Cases Of Needlestick Injuries Research Articles

Financial impact of needle stick injury on a tertiary care teaching hospital

BackgroundAccidental needle stick injuries (NSIs) are an occupational hazard for healthcare workers (HCWs). Despite the implementation of preventive measures, NSIs still continue to occur in health care settings. The cost incurred by an institute for the management of occupational exposure to blood borne pathogen is a significant economic burden.This retrospective study was aimed to estimate the prevalence, factors associated with NSIs and cost burden on hospital due to NSIs. Material and methodsRetrospective data of all reported NSIs among HCWs between January 2019 and December 2021 in a tertiary care hospital was collected and analyzed. CDC definition was used to calculate direct & indirect cost. Results& Discussion- A total 205 NSIs were reported between January 2019 and December 2021. Nurses were the most affected category of HCWs. The maximum number of NSI cases (18.54 %) occurred during handling of biomedical waste. Both the source and the affected HCWs were tested and it was found that the source was seropositive in 30(14.63 %), seronegative in 128 (62.44 %) cases and in 47(22.93 %) cases there was an unknown source resulting in NSI. A total of 13, 21,206 INR, which included both direct and indirect cost, spent by hospital in the management of NSI's, over a period of 3yrs. ConclusionSurveillance and analysis of NSI is very crucial for the planning of both preventive measures and training modules. Managing NSI generates significant cost. Hepatitis B vaccination for all healthcare workers plays major role in reducing cost of managing NSIs.

Needlestick Injuries among Nurses in Selangor Public Hospital, Malaysia

Background: Needlestick injuries (NSIs) are one of the greatest risks nurses face. NSIs are associated with an increased risk of diseases that can be transferred through skin exposure, such as Hepatitis B, Hepatitis C, and the human immunodeficiency virus. Certain factors can influence the mechanism and frequency of NSI among nurses. Objective: To determine the factors associated with the frequency and mechanisms of NSIs among nurses at a public hospital in Selangor. Methods: A cross-sectional study was conducted from April to September 2020. A total of 233 nurses were conveniently sampled from a public hospital in Selangor. A questionnaire was distributed to capture data on socio-demographic characteristics, frequency, and mechanisms of NSI. The inferential statistics were conducted using SPSS 22. Results: Of the 233 respondents, the incidence rate of NSI was 23.6%. Most cases of NSI occurred during the morning shift (12.4%), and the most common mechanism of NSIs was the action of recapping needles (6.9%). Factors associated with the NSI were gender, age, ward, and working experience. Conclusion: The prevalence of NSIs is relatively low in this study. However, nurses should still apply universal precautions to prevent NSIs. Several risk factors that influenced the NSI should be highlighted among nurses and nursing management to prevent its incidence.

Prevalence and Determinants of Needle stick Injury among Nurses

Needle stick injuries pose a serious risk of transmission of fatal diseases to the workers of the Health care. Globally, more of the reported cases of needle stick injuries happen among nurses than other health professionals. Our aim is to explore the prevalence of needle stick injuries and determinants among nurses for better prevention and control. This is a cross- sectional study where we recruited 282 nurses working at King Fahd Hospital in Jeddah city. The validated self-administered questionnaires were distributed by the head nurse to the participating nurses who were in a direct contact with the patients. From questionnaires we investigated demographics, work-related factors, determinants of needle stick injuries and safety measures. Results of our study showed that about 92% of nurses were females and about 80% regularly take care of 10 patients or less. This study reported a lifetime occurrence of needle stick injury among nurses to be 37.6% (95% CI = 31.9% to 43.3%). The syringe needle was the most common item which caused the recent NSIs among the affected nurses (78.3%), followed by intravenous catheter and tapping needle with prevalence of 11.3% and 7.5% respectively. The occurrence of needle stick injury could not be predicted by nurses’ characteristics such as years of experience, educational level, hours of working and number of patients on duty. However, training on NSIs prevention, Hepatitis B virus vaccination status and availability of safety box in their work place were significant predictors. We conclude that despite the high level of training, awareness, and availability of safety precautions, more than a third of nurses in the KFGH were affected by needle stick injury. Training on NSIs prevention and availability of safety box in their work place were the major determinants of the needle stick injury in KFGH.

