A hospital employee has a needlestick injury. What is the next appropriate step to take?

In the context of a needlestick injury, the most appropriate immediate step is to evaluate the risk of bloodborne pathogen exposure, specifically HIV and Hepatitis B/C viruses. One of the key aspects of post-exposure management is to determine the serostatus of the source patient if known. An enzyme-linked immunosorbent assay (ELISA) test is commonly used to assess for HIV antibodies and can be part of the follow-up and evaluation process.

Testing for HIV allows for early intervention and management, should the source patient be HIV positive. If the source patient is determined to be HIV positive and the exposed individual is not HIV positive, post-exposure prophylaxis (PEP) can be initiated within 72 hours to reduce the risk of seroconversion. Thus, ordering an ELISA test is a critical step in the protocol for managing a needlestick injury.

While providing a tetanus booster, offering hepatitis B immunoglobulin, and ordering a chest x-ray are also valid considerations based on the patient's vaccination status and potential exposure, they do not address the immediate need to assess the risk of HIV transmission resulting from the needlestick.