Accidental Needlestick Injuries Research Articles

Tularemia From Veterinary Occupational Exposure.

Tularemia is a disease caused by Francisella tularensis, a highly infectious bacteria that can be transmitted to humans by direct contact with infected animals. Because of the potential for zoonotic transmission of F. tularensis, veterinary occupational risk is a concern. Here, we report on a human case of tularemia in a veterinarian after an accidental needlestick injury during abscess drainage in a sick dog. The veterinarian developed ulceroglandular tularemia requiring hospitalization but fully recovered after abscess drainage and a course of effective antibiotics. To systematically assess veterinary occupational transmission risk of F. tularensis, we conducted a survey of veterinary clinical staff after occupational exposure to animals with confirmed tularemia. We defined a high-risk exposure as direct contact to the infected animal's body fluids or potential aerosol inhalation without use of standard personal protective equipment (PPE). Survey data included information on 20 veterinary occupational exposures to animals with F. tularensis in 4 states. Veterinarians were the clinical staff most often exposed (40%), followed by veterinarian technicians and assistants (30% and 20%, respectively). Exposures to infected cats were most common (80%). Standard PPE was not used during 80% of exposures; a total of 7 exposures were categorized as high risk. Transmission of F. tularensis in the veterinary clinical setting is possible but overall risk is likely low. Veterinary clinical staff should use standard PPE and employ environmental precautions when handling sick animals to minimize risk of tularemia and other zoonotic infections; postexposure prophylaxis should be considered after high-risk exposures to animals with suspected or confirmed F. tularensis infection to prevent tularemia.

Incidence and Risks of HIV Infection, Medication Options, and Adverse Effects in Accidental Needle Stick Injuries: A Narrative Review.

Accidental needle sticks can lead to infections, including HIV. As scientists have learned more about HIV and its replicative physiology, identification of target sites and novel medications have been developed. HIV is spread throughout the population through contact with blood, semen, and rectal or vaginal secretions of infected individuals. Therefore, it is important in general for healthcare workers to be aware of its transmission modes and ways to minimize exposure. In this regard, even with hospitals providing education, training, and safety protocols, there is a continued infection spread with HIV, especially by accidental needle sticks.There is also a wide variety of testing that can be used for HIV utilizing different methodologies, allowing for improved measurement of infection status.Any person with HIV should be tested to clarify infection status and be educated to minimize future virus spread. The current CDC recommendations for HIV infection treatment are antiretroviral therapies, such as an HIV postexposure prophylaxis regimen, which consists of a cocktail of antiretrovirals and postexposure prophylaxis immediately for occupational exposures, such as accidental needlestick exposure from an HIV infected patient. To decrease accidental HIV stick injuries, there are safety precautions in place, that if followed, would help reduce this incidence.HIV accidental needle stick injuries still happen in the hospital workplace, but with proper education and treatment, if exposed, there is hope to minimize the effects.

Cutaneous leishmaniasis by a needlestick injury, an occupational infection?

Leishmaniasis is a parasitic disease caused by over 20 species of Leishmania. Transmission is mainly via sandfly bites infected with promastigotes, through the placenta from mother to child, by sexual intercourse, blood transfusion, and occupationally acquired by direct inoculation into the skin. Clinical manifestations vary from self-limited cutaneous disease to a life-threatening visceral infection. In November 2021, a 29-year-old otherwise healthy dermatology resident suffered an accidental needlestick injury while performing a biopsy on a patient with a presumptive diagnosis of an infectious dermatosis, later confirmed as mucocutaneous leishmaniasis caused by Leishmania panamensis. Later, the resident developed an erythematous, painless papule at the point of inoculation, with a central ulcer and painful enlargement of ipsilateral lymph nodes. Biopsy was compatible with leishmaniasis. After completing a 20-day treatment with meglumine antimoniate, the ulcer had healed completely. At the 6-month follow-up, both patients remain asymptomatic. This case serves as a reminder that health providers should have the proper training and knowledge of their hospital management protocol for occupational injuries. Moreover, physicians should bear in mind that leishmaniasis is not exclusively transmitted by sandfly vectors.