Epidemiology of needlestick injury exposures among dental students during clinical training in a major teaching institution of China: A cross-sectional study

Background/purposeDental students are particularly vulnerable for needlestick injuries (NSI). However, the epidemiology of NSI exposures among Chinese dental students was rarely reported. The objectives of this study were to determine the prevalence of NSI among dental students in a major teaching institution of China, and to identify associated factors.Materials and methodsA self-administrated online questionnaire was developed based on previously published studies, and distributed to dental students of Class 2011–2015 recruited from Peking University School and Hospital of Stomatology.ResultsTwo hundred and sixty-eight dental students including 38.8% of males and 61.2% of females (response rate of 90.0%) completed the survey. Approximately 36.2% of the respondents had sustained at least one NSI. A total of 112 NSI cases were reported. The majority of NSIs were related to the procedures of local anesthesia administration (15.2%) and tooth cleaning or scaling (15.2%). Syringe needles, dental burs and ultrasonic chips were the most notorious devices. Statistical analysis showed significant distribution in NSI occurrence between July–September and October–December. The main cause was lapse in concentration (67.9%), followed by fatigue (22.3%). Up to 66.1% of the exposures occurred when the student was working alone, while only 10.7% with assisting. Unfortunately, 26.8% of the incidents were under-reported.ConclusionDental students are prone to needlestick injuries. The present study clearly reveals a need for increased awareness of NSI prevention among dental students. The quality of infection control education at dental teaching institutions is crucial and indispensable for reducing NSI exposures.

Knowledge, Attitude and Practice concerning Hepatitis B infection among the health care personnel in selected Primary Health Care Centres in Lucknow

Background: Hepatitis B is a major global health problem and one of the most serious type of viral hepatitis, but it can be prevented with strategies like safe and effective vaccination, increasing awareness and by adhering to universal precautions. Objective: To assess the knowledge, attitude and practice concerning Hepatitis B infection among the health care personnel. Materials and methods: Cross-Sectional study was conducted among health care personnel working at the Primary Health Centres in Lucknow. A total of 89 health care personnel comprising of medical officers, staff nurses, laboratory technicians, pharmacists including class IV workers present on the day of data collection were included in the study and interviewed using pretested questionnaire. Descriptive summary using frequencies, proportions and percentages were used to present study results. Result: Majority (93.4%) of the medical officers were aware about type of hepatitis in comparison to staff nurses, paramedical staff and class IV workers (20.0%, 21.8% and 4.5% respectively). Knowledge about symptoms of hepatitis B was found minimal (9.1%) among class IV workers and paramedical staff (18.7%) as compared to doctors (80.0%) and staff nurse (35.0%). Only 13.6% of class IV worker had concern to report each and every case of needle stick injury. Practice to strictly follow of universal precautions and biomedical waste management guidelines was found to be least (9.1% and 18.1% respectively) among class IV workers. Conclusion: The study revealed sub-optimal KAP (Knowledge, attitude and practices) in concern to several aspects of Hepatitis B infection among primary healthcare personnel. Key words: Hepatitis B, Knowledge, Attitude, Practices, Healthcare personnel

Needlestick injuries at a tertiary teaching hospital in Singapore.

This study investigated the incidence and risk to staff groups for sustaining needlestick injuries (NSIs) in the National University Hospital (NUH), Singapore. A retrospective cohort review of incident NSI cases was undertaken to determine the injury rate, causation, and epidemiological profile of such injuries. Analysis of the risk of sustaining recurrent NSI by occupation and location was done using the Cox proportional hazards model. There were 244 NSI cases in 5957 employees in NUH in 2014, giving an incidence rate of 4·1/100 healthcare workers (HCWs) per year. The incidence rate was highest for doctors at 21·3, and 2·7 for nurses; 40·6% of injuries occurred in wards, and 32·8% in operating theatres. There were 27 cases of repeated NSI cases. The estimated cost due to NSIs in NUH ranged from US$ 109 800 to US$ 563 152 in 2014. We conclude that creating a workplace environment where top priority is given to prevention of NSIs in HCWs, is essential to address the high incidence of reported NSIs. The data collected will be of value to inform the design of prevention programmes to reduce further the risk of NSIs in HCWs.

