Circumstances Surrounding Needlestick/Sharp Injuries among Healthcare Workers in a Venezuelan Public Hospital

Abstract

BACKGROUND/OBJECTIVES: In Venezuela, like other developing countries, inadequate industrial hygiene and unsafe conditions characterize many workplaces, including healthcare settings. Healthcare workers (HCWs) are faced with the challenge of providing the best care to their patients while facing risks of exposure to biological agents, particularly hepatitis B, C and human immunodeficiency virus (HIV). One of the greatest risks for HCWs acquiring a bloodborne pathogen infection is through a needlestick or sharps injury. The objective of this study was to explore the circumstances surrounding needlesticks and sharp injuries from the perspective of the healthcare workers in a Venezuelan public hospital. METHODS: The setting for this study was a 470-bed public teaching hospital in Maracay, Venezuela. One-on-one interviews were performed using 49 forced-choice and 2 open-ended questions. The questions were pre-tested among a group of Venezuelan nurses and revised prior to use in this study. A random sample of 129 (12%) total HCWs, including physicians, dentists, nurses, laboratory professionals, technicians, and environmental services staff were interviewed. No names or personal identifiers were used. Results were analyzed using descriptive statistics. RESULTS: Of the 129 respondents to the interviews, 39 (30%) reported sustaining a needlestick or other sharps exposure and 113/129 (88%) reported routinely recapping used needles. The two activities most frequently involved in the exposures were blood withdrawal and disposal related activities, involving 14.7% and 12% of the injuries respectively. Professional nurses sustained the majority of injuries (21/39) with the next highest frequency occurring in physicians and lab assistants (4/39). The medicine and obstetrics wards were locations with the highest frequency and percent of injuries (5/13%) followed by the pathology and surgery room (4/10%). The circumstances most frequently reported to contribute to needlestick injuries were recapping of used needles (23%) and manipulating the needle in the patient (21%). It is important to note that 35/39 (90%) of respondents who had sustained needlestick injuries reported recapping used needles as a routine procedure. CONCLUSIONS: The widespread practice of recapping used needles is an alarming and important finding indicating an area for intervention and education that must be targeted to prevent future needlestick and sharps injuries. Until legislation regarding safer needle device use is passed in Venezuela, education regarding the risks of recapping used needles can be increased and alternatives proposed. Exploration into wards with the highest frequency of injuries should also be conducted.