Meta-Analysis: Effect of Training and Needle Recapping on Needle Stick Injury in Health Workers

DEAR EDITOR, Needle stick injuries (NSIs) has always been one of the most important risk factor for health care workers (HCWs) for transmission of various infections such as hepatitis B, hepatitis C, and human immunodeficiency virus.[1] Variety of procedures like needle recapping, injuries sustained in the operating room, blood collection or intravenous line administration, suturing, checking blood sugar etc., can lead to accidental NSIs [Table 1].[2,3] Although modern dentistry has been cited as the least hazardous of the all the occupations, risks like NSI still challenge the status of this occupation.[4] Compared with many other health care settings, dental professionals are at higher risk of acquiring infections due to the fact that dentists work in a limited-access and restricted-visibility field and frequently use sharp devices.[5] Table 1 Various determinants of NSIs Every year about 16 billion injections are administered in developing and transitional nations and approximately three million individuals are injured annually due to needle stick and sharp injuries.[6] These types of blood-borne exposures can be career and life-ending. There is gross under reporting of NSI and therefore the incidence of NSI is higher than the current estimates.[7] In developing countries such as Ghana, Indonesia and Uganda, 80–90% of patients who visited a health center received one or more injections per visit.[8] Another study reported a high incidence of needle stick and sharp injuries among HCWs in Jordan.[9] In a country like India, in spite of large number of awareness programs, it is not possible to estimate the annual incidence of NSI in different occupations because of scarcity of data.[1] Very few studies that have been conducted among dental HCWs reporting their knowledge, awareness and practice regarding NSI. Findings of a study conducted on dental students reported that on an average 89.23% of the students had correct knowledge about NSI and 89% of them were aware of taking postexposure prophylaxis (PEP) after an accidental NSI.[10] According to some other study reports, 11% of the students were not aware that the virus could be transmitted through infected needles and found that 44% of the students would destroy the needle using needle destroyer and 15% would destroy in puncture-resistant container with disinfectant.[11] Only 39.8% of the health care students could correctly define sharp instrument injury in some other study reports and 75.4% of the students experienced sharp instrument injuries during the last 1-year and 52.3% of the sharp instrument injuries occurred during administration of local anesthetic injection.[12] Reports of another study revealed that 88% of the dental students were aware of the occupational blood-borne diseases, and 75% of them reported exposures majority of who were postgraduate students.[13] It can be concluded that knowledge, awareness and practices of the dental students in among different studies is adequate though there is considerable variation in practice and management of NSI. Not every NSI can be preventable, but according to research 83% of injuries from hollow-bore needles can be prevented.[14] The present article also concludes that for prevention of NSI, knowledge and awareness amongst dental HCWs should be increased. More studies should be conducted involving dentists and other dental professionals as there is scarcity of literature on knowledge and awareness levels of dentists in India. Various health and safety measures can be adopted to decrease the incidence of NSI. Workers should be properly trained Personal protective equipment and clothing should be provided An effective occupational health and safety program should be established that includes immunization, PEP, medical and dental surveillance.