Nurses’ Self-report on the Infection Control Unit Activities and their Experience in the Hospital toward Nosocomial Infections in the Sulaimani Hospitals

Background and objectives: Nurses can prevent the occurrence and transmission of noso-comial infections by following infection control measures such as wearing gloves and masks, using appropriate disinfection of skin and preventing accidental needle-stick inju-ries. This research aimed to evaluate the availability of hospital uniforms, personal protec-tive equipment, and infection control activities at hospitals in Sulaimani in the Kurdistan Region of Iraq, and to examine nurses’ experience of nosocomial infections. Methods and materials: A cross-sectional study was performed at 10 governmental hospi-tals during the period from 20th February to 28th September 2018. 525 nurses were se-lected as participants by a convenience sampling method. A self-administrated question-naire was used to collect data, which were analysed using SPSS software. Results: The results showed that 268 nurses (51%) reported that their hospitals provided sufficient uniforms to all the medical staff and the majority of nurses, 444 respondents (84.6%) stated that they were responsible for cleaning their working uniforms. 441 nurses reported that they did not acquire a nosocomial infection, and 479 (91.2%) did not have an accident during their work in the hospital. 79.9% of the nurses (404) reported recapping syringe needles after the usage, and 98 (18.7%) gave a low rating to the infection control unit activity in their hospitals. Finally, more than half of nurses (330) representing 62.9% of the sample were vaccinated against nosocomial infections. Conclusions: Most of Sulaimani governmental hospitals are providing sufficient uniforms for the health staff, the majority of nurses were vaccinated against one or more nosocomi-al infections, and the majority of nurses do needle syringe recapping.

Complete Blood Count Collected Via Venipuncture Versus Peripherally Inserted Central Catheter in Hematological Patients: A Comparison of 2 Methods.

The use of peripherally inserted central catheters (PICCs) in cancer care is increasing over traditional central venous catheters. Nurses frequently collect blood by venipuncture when a PICC is inserted, as there is no available evidence to confirm the reliability of blood tests collected through PICCs in adults. The aim of this study was to assess the reliability of blood samples for complete blood count (CBC) obtained through PICCs as an alternative to venipuncture. A cross-sectional design was used to recruit adult hematological patients. The blood samples were collected within 5 minutes of each other by a specialist nurse. Hemoglobin, hematocrit, and platelet count were evaluated. To determine method comparison, Passing-Bablok regression, test of linearity, Pearson product-moment correlation coefficient, and Bland-Altman plots were used. Thirty paired blood samples were collected in 29 hematological patients with a mean age of 66.8 years. A statistical difference was found for hemoglobin (P = .001) and hematocrit (P = .001) levels, but no clinical difference. The regression models revealed no systematic differences and no proportional differences with a linear relationship between the methods. Bland-Altman plots highlighted a good agreement between methods. Blood samples for CBC drawn by PICCs are as reliable as those collected via venipuncture. Blood sampling via PICC could be recommended in people with hematological malignancies in needs of frequent blood tests. Sampling through a PICC provides reliable laboratory results for CBC, and it could reduce patients' discomfort and increase the safety of professionals reducing the risk of accidental percutaneous needlestick injuries.

The design and implementation of restraint devices for the injection of pathogenic microorganisms into Galleria mellonella.

The injection of laboratory animals with pathogenic microorganisms poses a significant safety risk because of the potential for injury by accidental needlestick. This is especially true for researchers using invertebrate models of disease due to the required precision and accuracy of the injection. The restraint of the greater wax moth larvae (Galleria mellonella) is often achieved by grasping a larva firmly between finger and thumb. Needle resistant gloves or forceps can be used to reduce the risk of a needlestick but can result in animal injury, a loss of throughput, and inconsistencies in experimental data. Restraint devices are commonly used for the manipulation of small mammals, and in this manuscript, we describe the construction of two devices that can be used to entrap and restrain G. mellonella larvae prior to injection with pathogenic microbes. These devices reduce the manual handling of larvae and provide an engineering control to protect against accidental needlestick injury while maintaining a high rate of injection.

