Injuries In Healthcare Workers Research Articles

The differential and accumulative impacts of self and other sources of moral injury on well-being in mental healthcare staff

PurposeResearch has established the prevalence and relevance of moral injury in healthcare workers, though less attention has been paid to the different classes of potentially morally injurious events (PMIEs) experienced by this population and their impact. This exploratory study sought to examine the frequency of self- and other-generated PMIE classes and their associations with demographic characteristics and well-being outcomes among mental healthcare staff.Design/methodology/approachSecondary analysis of data drawn from two cross-sectional surveys of 267 frontline and leadership staff from mental healthcare settings in the UK was conducted. Responses on the Moral Injury Events Scale and the Short Professional Quality of Life Scale were extracted for analysis.FindingsBetrayal by others was most frequently endorsed (61.8%), whilst self-transgressions were least frequently reported (25.5%). After controlling for the number of PMIE classes experienced, betrayal significantly predicted secondary traumatic stress (p = 0.01) and burnout (p = 0.04). Additionally, other transgressions significantly predicted secondary traumatic stress (p = 0.008). The predictive effects of self-transgressions on burnout, secondary traumatic stress and compassion satisfaction were all nonsignificant after controlling for the number of PMIE classes experienced.Practical implicationsFindings highlight differences in the frequency and impact of self and other PMIEs experienced by healthcare professionals. Reducing cumulative exposure to differential PMIE classes appears to be of critical importance to improving occupational well-being in this group.Originality/valueTo our knowledge, this study is the first to explore the associations between PMIE classes and occupational well-being in a mental healthcare population, inclusive of frontline and leadership staff.

Moral Injuries in Healthcare Workers: What Causes Them and What to Do About Them?

Moral injury (MI) refers to the persisting distress which may occur following exposure to potentially morally injurious events (PMIEs). The COVID-19 pandemic has drawn attention to MI in healthcare workers, who have been found to experience more frequent PMIEs in their day-to-day work than those in other occupational groups such as the military. These events may occur on an individual, team, organizational or system level and have been associated with increased clinician burnout and distress, and poor psychological wellbeing. This paper focuses on healthcare workers' experiences of MI, including potential causes and ways to reduce them. There are myriad challenges that influence the development of MI, such as chronic understaffing and the pressure to treat high numbers of patients with limited resources. There are also multiple impacts of MI: at the individual-level, MI can lead to increased staff absences and understaffing, and prolonged patient contact with limited decision-making power. COVID-19 exacerbated such impacts, with a lack of organizational support during a time of increased patient mortality, and uncertainty and heightened pressure on the clinical frontline associated with scarce resources and understaffing. Potential methods for reduction of MI in healthcare workers include pre-exposure mitigation, such as fostering work environments which treat PMIEs in the same way as other occupational hazards and post-exposure mitigation, such as facilitating healthcare workers to process their experiences of PMIEs in peer support groups or with spiritual advisors and, if MI is associated with mental ill-health, talking therapies using trauma-focused and compassion-oriented frameworks.

Alcohol consumption in healthcare workers and risk of workplace injury: a case-control study

Medical surveillance for alcohol abuse and dependency at work is mandatory for a list of high-risk occupations. The occupational physician is the only figure entitled to perform alcohol and laboratory tests on employees. This study aims to investigate alcohol-induced injuries in healthcare workers, by using Carbohydrate-Deficient Transferrin (CDT) as a marker during medical surveillance visits. A retrospective study was carried out in an Italian healthcare unit. The sample consisted in 75 healthcare workers who sustained an occupational injury. To assess alcohol consumption, CDT levels were tested as well as serum alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyltransferase (GGT), mean corpuscular volume (MCV). No worker had positive CDT levels (cut-off 2%); 12% of cases (5 male and 4 female workers) had γ-GT level higher than normal range (cut-off: 36 U/L). Most injuries (53.33%) occurred during morning shifts, 33.33% during afternoon shifts and 13.33% during night shifts. Female workers had a higher injury rate (73%); biological injuries were the most frequent (36%), followed by slipping and falling 33%. This study seems to indicate that alcohol does not represent an important cause of occupational injuries, as no cases of workplace injury were found positive for CDT. CDT as a biomarker in health surveillance programs could be used to assess alcohol consumption when used alongside other biochemical parameters, and its routine use during medical surveillance could act as a deterrent.

Feasibility of Implementing the STEADY Wellness Program to Support Hospital Staff During the COVID-19 Pandemic