Background and aim Needle stick injuries are one of the most important threats for the nursing staff in teaching hospitals. this study aimed to determine incidence, risk factors and protective factors of needle stick injuries in nursing staff. Materials and Methods In a cross sectional study, we gathered information on needle stick injuries from March 2007 up to March 2010. All nurses in Bou-aAli Sina teaching hospital (n=246) included in the study (census). A questionnaire which consisted of questions on demographic characteristics, working habits, history of related training courses, educational level, work experiences and injury-related information. Was administerd Validity and reliability of the questionnaire were assessed by content validity and test-retest (r=0.89) methods respectively. Epi Info 3.5.1 package was used for statistical analysis. Findings Needle stick injury was reported in 77 nurses out of 246 in different positions. Independent risk factors for needle stick injuries were habitual recapping of used needles and consecutive shift works. Overall 54.5% of incidents were reported to hospital infection control facilities. Male gender and younger age had significant statistical association with lower likelihood of reporting of needle stick injuries. Conclusion According to the complications of needle stick injuries, training programs in this field are one of the priorities in the teaching hospitals. In addition, decrease in consecutive shift works for nurses may have a significant impact on prevention of these injuries in nursing staff. Keywords : Needle sticks injuries, Incidence, Risk factors * Corresponding author: Assisstant Professor, faculty of Medicine, Qazvin University of Medical Sciences, Qazvin Iran E-mail: azimianj@yahoo.com REFERENCES -Abu-Gad HA Al-Turki KA (2001). Some epidemiological aspects of needle stick injuries among the hospital health care workers: Eastern Province, Saudi Arabia. European Journal of Epidemiology. 17 (5) 401-407. -Afrasiabifar A Salari M Zarifi A (2003). [Skin penetrating injuries due to the insertion of sharp medical instruments contaminated with patients' blood or body secretion among the healthcare [stuffs] of Yasuj hospitals and the measures taken after injury, 1380]. Armaghane-Danesh, journal of yasuj university of medical scinces. 7 (28) 17-23. (Persian) -Aghadoost D et al (2007). [Occupational exposure to blood in the stuff of educational-medical centers of Kashan University of Medical Sciences in 2007].Feyz. 10 (4) 59-64 (Persian) -Aghajanloo A et al (2007). [Types and rates of occupational accidents in nursing students at nursing and midwifery colleges in Tehran].Journal of Faculty of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences. 17 (57) 11-16 (Persian) -Askarian M Shaghaghian S McLaws M (2007). Needlestick injuries among nurses of Fars province, Iran. Annals of Epidemiology. 17 (12) 988-992. -Azar Cavanagh M Burdt P Green-McKenzie J (2007). Effect of the introduction of an engineered sharps injury prevention device on the percutaneous injury rate in healthcare workers. Infection Control and Hospital Epidemiology. 28(2) 165-170. -Beltrami E et al (2000). Risk and management of blood-borne infections in health care workers. Clinical Microbiology Reviews. 13 (3) 385-407. -Boal W et al (2008). The national study to prevent blood exposure in paramedics: exposure reporting. American Journal of Industerial Medicine. 51(3) 213-222 -Clarke S Sloane D Aiken L (2002). Effects of hospital staffing and organizational climate on needlestick injuries to nurses. American Journal of Public Health. 92(7) 1115-1119. -Elmiyeh B et al (2004). Needle-stick injuries in the national health service: A culture of silence. Journal of the Royal Society of Medicine. 97 (7) 326-327. -Falagas M Karydis I Kostogiannou I (2007). Percutaneous exposure incidents of the health care personnel in a newly founded tertiary hospital: a prospective study. Public Library of Science One. 2 (2) e194. -Ippolito G et al (1999). Occupational human immunodeficiency virus infection in health care workers: Worldwide cases through September 1997. Clinical Infectious Diseases. 28(2) 365-383. -Kazemi galougahi MH (2010). Evaluation of needle stick injuries among nurses of Khanevadeh Hospital in Tehran. Iranian Journal of Nursing and Midwifery Reasearch 15 (4) 172-177. -Khalooei A et al (2010). [Study on epidemiology of needle stick injury among nursing personnel of Kerman University hospitals. Kerman, Iran in (2006-2007)]. Journal of Jahrom University of Medical Seiences. 7(3) 43-51.(Persian) -Lee JM et al (2005). Needlestick injuries in the United States. Epidemiologic, economic, and quality of life issues. Official Journal of the American Association of Occupational Health Nurses. 53(3) 117-133. -Lorentz J Hill L Samimi B (2000). Occupational needlestick injuries in a metropolitan police force. American Journal of Preventive Medicine. 18 (2) 146-150. -Lotfi R Gashtasbi A (2008). [Needle stick and sharps injuries and its risk factors among health center personnel (Astara; Iran, 2006)]. Journal of Babol University of Medical Sciences. 10(4) 71-77.(Persian) -Mahfouz AA et al (2009). Injection safety at primary health care level in south-western Saudi Arabia. Eastern Mediterranean Health Journal. 15(2) 443-450. -Makary MA et al (2007). Needlestick injuries among surgeons in training. New England Journal of Medicine. 356 (26) 2693-2699. -Mirzaee T Ravari A (2003). [Risk of recapping: Why do health care worker recap needles?]. Journal of Birjand university of medical sciences. 10 (2) 28-33. (Persian) -Nasiri E et al (2005). [The prevalence and study of the rate of needle stick injuries infected by blood in staffs of special departments of teaching and non teaching hospitals of Mazandaran province in 2003-2005]. Iranian Journal of Infectious Diseases and Tropical Medicine. 10 (29) 41-46. (Persian) -Norsayani MY Noor HI (2003). Study on incidence of needle stick injury and factors associated with this problem among medical students.Journal of Occupational Health. 45(3) 172-178.l -Nsubuga FM, Jaakkola MS (2005). Needle stick injuries among nurses in sub-Saharan Africa. Tropical Medicine & International Health. 10(8) 773-781. -Parks D et al (2000). Day-night pattern in accidental exposures to blood-borne pathogens among medical students and residents. Chronobiology International. 17 (1) 61-70. -Perry J Parker G Jagger J (2001). Percutaneous injuries in home healthcare settings. Home Healthcare Nurse. 19(6) 342-344. -Rakhshani F Heidari MT Barati S (2008). [Prevalence of needlestick injuries among the healthcare professionals in Zahedan Medical Sciences University]. Iranian Journal of Epidemiology. 4 (3) 87-91. (Persian) -Rampal L et al (2010). Needle stick and sharps injuries and factors associated among health care workers in a Malaysian hospital. European Journal of Social Sciences, 13(3) 354-362. -Shah S Merchant A Dosman J (2006). Percutaneous injuries among dental professionals in Washington State. BMC.Public Health. Doi: 10.1186/1471-2458-6-269 -Smith D et al (2006a). Epidemiology of needlestick and sharps injuries among professional Korean nurses. Journal of Professional Nursing. 22 (6) 359-366. -Smith D et al (2006b). Epidemiology of needlestick and sharps injuries among nurses in a Japanese teaching hospital. Journal of Hospital Infection. 64(1) 44-49. -Smith DR et al (2006c). Needlestick and sharps injuries among nurses in a tropical Australian hospital. International Journal of Nursing Practice. 12 (2) 71-77.