Multicenter cross-sectional study on the reporting status and influencing factors of needlestick injuries caused by insulin injection devices among nurses in Peking, China

Needlestick injuries (NSIs) most commonly occur in conjunction with insulin injections, and nurses had the highest rate of NSIs among different occupational groups. However, only few nurses have the awareness to report these incidents. We aimed to investigate the current reporting status and influencing factors of NSIs caused by insulin injection pen devices among nurses and nursing interns in Peking, China. The study consisted of 4,609 nurses and nursing interns in different hospital departments, namely endocrinology wards, medical (except endocrinology) and surgical departments, emergency, outpatient departments, operation theaters, intensive care units, and other departments from 16 districts of Peking, China. A researcher-devised questionnaire was designed to assess the rate of reporting of accidental NSIs and its influencing factors. Descriptive statistics, the χ2tests, and univariate and multivariate regression were used to analyze the independent influencing factors of reports on NSIs caused by insulin injection pen devices. Among all participants, most of them were women (97.61%). More than half of the participants had been working as nurses over 5 years (59.58%). Approximately 63.66% of participants had been trained to prevent and deal with accidental NSIs within 1 year. Approximately 19.33% of the participants experienced NSIs before, but only 30.30% of them reported the injury to the management department or director. The main reasons for not reporting were complex/cumbersome reporting procedure (317 of 621; 51.05%), being too busy at work at the time of injury (301 of 621; 48.47%), and low-risk for personal health (197 of 621; 31.72%). Multivariate analysis showed that age (P = .014; odds ratios [OR; 1.063, 1.736]), prior needlestick training education (P = .018; OR [0.406, 0.917]), and written system for preventing (P < .001; OR [0.289, 0.622]) were independent factors associated with reporting of NSIs caused by insulin injection pen devices. NSIs caused by insulin injection pen devices are common among nurses and are often not reported. It is necessary to provide nurses with regular training to prevent and deal with NSIs.Hospital management departments should adopt a simpler reporting procedure to understand the actual occurrence of NSIs to develop better prevention and improvement measures.

Accessing Medical Care After a Needlestick Injury: First Responders' Perception of HIV Risk and Attitudes Toward Syringe Service Programs.

First responders have an increased risk of occupational exposure to HIV as the result of a needlestick injury (NSI) because of the chaotic prehospital environment in which they provide care. Approximately 2.3 of every 1000 first responders (0.23%) who are exposed to HIV via a NSI risk seroconversion if left untreated. Participants completed a 28-question online survey examining level of concern about HIV, thoughts about injection drug use, number of accidental NSIs, and medical services received after a needlestick. First, all data were analyzed descriptively. Second, a multiple linear regression model was used to explore the level of concern about HIV as a function of the predictor variables. Nearly half of the respondents worked as paramedics (n = 141, 23.5%) or emergency medical technicians (n = 154, 25.7%), followed by 15.5% (n = 93) and 11.3% (n = 62) who indicated their primary first responder affiliation as "firefighter" or "police," respectively. The majority of the study population identified as male (75%, n = 450); 24.8% identified as female (n = 149). Slightly more first responders reported receiving no medical services after a needlestick (9.8%, n = 59) than received an HIV screening (9.5%, n = 57), and only 3.2% (n = 19) of those who experienced a needlestick reported receiving post-exposure prophylaxis. The results suggest that perceived risk of HIV infection via needlestick ultimately influences follow-up medical screening. Greater concern about HIV is significantly associated with HIV screening and willingness to obtain post-exposure prophylaxis. Future research should examine the impact of continued HIV education and policies outlining medical evaluation and other post-exposures procedures.