Introduction:The COVID-19 Pandemic negatively impacted the mental wellbeing of healthcare workers worldwide. Many organizations responded reactively to their staff needs. The novel, evidence-informed Social Support, Tracking Distress, Education and Discussion Community (STEADY) program was implemented, with senior leadership support across a large hospital. STEADY is a multi-pronged program developed to mitigate occupational stress injury in healthcare workers and first responders. This project examined the feasibility of implementing STEADY across hospital units during a pandemic.Method:STEADY was implemented in five acute care units and across the rehab site of a large hospital. Data was collected on the five program components (drop-in peer support groups and critical incident debriefs, psychoeducation workshops, wellness assessments, peer partnering, community-building initiatives). Most peer support groups were facilitated by the program manager trained in peer support and one of six clinical staff.Results:The program was iteratively adapted to meet the needs of target units/groups. More than 300 sessions were run in ~one year, for an average of ~1.15 sessions per unit per week. With flexible adaptation to the mode of facilitation, ~75% of planned workshops and ~85% of peer support sessions were run. Three critical incident stress debriefs were held. The formal partnering program was offered via e-mail with minimal uptake. Ninety-five wellness assessments were completed by target end-users, with 36 personalized responses sent. Gratitude trees were posted in each unit for community-building. Eight target unit staff completed formal peer support facilitation training. Twenty additional groups across the organization requested STEADY programming support and ten requested gratitude trees.Conclusion:Results indicate that most components of the STEADY program were feasible to implement in hospital units during the pandemic. On-site, interactive programming was most engaging for end-users. Leadership support and flexible, continuous adaption by program leaders were identified as facilitators to program implementation and uptake.

THE SITUATION OF SHARPS INJURIES AMONG IN MEDICAL STAFFS AT DUC GIANG GENERAL HOSPITAL IN 2022

The study aimed to: (1) Describe the situation of damage caused by sharp waste in medical staffs and (2) Identify association factors at Duc Giang General Hospital in 2022. The study is a cross-sectional descriptive research on 121 health care workers. The results showed that 24,8% of healthcare workers injuried by medical sharp waste, of which the wounds on finger and hand accounted for the most with 96,7%, the skin and mucous lesions wounds accounted for the majority with 63,3%, the damage related to patients who may have HIV, hepatitis B other infectious diseases accounted for 16,7%, 13.3% and 30%, respectively. Factors associated with sharp waste injury in healthcare workers include age, training in medical solid waste, and knowledge of medical solid waste management (p<0.05). Conclusion: The rate of damage caused by sharp waste among healthcare workers is still high, especially among young people, those who have not been trained in medical waste, and those with poor knowledge of medical waste management.

NEEDLE STICK INJURY AND POST EXPOSURE PROPHYLAXIS FOR HIV AND HBV – A KAP STUDY AMONG HEALTH CARE WORKERS

Needle stick injuries (NSI) are occupational injuries in Health Care Workers (HCWs) on using sharps. Though there are more than 20 pathogens transmitted through NSI, human immune deciency virus (HIV), hepatitis B & C virus (HBV&HCV)[1] are of signicance due to grave complications and minimum available preventive measures. According to WHO, nearly 40% of HBV and 2.5% of HIV infections among HCWs is attributed to NSI[2]. The occurrence of NSI can be reduced if Standard Work Precautions are strictly adhered by all HCWs at all times and also by taking Post Exposure Prophylaxis for HIV & HBV within the golden period of 2 hour. This study is done to assess the knowledge, attitude and practice of HCWs of various categories on NSI and PEP. A Self structured questionnaire was administered to the study population (n=307) including Post graduates, Interns, Staff nurses, Nursing students , Lab technicians, Lab technical students. There was 10 questions under three sections.1) KNOWLEDGE 2) ATTITUDE 3) PRACTICE . This study revealed that knowledge regarding transmission of all three viruses (HIV,HBV,HCV) was less among paramedics compared to medicos, but the practice of HBV vaccination is the same. 53.1% of HCWs had NSI in our study. Majority incurred NSI during recapping needles. Attitude of HCW after being exposed to report NSI is very low (30.7%). Though 37.5% of the respondents not aware of golden hour of PEP, most of them aware of initiating PEP within 72 hours of exposure . Applying disinfectants/pressure over exposed area (38.9%) & recapping (31.6%) is still prevalent among study population. And 20 % of the HCWs were not vaccinated against Hepatitis B yet.

FFP3 Feelings and Clinical Experience (FaCE). Facial pressure injuries in healthcare workers from FFP3 masks during the COVID-19 pandemic

AimsProlonged wear of filtering facepiece 3 (FFP3) masks during the COVID-19 pandemic has led to dermatoses, including pressure sores. This study aimed to better understand the local scale and nature of the problem, coping strategies, and impact on those affected.MethodsA survey was designed by plastic surgeons, tissue viability nurses, and critical care doctors. Key elements were demographics, mask-wearing behaviours, facial injuries, coping mechanisms, and impacts, such as time off work or redeployment. Question types were multiple-choice questions, visual analogue scales, and blank space. It was distributed for voluntary completion at a London NHS Trust via staff update emails and posters.ResultsBetween 24th April–15th May 2020, 178 surveys were completed in full. Participants were 84% female, 55% worked in ITU, and 48% were nurses. Grade 1 facial pressure injuries were reported by 79% of respondents (n=124). Other significant occupational dermatoses included pain (70%), dry skin (50%), and acne (41%). The cheeks and bridge of nose were most affected. Staff used barrier creams (17%), dressings (17%), and analgesia (10%) to manage facial injuries. Half of those who modified their mask were not re-fit tested. A total of 33% required redeployment to a non-FFP3 area or time off.ConclusionsFFP3 masks worn beyond the recommended 1 h are associated with facial injuries. When advanced PPE (i.e., powered airflow masks) is unavailable, we must provide targeted skincare support (prevent and manage), modify shift patterns to reduce mask wear intensity, and amend fit test protocols to optimise protection against COVID-19.