To characterize the epidemiology of percutaneous injuries of healthcare workers (HCWs) in Ile-Ife, Nigeria. A cross-sectional survey of a random sample of HCWs regarding details of needlestick and sharp instrument injuries within the previous year. University hospital and clinics in Ile-Ife, Nigeria. Hospital personnel with potential occupational exposure to patients' blood. Needlestick accidents during the previous year were reported by 27% of 474 HCWs, including 100% of dentists, 81% of surgeons, 32% of nonsurgical physicians, and 31% of nursing staff. The rate of needlestick injuries was 0.6 per person-year overall: 2.3 for dentists, 2.3 for surgeons, 0.4 for nonsurgical physicians, and 0.6 for nursing staff. Circumstances associated with needlestick injuries included unexpected patient movement in 29%, handling or disposal of used needles in 23%, needle recapping in 18%, accidental stick by a colleague in 18%, and needle disassembly in 10%. Sharp instrument injuries were reported by 15% of HCWs and most commonly involved broken glass patient specimen containers (39%). Almost all HCWs were aware of the potential risk of HIV transmission through percutaneous injuries, and 91% considered themselves very concerned about their occupational risk of HIV acquisition. The high frequency of percutaneous exposure to blood among HCWs in this Nigerian hospital potentially could be reduced by simple interventions at modest cost.