An experimental study of a spring-loaded needle-free injector: Influence of the ejection volume and injector orifice diameter

Needle-free injection is an alternative strategy to conventional needle injection in the field of drug delivery. This approach offers a number of advantages, especially in reducing complaints of needle phobia and avoiding the occurrence of accidental needle stick injuries. The ejection volume and orifice diameter are inherently important in determining the injection depth and percent delivery. In this study, we investigate the dispersion pattern of liquid penetration into gels and porcine tissues using a needle-free injector with ejection volumes of 0.05 to 0.35 mL and orifice diameters of 0.17 to 0.50 mm. In addition, the influence of the two parameters is analyzed quantitatively on the dispersion pattern through impact experiments and injection experiments. Furthermore, an equation of the jet power calculated by the ejection volume and orifice diameter is proposed to describe the delivery fraction of the injection experiments. Controls of the ejection volume and orifice diameter are demonstrated to help achieve a more effective injection process and a better injection experience.

Epidemiological characteristics of accidental needle-stick injury among health care professionals in primary healthcare in Zenica.

Aim To determine the extent and characteristics of incidental injuries, primarily by needles and other medically sharp instruments and to recommend preventative activities to health care professionals. Methods The survey was conducted among 200 healthcare and non-healthcare employees of the Primary Health Care Centre Zenica (48% of the total number of employees). Care workers were surveyed, and the sample was randomly selected in proportion to the number of employees in institutional departments. Respondents answered questions about gender and age, work experience and qualifications; the number and type of exposure to incidents in the past year, number of career incidents, number of reported incidents; information on the manner and cause of the incident. Results The sample consisted mainly of females, 153 (83.2%). An exposure to incident during their work was experienced by 128 (69.6% ) respondents: needle-stick injury, 79 (42.9%), unforeseen patient response, 42 (22.8%), rush to perform the procedure, 34 (18,5%), and negligence, 18 (9.8%). The incidents most frequently occurred in gynaecology department (all respondents experienced an incident event), followed by department of family medicine, 47 (67%). The main reason for these incidents was rush to perform procedures, in 9 (12.5%). Of 128 experienced incident events, 21 (16.4%) were reported. Conclusion The low rate of reporting of exposure to incidents does not provide a realistic basis for risk assessment and preventive action. Primary task for improving safety of work processes at our setting will be to raise employee's awareness of the need to report exposure incidents.

A cross-sectional observational study to assess the awareness regarding needle prick injuries among health care providers of a tertiary care teaching hospital in Madhya Pradesh, India

Background: Health care workers (HCW) are at risk of an occupational exposure to blood borne diseases like HIV and Hepatitis B through accidental needle stick injuries. This study was conducted to assess the awareness regarding needle prick injuries among health care providers and their exposure to NSIs in a tertiary care medical college hospital with 750 bed capacity.Methods: This cross sectional observational study was conducted on 300 voluntarily participated HCWs out of total 650 HCWs. A semi structured questionnaire was used to assess their knowledge about exposure to blood and body fluids, needle stick injuries and associated risks and post exposure prophylaxis. Details of previous exposures to NSIs in last one year (2017-18) were also asked and their opinion about role and responsibilities of hospital administration for management of NSI was also recorded.Results: More than 90% HCWs were aware of exposure to blood and body fluids, 80.7% were aware of needle stick injuries, all 100% were aware of transmission of HIV and Hepatitis B from NSis and 78% were aware of post exposure prophylaxis. 97 cases of NSIs occurred in last one year which was higher than estimated EPInet data. Injection needle was most commonly (93.8%) involved in causing accidental NSIs.Conclusions: Practice of universal precautions and standard injection procedures by HCWs should be followed and education, training, and group insurance should be provided by hospital administration for prevention of NSIs.

