Behavior, perception and compliance related to adoption of safety measures in response to needle stick injuries among nursing personnel at a tertiary care institute of North India

Abstract

Background: Needle stick injuries (NSIs) caused by sharp instruments such as hypodermic needles, blood collection needles; intravenous (IV) cannula or needles used to connect parts of IV delivery system are common in clinical practice. A potential risk of transmission of various fatal diseases such as acquired immunodeficiency syndrome, hepatitis and others have been a matter of serious concern in busy clinical settings. Aim and Objectives: The present survey study was carried out to evaluate the prevalence of NSIs among nursing personnel of our institute so as to identify the potential risk factors responsible for possibly acquiring NSIs. The study also aims to reinforce uniformly the recommended preventive measures by the nursing personnel in our institute with the formulation and implementation of newer preventive strategies by hospital authorities. Materials and Methods: A cross-sectional survey was carried out from July 2012 to November 2012 in the nursing department of our hospital. Informed verbal consent was taken from nursing personnel prior to distribution of the self-reporting questionnaire. Questions related to awareness such as cause of NSIs, number of NSIs, procedures that caused NSIs, clinical response of personnel after injury, preventive measures like hepatitis B immunization, use of personal protective equipment (PPE) and reasons for not using the PPE and training regarding prevention of NSIs were also included. A total of 179 staff nurses from all clinical areas of the hospital participated in this study excluding those who were on any kind of long leave. Statistical analysis was performed by using the Statistical Package for the Social Sciences version 15 for windows and value of P < 0.05 was considered as significant and P < 0.001 as highly significant. Results: Almost more than half of the nursing personnel (57.5%) had NSIs at one occasion or the other. Nearly 58% nursing personnel had NSIs for 3-times and few had even more than 10 times. NSIs during bedside care of the patient (57.2%) were reported as one of the significant potentially vulnerable location to get the NSIs as compared with the operation theater and emergency (5%) areas (P < 0.001). About 92% of the nursing personnel reported that needles used in routine injection practices were the main instrument that caused NSIs as compared with the hypodermic needle and surgical blades. Recapping of needles (66%) was the main procedure that caused NSIs as compared to IV line (20.4%) and others (P < 0.001). Around 81% nurses were already vaccinated against hepatitis B before the survey study. Conclusion: NSIs are highly prevalent among nurses. Injection practices have to be improved with reinforcing and modification of existing preventive measures. Procedures associated with higher risks of NSIs such as recapping of needles, non-wearing of gloves, improper disposal of sharps and others should be strongly discouraged so as to decrease the incidence of NSIs and morbidity and mortality associated with it.