To assess the rate and determinants of sharp injuries during the previous 6 months among health care workers at first-level care facilities in two districts of Pakistan. Cross-sectional survey at public, general practitioners and non-licensed private practitioners selected through stratified random sampling. At each facility, we interviewed a prescriber and a dispenser/injection provider about knowledge of bloodborne pathogens transmission and preventive practices, risk perception, and use of precautions and sharp injuries received during the previous 6 months. Multivariable Poisson regression was used to assess the factors associated with the number of sharp injuries. Fifty-four percentage of the 233 workers had at least one injury during the previous 6 months. The overall rate of sharp injuries per person per year was 3.7; among non-physician prescribers (9%), it was 4.3; among dispensers (69%), it was 3.7, and among physicians (18%), it was 2.1. In the multivariable model, work experience, risk perception and type of health care worker were significantly associated with receiving sharp injuries during the previous 6 months. In the model including dispensers only, a higher knowledge score was associated with fewer sharp injuries, while perceived severity of disease and lack of professional qualification were associated with more. Sharp injuries are common in Pakistan. Better knowledge about modes of bloodborne pathogen transmission and professional qualification may reduce their incidence.

The impact of wearing gloves on surface contamination and on the incidence of percutaneous injury were prospectively compared for two 4-mo periods in a single anesthesia department. Period I was immediately prior to the institution of mandatory glove wearing, and Period II followed a 1-mo adjustment period of mandatory glove use. Recording of all needlestick and other percutaneous injuries was performed on an ongoing basis, and incident reporting was actively and regularly solicited. During the final week of each period, 12 specific sites at each of nine anesthetizing locations were tested for occult blood. The incidence of needlestick injury was 0.28% for Period I versus 0.10% for Period II (P = 0.10) and the incidence for all percutaneous injuries was 0.60% for Period I and 0.27% for Period II (P = 0.06). If the one needlestick that occurred during noncompliance with gloving during Period II is eliminated, then there was a significant reduction in both needlestick and overall percutaneous injury (P < 0.05). Of 109 operating room sites, 42.2% were contaminated after Period I versus 31.2% after Period II (P = 0.07). The implementation of a mandatory glove use policy was associated with nonsignificant trends toward reduction in the incidence of needlestick and other percutaneous injury and in the level of surface contamination in the anesthesia workplace. Compliance with glove use resulted in a significant reduction in needlestick injury and overall percutaneous injuries.

Background and Purpose: Needle stick injuries (NSIs) remains a significant risk of occupational transmission of Bloodborne pathogens in health care workers (HCWs). This study aimed to determine the “Risk Factors of Needlestick and Sharps Injuries among Healthcare Workers in Naft hospital, Mahshahr”. Methods: A descriptive-cross sectional study carried out on 135 HCWs in Naft hospital in Mahshar, in 2011-12. Data were collected by a self-administered questionnaire. The first part included questions about demographic characteristics. The second part of the questionnaire consisted of 11 items related to the sharp instrument injuries. After confirming content and face validity, reliability of the questionnaire was determined to be 0.88, using Cronbach's alpha test. Data analysis, including descriptive and analytical statistics was performed using SPSS Ver. 16. A P≤ 0.05 was considered statistically significant. Results: The mean age of the participants was 33.83 +/- 6.22. (24-50) years old and 69.3% were females. The incidence rate of NSI was 64.1%. Recapping of needles (25.8%) and IV access (19.7%) were the most common actions resulted to exposure. Exposed people believed that the most important reason for NSIs was patients unpercaution (38.5%), and crowdedness (33.8%).The most injuries were occurred in the emergency department(21%) and Internal ward(16.1%). 80.8% of nurses had been vaccinated against hepatitis B virus. There weren't statistically significant differences in demographic variables with NSIs. Conclusion: The present study showed a high occurrence of NSI among HCWs in this Mahshar hospital. Training in handling and disposal of sharps, preventing and reporting strategies are needed to increase safety practices for HCWs.