Post exposure prophylaxis for occupational and non occupational exposure to HIV in a tertiary care hospital in central Nepal

Introduction: Post exposure prophylaxis (PEP) to HIV is the short term use of prescribed dose of antiretroviral therapy among persons exposed to high risk behaviors in order to prevent them from HIV infection. While occupationally exposed cases among health care workers are the major target of PEP, it is equally applicable to non occupational exposure to HIV including sexually exposed cases. This study was carried out to know the current scenario of PEP for HIV in terms of various determinants/ risk factors and outcomes of HIV positivity after prophylaxis.&#x0D; Methods: A prospective study was carried out by Antiretroviral therapy center of Tribhuvan University Teaching Hospital. The study period was between August 2006 and September 2016. Altogether 50 cases exposed to known HIV seropositive persons were included in this study.&#x0D; Results: The majority of the occupationally exposures were interns (48.6%), followed by staff nurse (18.9%), CMLT student (13.5%), hospital staff (10.8%) and resident doctor (8.1%). Majority (70.3%) were exposed to needle prick injury. Six-month follow-up showed zero seroconversion for HIV ELISA among the exposed cases.&#x0D; Conclusion: Intern constituted the greater proportion of health care workers exposed to accidental needle stick injury. Timely administration of prophylaxis might have resulted zero seroconversion for HIV ELISA among the exposed cases.

Severe Plasmodium vivax malaria, HIV, tuberculosis co-infection in a Sri Lankan traveller: case management and challenges during the prevention of malaria reintroduction phase

BackgroundThe country received malaria-free certification from WHO in September 2016, becoming only the second country in the WHO South East Asia region to be declared malaria-free. Imported malaria cases continue to be reported, with 278 cases reported between 2013 and 2017. The diagnosis of a severe Plasmodium vivax patient co-infected with HIV and tuberculosis is discussed with an overview of the rapid response mounted by the Anti Malaria Campaign (AMC), Sri Lanka.Case presentationA Sri Lankan gem miner who returned from Madagascar on the 6th of April 2018 presented to a private hospital for a malaria diagnostic test on the 21st April, 2 days after the onset of fever. He came on his own for this test due to the awareness he had regarding the risk of imported malaria. As the patient was positive for P. vivax malaria, he was admitted to a government hospital for further management. The patient had features of severe malaria upon admission with a systolic BP < 80 mmHg and thrombocytopaenia (38,000 cells/mm3). Treatment with IV artesunate was initiated immediately and management was carried out rapidly and efficiently by the clinicians with guidance from the staff of the AMC headquarters, which resulted in a rapid recovery of the patient. IV artesunate was followed by a course of artemether plus lumefantrine and the blood smear was negative for malaria by the 2nd day. A 14-day course of primaquine was commenced after excluding a G6PD deficiency. Due to an accidental needle stick injury of a health care worker attending on the patient was tested for HIV and subsequently tuberculosis and was found to be positive for both infections. The patient was discharged on the 1st of May with instructions for follow up visits for malaria. Management of the HIV and tuberculosis infections was attended to by the clinicians and staff of the appropriate disease control programmes (i.e. the national STD/AIDS Control Programme in Sri Lanka and the National Programme for tuberculosis control and chest diseases).ConclusionsIt is important to consider comorbid conditions and immunosuppression when a patient with a benign form of malaria presents with severe manifestations. Measures should be strengthened to prevent importation of diseases, such as malaria and AIDS through migrant workers who return from high-risk countries.