Hepatitis B infection and vaccination: Knowledge, Attitude and Practices among primary health care personnel in Lucknow

Background: Hepatitis B is a major global health problem and one of the most serious type of viral hepatitis, but it can be prevented with strategies like safe and effective vaccination, increasing awareness and by adhering to universal precautions. Objective: The present study aimed to assess the knowledge attitude and practice concerning Hepatitis B infection among the health care personnel in selected Primary Health Care Centres in Lucknow. Materials and methods: Cross-Sectional study was conducted among health care personnel working at the Primary Health Centres in Lucknow. A total of 89 health care personnel comprising of medical officers, staff nurses, laboratory technicians, pharmacists including class IV workers present on the day of data collection were included in the study and interviewed using pretested questionnaire. Descriptive summary using frequencies, proportions and percentages were used to present study results. Result: Majority (93.4%) of the medical officers were aware about type of hepatitis, while knowledge regarding same was comparatively low among staff nurses, paramedical staff and class IV workers (20.0%, 21.8% and 4.5% respectively). Knowledge about symptoms of hepatitis B was found minimal (9.1%) among class IV workers and paramedical staff (18.7%) as compared to doctors (80.0%) and staff nurse (35.0%). Only 13.6% of class IV worker had concern to report each and every case of needle stick injury. Practice to strictly follow of universal precautions and biomedical waste management guidelines was found to be least (9.1% and 18.1% respectively) among class IV workers. Conclusion: The study revealed sub-optimal KAP in concern to several aspects of Hepatitis B infection among primary healthcare personnel. Therefore insights a need to increase the knowledge level as well ideal behaviour in practice through quality training and proper orientation programmes for health care personnel to prevent the spread of hepatitis B infection.

Assessing the Utilization of Needle-Stick Injury Protocols by General Practices in Liverpool

Background: Needle-Stick Injuries (NSIs) incur huge financial, emotional, social and economic costs, and therefore constitute a serious global burden of disease. Protocols to manage NSIs at the primary care level are in place to ensure both staff and the public are well protected. Aim: This study aims to assess the utilization of NSI Protocols by General Practices in Liverpool, with respect to the North-West of England regional guidelines. Design and Setting: This is a cross-sectional survey, focusing on 77 general practices in Liverpool, North-west of England. Methods: Self-administered, pre-piloted questionnaires were distributed by post, email, and personal delivery to Practice Managers in the GP Surgeries. Completed forms were analyzed. Results: The study achieved an 82% response rate (63 responses out of 77). Eight (12.9%) of the Surgeries witnessed NSI cases in the preceding 12 months. Five (62.5%) of these Surgeries reported cases among the public, while the rest were among Practice staff. About 90% of the practices were aware of the regional NSI Policy, though 87.3% actually possess it. Less than 14% had difficulties adopting or implementing recommended guidelines, mostly from not knowing who to contact if help is needed. There was no association between Practice Size and the Possession of Policy (χ2 = 0.002; P = 0.99). Conclusion: The awareness, adoption and implementation of the recommended NSI policy among Surgeries in Liverpool are quite high. However, efforts should be made to maximize possession and limit difficulties in the implementation of the policies.

의료종사자의 주사침 손상 사고 후 감염예방처치와 혈액매개바이러스 혈청양성전환

Purpose: Needlestick injuries (NSI) is the most frequent occupational hazard for healthcare personnel (HCP), and immediate report and adequate post-exposure prophylaxis (PEP) is essential in preventing occupational transmission of blood-borne pathogens. Methods: From June 2010 to October 2010, 544 NSI were reported through websites from 21 general hospitals in Korea. Among those, 499 cases of NSI were analyzed to identify the rate of follow-up treatment completion and for seroconversion. Results: 88.2% of the cases were completed with follow-up treatment, 8.8% of the NSI were not completed with follow-up treatment, and 5 cases were unavailable to trace. 4.2% cases of NSI required a hepatitis B vaccination concurrent with hepatitis B immunoglobulin. 41.1% of the cases and 31.1% of the cases needed to be tested for anti HCV and anti HIV, respectively. Prophylaxis medication for HIV was prescribed in 3 cases, and all cases completed required 1 month of medication. There was 1 case (0.2%) of seroconversion to HCV. Conclusion: The PEP completion rate was not satisfactory, and the importance of completion of PEP treatment should be emphasized through education and counseling. Also, a careful risk assessment is needed for HCP who are exposed to HCV or HIV.