Background: Healthcare workers in various fields, including dentists, are exposed to needle stick incidents, which can lead to infectious diseases. Objectives: This study was conducted to investigate the frequency and causes of needle stick and sharp object injuries among dentists in Lorestan province, west of Iran, in 2023. Methods: Considering the inclusion and exclusion criteria of this analytical cross-sectional study, a total of 218 dentists from Lorestan province were selected through stratified sampling and investigated. Data were obtained using a checklist that included demographic and technical questions. Data were analyzed using SPSS software at a significance level of P &lt; 0.05. Results: Among the participants, 120 dentists were male and 98 were female. In total, 101 dentists (46.3%) had experienced needle stick injuries, 50 (22.9%) had broken vial injuries, 77 (35.3%) experienced splashing of discharge into the eye, 13 (6%) had bistoury-caused injuries, 60 (27.5%) experienced splashing of discharge into the mucous membrane, and 59 (27.1%) had surgical suture injuries. There was a statistical relationship between age, working experience, and work shift with the incidence of needle stick injuries (P &lt; 0.05). However, there was no relationship between needle stick injuries and sex, level of education, or the service location of the dentist. Conclusions: Given the high frequency of needle stick experiences among dentists, further studies are necessary to understand the behavioral and organizational factors involved in this issue and to implement preventive measures to reduce the incidence rate and adverse consequences of such accidents.

BackgroundNeedle-stick injuries (NSIs) pose a substantial occupational hazard, exposing healthcare professionals to potentially infectious diseases. Nurses’ clinical competence plays a crucial role in preventing and mitigating the incidence of NSIs. This study aimed to investigate the relationship between clinical competence and the incidence of NSIs, as well as the factors contributing to these injuries, among nurses in Fars Province, southern Iran, from March 2023 to May 2023.MethodsThis descriptive cross-sectional study included 264 nurses selected through convenience sampling. All participants were employed in various departments of teaching hospitals in Fasa city, southern Iran, during the study period. Data were collected using a demographic questionnaire and a clinical competence questionnaire specifically developed for nurses. The demographic questionnaire captured variables such as age, gender, marital status, educational background, departmental assignment, work experience, and weekly working hours. The clinical competence questionnaire consisted of 55 items assessing seven dimensions: clinical care, leadership, legal and ethical performance, professional development, interpersonal relationships, education and coaching, and critical thinking and research aptitude. Statistical analyses were performed using SPSS software (version 16), employing the Chi-square test, Kruskal-Wallis test, and multiple logistic regression analysis. A significance level of p < 0.05 was applied to all tests.ResultsThe findings revealed that 39.4% of the participating nurses exhibited high clinical competence, 51.5% demonstrated moderate competence, and 9.1% were classified as having low competence. Statistical analysis indicated a significant association between clinical competence levels and needle-stick status (P = 0.002). Moreover, a significant difference was identified between clinical competence levels and the frequency of NSIs (P = 0.001). A logistic regression model was employed to assess the likelihood of NSIs based on demographic variables. The results showed that 178 participants (67.42%) had experienced needle-stick or sharp injuries within the preceding year. Among these, 63 males (35.3%) and 115 females (64.6%) reported such incidents. The highest incidence of needle-stick and sharp injuries occurred in the Operating Room (91.7%), followed by Dialysis (88.9%), Pediatrics (80%), Surgical Intensive Care (76.5%), Emergency (74.3%), Women’s Surgery (70%), Post-Cardiac Intensive Care (69.2%), Oncology (63.6%), Internal Medicine (59.1%), Surgery and Infectious Diseases (54.5%), Laboratory and Cardiac Intensive Care (52.9%), Men’s Surgery (50%), and the Psychiatric Ward (41.2%).ConclusionsConsidering that the majority of nurses working in hospitals exhibited moderate to low levels of clinical competence, it is recommended that hospitals implement an annual clinical competence assessment for nurses. Regular evaluations and targeted training programs can enhance nurses’ competence levels, thereby improving patient care quality and reducing the incidence of NSIs among healthcare providers. Additionally, specific strategies should be developed and implemented in medical centers and hospitals to mitigate the risk of NSIs across all hospital departments, particularly in high-risk areas such as operating rooms and dialysis units, where the prevalence of NSIs is significantly higher.Clinical trial numberNot applicable.