Needle Stick Injuries among health care workers in a tertiary care hospital in District Bathinda, Punjab

Background: Because of the environment in which health care staff works, many they are at an increased risk of accidental needle stick injuries (NSI). NSI has been recognized as one of the potential occupational hazards for healthcare workers which results in transmission of blood borne pathogens such as HBV, HCV, and HIV/AIDS while performing their clinical activities in the Hospital. Aims &amp; Objectives: To study the prevalence of needle stick injuries and knowledge and behavior of health care workers in a tertiary care centre. Material and Methods: A Hospital based cross sectional study was conducted among Health Care workers at a tertiary care hospital in 2016 at District Bathinda, Punjab. Results: A total of two hundred and eight (208) participants took part in the study from various departments. 58 health workers out of 208 i.e. 27% had NSI in the last 12 months. 84.1% of the health care workers were aware of the fact that HIV could transmitted by needle-stick injuries. While 55.8% and 83.2% knew that HBV and HCV respectively be transmitted through NSI. Only 46.6% of the health workers remembered that they had ever received HBV vaccination. Conclusions: The survey found out that the knowledge regarding the risk associated with NSI and use of preventive measures was adequate among the heath care workers but still there was a slight room for improvement in their attitude and practice and the same can be addressed through proper education and training

Factors influencing observation of standard precautions among nursing staff in tertiary care setting in Mangalore

Background: Health care professionals and particularly nurses are often exposed to microorganisms, many of which can cause serious infections. Although the potential for HBV transmission in the workplace setting is greater than for HIV, the mode of transmission for these two viruses are the same. Because of the environment in which they work, many health care workers are at an increased risk of accidental needle stick injuries (NSI) and blood borne pathogens such as HIV, Hep B, and HCV. The objectives of the study were to assess the knowledge, attitude and practice of standard precautions among nursing staff working in 5 tertiary care hospitals attached to teaching institutions in Mangalore and to assess the factors associated with non-compliance with standard precautions among nursesMethods: The study was done in 5 tertiary care hospitals attached to teaching institutions in Mangalore among the working nursing staff in these hospitals. A pre-tested questionnaire was used to collect the information regarding knowledge, attitude and practice and the reasons for non-adherence to standard precautions. Results: Regarding standard precautions 66.7% had a good knowledge, 74.7% had good practice and 87.3% had a positive attitude towards it. 26.34% attributed noncompliance to excess workload. Increasing age and increase in duration of nursing practice showed a significant increase in KAP scores. Conclusions: The duration of nursing practice influenced the knowledge and the compliance to standard precautions.

A Mathematical Model and Experimental Verification of Optimal Nozzle Diameter in Needle-Free Injection

Needle-free injection (NFI), as an alternative drug delivery strategy, owns great potential. It is able to reduce complaints about needle phobia and avoid the occurring of accidental needle stick injuries. The nozzle diameter is inherently important in determining the injection dose, injection depth, and pain associated with NFIs. In this work, needle-free injectors with nozzle diameters of 0.17, 0.20, 0.30, 0.40, and 0.50 mm were studied in the simulation and experiment. This article optimizes the mathematical model for spring-powered NFI by considering the hydraulic loss due to the abrupt change in the nozzle exit area and the friction force between the piston and ampoule. We explore the dispersion pattern in gels with different nozzle diameters. Mice insulin injection was conducted to investigate the pharmacological effect of different injection methods. The experimental results show that there is the best dispersion effect and available injection depth while the nozzle diameter is 0.30 mm, which is in agreement with the result predicted by the mathematical model. Also, there is a satisfactory pharmacological effect on the mice insulin injection under the same injection condition. Undoubtedly, the mathematical model is capable of predicting the suitable nozzle diameter under the given conditions.

Microneedle Manufacture: Assessing Hazards and Control Measures

Transdermal microneedles have captured the attention of researchers in relation to a variety of applications, and silicone-based moulds required to produce these systems are now widely available and can be readily manufactured on the lab bench. There is however some concern over the potential for accidental needlestick injuries and, as with any sharp hazard, the potential for blood-borne pathogen transmission must be considered. This follows from recent governmental concerns over the use of microneedle systems in dermabrasion. Despite the piercing nature of the microneedle patch sharing many similarities with conventional hypodermic needles, there are notable factors that mitigate the risk of contamination. A range of microneedle systems has been prepared using micromoulding techniques, and their puncture capability assessed. A critical assessment of the potential for accidental puncture and the control measures needed to ensure safe utilisation of the patch systems is presented.