Needle stick injuries in restorative dentistry: The need for prevention

Risk of exposure to blood‑borne pathogens has always been a problem for healthcare professionals including dental professionals. The emergence of acquired immunodeficiency syndrome (AIDS) in 1981 brought the issue to the forefront of public health policy. Percutaneous injuries, which include needle stick injuries (NSI), expose dental healthcare workers to deadly blood‑borne pathogens such as Hepatitis C virus (HCV), Hepatitis B virus (HBV), and Human Immunodeficiency Virus (HIV). The risk of transmission of HCV, HBV, and HIV from patient to the healthcare personnel is 3%, 30%, and 0.3%, respectively. [1,2] Although the likelihood of being infected by a blood‑borne virus (BBV) may be low after a single exposure, the consequences for the dental professional who becomes infected are potentially serious and include the potential of transmission of blood‑borne pathogens and associated detrimental effects on their personal and professional lives. [3] Needles used for injecting local anesthesia during restorative procedures and the use of sharps during endodontic and prosthodontic procedures pose a high risk of transmission of BBVs. Procedures in restorative dentistry that may make the patient to cause a sudden jerky movement can lead to increase probability of NSI. Thus, education and training regarding the use of universal precautions when handling body fluids should be conducted. New employees should go through the training program stressing the need to report all injuries and the availability of chemoprophylaxis. Improving sharps disposal by introducing improved sharps containers in the dental clinics. Sharps should be disposed immediately. Recapping and re‑sheathing should be discouraged and new arrangements for sharps disposal should be done to avoid overfilling boxes. NSI prevention strategies for dental professionals should be implemented in the dental curriculum and during the pre‑occupational/occupational training programs. Since a relatively high percentage of patients are positive for major blood‑borne infections, the risk of exposure to blood‑borne pathogens for healthcare workers through NSI should not be ignored. Regular health checkups, tests for serum antibodies and antigens of HBV, and appropriate hepatitis B vaccination are mandatory for occupational safety of healthcare workers. Report of NSI cases should be encouraged since it is needed for root cause analysis of the adverse events and future prevention. The report of NSI events is also highly important for the injured parties in view of risk assessment and implementation of appropriate prophylactic measures for blood‑borne infections.

Psychiatric consequences of needlestick injury

Needlestick injuries (NSIs) are a common occupational hazard with potential physical health effects, including viral infections such as hepatitis and HIV. Less appreciated are the psychiatric consequences of NSIs, potentially including post-traumatic stress disorder (PTSD) and adjustment disorder (AD). To study psychiatric consequences of NSIs by diagnosis, duration and severity of depressive symptoms. Case control study from patients referred to a psychiatric trauma clinic diagnosed according to ICD-10 diagnostic research criteria guidelines. The Beck Depression Inventory (BDI) was administered to measure depressive symptomatology and assess differences in depression severity between psychiatric trauma patients who had or had not experienced an NSI, and for relationships between the severity of depression and time since NSI using linear models. There were 17 NSI cases and 125 controls. NSI patients had moderately severe depressive symptoms (mean BDI score 22.7 15), which was similar to 125 non-NSI trauma patients. 13 of these 17 cases had AD and four had PTSD. None contracted infections from their NSI, but most described secondary effects of psychiatric illness on occupational, family and sexual functioning. Severity of depressive symptoms declined with time after NSI, but psychiatric illness lasted 1.78 months longer for every month a NSI patient waited for seronegative test results (P < 0.05). Enduring psychiatric illness can result from NSIs with a severity similar to other psychiatric trauma. Swift delivery of test results may reduce the duration of depression associated with NSI. Occupational health professionals need to be aware of the psychiatric and physical effects of NSIs.

Incidence of occupational exposures in a tertiary health care 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.

Incidence of occupational exposures in a tertiary health care center.

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.

Occupational Needlestick Injuries in a US Airport

To characterize needlestick injuries (NSIs) among airport workers, and to suggest preventive strategies. A retrospective chart review (2003-2008) of workers evaluated at a clinic in a large US airport that provides occupational health services. Over a period of 6 years, 14 NSI cases were seen. The majority of injuries occurred while workers cleaned lavatories in the airport or on airplanes. Insulin needles were involved in most cases, and the injuries typically occurred on the hand. No cases of hepatitis B, C, or HIV seroconversion were documented, although follow-up was typically incomplete. The improper disposal of used insulin needles among travelers can result in potential bloodborne pathogen exposure among airport workers. Occupational NSIs have not previously been described among airport workers. A multilevel approach to prevention is recommended.