BackgroundNeedle stick and sharps injuries are occupational hazards to healthcare workers. Every day healthcare workers are exposed to deadly blood borne pathogens through contaminated needles and other sharp objects. About twenty blood borne pathogens can be transmitted through accidental needle stick and sharp injury. The study was conducted to determine the lifetime and past one year prevalence of needle stick and sharps injuries and factors associated with the past one year injuries among hospital healthcare workers in Southeast Ethiopia.MethodsAn institutional based cross sectional study was conducted in December 2014 among healthcare workers in four hospitals of Bale zone, Southeast of Ethiopia. A total of 362 healthcare workers were selected randomly from each department in the hospitals. Data were collected using self-administered questionnaire. The collected data were entered into Epi-Info version 3.5 and analyzed using SPSS version 20.0. Multivariable logistic regression analysis was used to identify the independent effect of each independent variable on the outcome variable. Written informed consent was secured from the participants.ResultsThe prevalence of lifetime needle stick and sharp injury was 37.1% with 95% CI of 32.0% to 42.5%. The prevalence of injury within the past one year was 19.1% with 95% CI of 14.9% to 23.3%. Emergency ward was a department with highest needle stick and sharp injury (31.7%). The main cause of injury was syringe needles (69.8%). Participants who practiced needle recapping had higher odds of needle stick and sharp injury within the past 12 months (AOR = 3.23, 95% CI: 1.78, 5.84) compared to their counterparts.ConclusionsNearly one out of five respondents had experienced needle stick and/or sharp injury at least once within past one year. There were practices and behaviors that put healthcare workers at risk of needle stick and sharp injury at the study area. Needle recapping was key modifiable risk behavior. Health policy makers and hospital administrators should formulate strategies to improve the working condition for healthcare workers and increase their adherence to universal precautions.

BackgroundA needle stick injury is a serious occupational health hazard in health care settings. Health care workers are at risk of bloodborne diseases and the psychological consequences of these injuries. This study aims to estimate the incidence of needle stick injuries among healthcare workers during the previous 12 months and to assess their knowledge, attitude, and practice toward these injuries.MethodsThis cross-sectional study was conducted from 1st August 2019 till 15th February 2020, and included 786 healthcare workers in Abha city, Saudi Arabia. A structured questionnaire was used to collect the data.ResultsThe incidence of needle stick injury among healthcare workers during the previous 12 months was (91/786) 11.57%. Nurses, females, and Saudis reported most needle stick injuries. More than half (52.7%) of the injuries went unreported. About 52.7% of needle stick injuries occurred during using sharp devices, and 42.9% of injuries happened in the patient room. The incidence of needle stick injury was significantly higher among those working at the secondary healthcare level (p = 0.003) and those practicing surgery (p < 0.001). Out of 786 participants, 94.7% knew the definition of needle stick injury, and 81.0% were aware of the procedure and guidelines to follow on sustaining a needle stick injury. Only 61.2% recognized that the recap of the needle is not recommended. Almost half of the participants (47.1%) agreed, and 33.6% strongly agreed that needle stick injury is preventable. A majority of healthcare workers (89.1%) had been vaccinated against Hepatitis B. Nearly 27.5% of healthcare workers incorrectly practiced recapping the needles with two hands and 8.7% bent needles before disposal. Recapping the needles was statistically significantly higher among healthcare workers who had a history of needle stick injury (p = 0. 046).ConclusionNeedle stick injury and its under reporting among healthcare professionals is still a prevalent risk. Raising awareness among healthcare workers and improving the reporting systems for needle stick injuries to ensure more protection and early use of post-exposure prophylaxis is required. Implementation of safety precautions and safe injection practices and providing engineered safety devices may further reduce the risk.