Knowledge of needle sticks injuries and its prevention among interns and post graduate students working at a tertiary health care centre, Bangalore

Background: Health care workers (HCW) especially doctors and nurses are at an increased risk of accidental needle stick injuries (NSI) due to the occupational environment in which they work. Hence the HCWs are at a higher risk of acquiring blood borne pathogens such as HIV, hepatitis B and C and other diseases. This study was done to assess knowledge regarding NSI and practice regarding disposal of needles and sharps among interns and postgraduate students.Methods: This study was a cross-sectional study done among 110 interns and postgraduates medical students working in various departments of a tertiary health care centre in Bangalore. A self-administered questionnaire was used to collect the data regarding knowledge, practices and preventive measures among HCWs in their work place.Results: Among the 110, 55 (50%) were from intern category and 55 (50%) were from the postgraduate category and 47 (42.7%) were male and 63 (57.3%) were female students. The prevalence of NSI was found to be 36.3%. Female participants and post graduates had better knowledge. Female participants and interns had better practice.Conclusions: The Knowledge among the medical students (interns and postgraduates) was inadequate, indicating the need for awareness programs to reduce the burden of NSI among HCWs.

A study on knowledge, attitude, practice and prevalence of needle stick injuries among health care workers in a tertiary care hospital of Assam

Background: The objective of study was to determine prevalence of needle stick injuries among health care workers in a tertiary care hospital of Assam and to assess the knowledge, attitude and practices on needle stick injuries among them.Methods: It was a cross-sectional study conducted from June 2016 to August 2016 amongst health care workers of a tertiary care centre of Assam. Sample size was calculated to be 90. A total of 10 departments were selected purposively based on their magnitude of risk exposure and the required sample size was allocated proportionally among these 10 departments. The required numbers of health workers from each of the ten departments were selected by using simple random sampling. A predesigned and pretested proforma was used to collect the data. Data were presented in terms of percentages and significance was tested using chi-square and Fisher’s exact test.Results: Prevalence of needle stick injury among the health workers was found to be 21.1%. Regarding spread of diseases after an accidental needle stick injury, 100% were aware of HIV, 98.9% were aware of Hepatitis B and 67.8% were aware of Hepatitis C. Regarding their attitude to report to in-charge medical officer, only 21.1% had reported about their injury. Around 58.9% of health care workers used gloves regularly for prevention of such injuries. Practice of recapping among the health care workers was 66.7% and out of total needle stick injuries, recapping contributed to 26.3%. While considering sharp waste disposal, 37.8% health care workers did not follow proper waste disposal guidelines. Only 26.3% of health care workers had done screening for HIV/AIDS and Hepatitis B after their injury.Conclusions: There is a need to have a pre-employment training to improve the knowledge, attitude and practice regarding accidental needle stick injuries among the health care workers.

A Novel Restraint Device for Injection of Galleria mellonella Larvae that Minimizes the Risk of Accidental Operator Needle Stick Injury.

Larvae of the insect Galleria mellonella are increasingly being used for studying pathogenic microbes and their virulence mechanisms, and as a rapid model for screening novel antimicrobial agents. The larvae (waxworms) are most frequently infected by injection of pathogenic organisms into the haemocoel through the insect's prolegs. The mostly widely used method for restraining the waxworms for injection is by grasping them between the operator's fingers, which puts the operator at risk of needle stick injury, an important consideration when working with highly pathogenic and/or drug-resistant microorganisms. While use of a stab proof glove can reduce this risk of injury, it does so at the loss of manual dexterity and speed, resulting in a more labor-intensive, and cumbersome assay. We describe a simple cost effective device (the so-called “Galleria Grabber”) for restraining waxworms for injection that keeps the operator's fingers clear of the needle thus reducing the risk of injury.