-Network Theory (ANT) as an analytical lens, the paper examines how clinicians, manufacturers, hospital administrators, regulatory agencies, and the devices themselves form a network whose alignment, or misalignment, produces safety outcomes. The Needlestick Safety and Prevention Act of 2000 serves as a central case study. Though the Act mandated the adoption of safety-engineered sharps devices across U.S. healthcare settings, NSI rates have not declined proportionally. The paper argues this is not a failure of the law itself, but of translation, the process by which the goals of policymakers must be taken up by hospitals, procurement officers, and clinicians in ways that fit real clinical conditions. When a safety device disrupts tactile feedback or requires two-handed activation mid-procedure, clinicians may bypass it, not out of carelessness, but because the device was never designed around their actual workflow. The paper identifies four areas where better alignment is needed: device design, regulatory evaluation, institutional training, and economic incentives.
Taken together, these two projects reflect a conviction that technical and social problems cannot be solved independently of each other. A redesigned Chiba needle, however elegant its mechanism, will not reduce injuries if hospitals lack the training infrastructure to adopt it, if procurement decisions are driven by upfront cost rather than long-term savings, or if clinicians find that its safety features compromise the precision they need. Conversely, better policy frameworks and stronger institutional cultures will mean little without devices that actually meet the demands of interventional radiology. The synthesis between my technical and STS work is not just thematic, but it is also practical. The recommendations emerging from the ANT analysis directly inform how the Chiba needle redesign should be developed, tested, and introduced into clinical settings.
Engineering education often trains us to treat the device as the deliverable. But this project reinforced for me that a device is always embedded in a system of relationships: with the people who use it, the institutions that procure it, the regulators who approve it, and the patients whose safety ultimately depends on all of these actors working in concert. I came to see the persistent problem of needlestick injuries not as a technical failure waiting for a better invention, but as a sociotechnical challenge requiring deliberate coordination across every level of the healthcare system. If my work contributes anything, I hope it is the demonstration that safer healthcare for clinicians requires both a thoughtfully engineered device and the social infrastructure to make that device matter.