To investigate the needlestick injuries in student nurses during nine months of in-ternship in our hospital, and reveal the high-risk periods, risk procedures, and influencing factors for needlestick injuries, and explore the prevention approaches. Three hundred and fifty student nurses who interned at our hospital from April to December 2014 and from July 2014 to March 2015 were surveyed using self-de-signed questionnaires. Three hundred and forty questionnaires were recovered and 334 out of them were valid. Data were collected and questionnaires were analyzed. The incidence of needlestick injuries was 60.8%; the incidence of needlestick injuries was substantially higher at the early stage than at the late stage of the internship, and higher in the day shift than in the night shift. Moreover, the incidence of needlestick injuries was the highest during the removal of a syringe or infusion needle, accounting for 24.3% of the total incidence. Some other significant factors for needlestick injuries in student nurses included education level, reports on oc-cupational exposure, constant update of nursing knowledge, regular hematological examination, and relevant training experiences. According to 61.7% of student nurses, clinical operations were affected due to underlying concern about needlestick injuries. More attention should be paid to high incidence of needlestick injuries in student nurses, especially at the early stage of their internship. To reduce the incidence of needlestick injuries, education on occupational protection should be given to student nurses in advance, and the pre-job training should be enhanced.

Introduction: The decision to support the implementation of safety cannulae in a health care institution requires analysis of its cost-effectiveness. The aim of our study was to evaluate the effectiveness of safety cannulae over conventional cannulae in reducing needle stick injury (NSI) incidence in Sri Jayewardenepura General Hospital (SJGH), Sri Lanka. Methods: Hospital device utilization data, NSI data, and total expenditure data including the cost of management of NSIs for conventional and safety cannulae were collected from the period 01/01/2016 to 30/06/2019. The NSI incidence (annual rates per 100,000 devices) for conventional and safety cannulae were calculated and compared to determine the existence of a statistical difference between them. The cost per device inclusive of the management of associated NSIs was also calculated. Results: The total number of conventional and safety cannulae utilized during the study period was 86,412 and 284,686 respectively. In total, there were 12 NSIs associated with conventional cannula insertion and 5 NSIs associated with safety cannula insertion. The annual NSI incidence per 100,000 devices for conventional and safety cannulae was 13.89 (95% CI 7.18-24.26) and 1.76 (95% CI 0.57-4.099) respectively. There was a significant reduction of NSI incidence with the use of safety cannulae (p Conclusion: There was a substantial reduction of NSI incidence with safety cannulae and we recommend its use in the prevention of occupational risk to health care workers. .

Occupational exposure to Hepatitis B virus (HBV), human immunodeficiency virus (HIV) and Hepatitis C virus (HCV) infection is a cause of concern to all health care workers (HCWs), especially those, in hospitals. Among the HCWs, nurses, interns, technicians, resident doctors and housekeeping staff have the highest incidence of occupational exposure. To analyze the cases of needle stick injuries and other exposures to patient's blood or body fluids among health care workers. A detailed account of the exposure is documented which includes incidence of needle stick injuries (NSI) and implementation of post-exposure prophylaxis (PEP) as per the hospital guidelines. We report a two-year continuing surveillance study where 255 health care workers (HCWs) were included. PEP was given to HCWs sustaining NSI or exposures to blood and body fluids when the source is known sero-positive or even unknown where the risk of transmission is high. Follow-up of these HCW's was done after three and six months of exposure. Of the 255 HCWs, 59 sustained needle stick injuries and two were exposed to splashes. 31 of the NSI were from known sources and 28 from unknown sources. From known sources, thirteen were seropositive; seven for HIV, three for HCV and three for HBV. Nineteen of them sustained needle stick during needle re-capping, six of them during clean up, six of them while discarding into the container, 17 during administration of injection, eight of them during suturing, two occurred in restless patient, 17 during needle disposal. So far, no case of sero-conversion as a result of needle stick injuries was reported at our center.

Introduction:Occupational exposure to Hepatitis B virus (HBV), human immunodeficiency virus (HIV) and Hepatitis C virus (HCV) infection is a cause of concern to all health care workers (HCWs), especially those, in hospitals. Among the HCWs, nurses, interns, technicians, resident doctors and housekeeping staff have the highest incidence of occupational exposure.Aims:To analyze the cases of needle stick injuries and other exposures to patient's blood or body fluids among health care workers.Materials and Methods:A detailed account of the exposure is documented which includes incidence of needle stick injuries (NSI) and implementation of post-exposure prophylaxis (PEP) as per the hospital guidelines. We report a two-year continuing surveillance study where 255 health care workers (HCWs) were included. PEP was given to HCWs sustaining NSI or exposures to blood and body fluids when the source is known sero-positive or even unknown where the risk of transmission is high. Follow-up of these HCW's was done after three and six months of exposure.Results:Of the 255 HCWs, 59 sustained needle stick injuries and two were exposed to splashes. 31 of the NSI were from known sources and 28 from unknown sources. From known sources, thirteen were seropositive; seven for HIV, three for HCV and three for HBV. Nineteen of them sustained needle stick during needle re-capping, six of them during clean up, six of them while discarding into the container, 17 during administration of injection, eight of them during suturing, two occurred in restless patient, 17 during needle disposal.Conclusion:So far, no case of sero-conversion as a result of needle stick injuries was reported at our center.

Background: Needlestick injury is a dangerous work accident that causes blood contact with pa- tients and is at risk of being infected with blood borne diseases such as hepatitis B virus (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). The purpose of this study was to analyze the influence of unsafe behavior factors on the incidence of accidents due to needlestick injury to health workers in hospitals. Subjects and Method: This research was conducted using a systematic review and meta-analysis study design using PICO, population: health workers, intervention: unsafe action and lack of work experience. Comparison: safe action and good work experience, Outcome: Needlestick Injury (NSI) incident. The articles used in this study came from 4 databases, namely Pubmed, ScienceDirect, ProQuest and Google scholar. The keywords of the article are ("Needle Stick Injury" or "Sharp Injury") AND aOR. The articles included in this study are full paper articles, observational study designs, 2011-2021 and the size of the relationship between Adj Odds Ratio Results: A total of 19 observational studies (case-control and cross-sectional) with 28,487 health workers from the African Continent (Egypt and Ethiopia), the Asian Continent (Thailand, Taiwan, Malaysia and Indonesia) and the European Continent (Bosnia and Herzegovina) were analyzed. From data processing, it was found that unsafe action increased the incidence of Needlestick Injury (NSI) in health workers in hospitals by 2.79 times higher than health workers who behaved safely (safe action) and statistically significant (aOR= 2.79; 95% CI= 2.18 to 3.67; p&lt;0.001). Work Experience increases the incidence of Needlestick Injury (NSI) in health workers in hospitals by 1.97 times higher than health workers who have good work experience and is statistically significant (aOR= 1.97; 95% CI= 1.16 to 3.34; p = 0.010) . Conclusion: The influence of human factors, especially unsafe action, in increasing the incidence of needlestick injuries in health workers. Keywords: needlestick injury, sharp injury, unsafe action Correspondence:Nurul Dwi Andriani. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: nurul.d.andriani@gmail.com. Mobile: +6282137279586. Journal of Health Policy and Management, 07(01): 58-71 https://doi.org/10.26911/thejhpm.2022.07.01.06 .