Research Gaps and Recommendations to Guide Research on Assessment, Prevention, and Treatment of Moral Injury Among Healthcare Workers.

Healthcare workers face numerous occupational stressors, including some that may challenge personal and shared morals and values. This is particularly true during disasters and crises such as the COVID-19 pandemic, which require critical decisions to be made with little time and information often under personal distress and situational constraints. Consequently, healthcare workers are at risk for moral injuries characterized by stress-related and functional impacts. Although research on the evaluation and treatment of moral injury among military veterans burgeoned in the recent decade, addressing moral injury in healthcare workers and other civilians remains an important gap. In this perspective piece, we identify research gaps and make recommendations to advance future work on assessment, prevention, and treatment of moral injury in healthcare workers. We draw on empirical studies of moral injury in veterans, limited studies of moral injury in health professionals, and our clinical experiences with healthcare workers affected by moral injury.

Healthcare Workers and COVID-19-Related Moral Injury: An Interpersonally-Focused Approach Informed by PTSD.

The COVID-19 pandemic has resulted in a still-unfolding series of novel, potentially traumatic moral and ethical challenges that place many healthcare workers at risk of developing moral injury. Moral injury is a type of psychological response that may arise when one transgresses or witnesses another transgress deeply held moral values, or when one feels that an individual or institution that has a duty to provide care has failed to do so. Despite knowledge of this widespread exposure, to date, empirical data are scarce as to how to prevent and, where necessary, treat COVID-19-related moral injury in healthcare workers. Given the relation between moral injury and post-traumatic stress disorder (PTSD), we point here to social and interpersonal factors as critical moderators of PTSD symptomology and consider how this knowledge may translate to interventions for COVID-19-related moral injury. Specifically, we first review alterations in social cognitive functioning observed among individuals with PTSD that may give rise to interpersonal difficulties. Drawing on Nietlisbach and Maercker's 2009 work on interpersonal factors relevant to survivors of trauma with PTSD, we then review the role of perceived social support, social acknowledgment and social exclusion in relation to potential areas of targeted intervention for COVID-19-related moral injury in healthcare workers. Finally, building on existing literature (e.g., Phoenix Australia—Centre for Posttraumatic Mental Health and the Canadian Centre of Excellence—PTSD, 2020) we conclude with individual and organizational considerations to bolster against the development of moral injury in healthcare workers during the pandemic.

A Scoping Review of Moral Stressors, Moral Distress and Moral Injury in Healthcare Workers during COVID-19.

Ethical dilemmas for healthcare workers (HCWs) during pandemics highlight the centrality of moral stressors and moral distress (MD) as well as potentially morally injurious events (PMIEs) and moral injury (MI). These constructs offer a novel approach to understanding workplace stressors in healthcare settings, especially in the demanding times of COVID-19, but they so far lack clear identification of causes and consequences. A scoping review of moral stressors, moral distress, PMIEs, and MI of healthcare workers during COVID-19 was conducted using the databases Web of Science Core Collection and PsycINFO based on articles published up to October 2021. Studies were selected based on the following inclusion criteria: (1) the measurement of either moral stress, MD, PMIEs, or MI among HCWs; (2) original research using qualitative or quantitative methods; and (3) the availability of the peer-reviewed original article in English or German. The initial search revealed n = 149,394 studies from Web of Science and n = 34 studies from EBSCOhost. Nineteen studies were included in the review. Conditions representing moral stressors and PMIEs as well as MD and MI as their potential outcomes in healthcare contexts during COVID-19 are presented and discussed. Highlighting MD and MI in HCWs during COVID-19 brings attention to the need for conceptualizing the impact of moral stressors of any degree. Therefore, the development of a common, theoretically founded model of MD and MI is desirable.

Enhanced personal protective equipment can cause acute kidney injury in health care workers during COVID-19 pandemics

Enhanced personal protective equipment can cause acute kidney injury in health care workers during COVID-19 pandemics

Investigation and Analysis of Sharp Injuries among Health Care Workers from 36 Hospitals in Shandong Province, China.

Background This study investigated and analyzed the current situation of sharp injuries among health care workers (HCWs) in China's Shandong Province. Methods By means of questionnaire survey, the incidence of sharp injuries among HCWs from 36 hospitals in China's Shandong Province in October 2019 was investigated, and the results of this survey were compared with those of October 2012. Results A total of 48165 HCWs were investigated. 549 cases of sharp injuries occurred. The incidence of sharp injuries was 1.14%, which was significantly lower than that in October 2012 (9.71%). In the occupational distribution of sharp injuries among HCWs, the proportion of nurses was 58.65%, doctors 23.32%, and interns 12.02%. Among the distribution of sharp injury departments, general wards, operating rooms, intensive care units, disinfection supply centers, and outpatient clinics were the high-incidence sites of occupational exposure among HCWs. The main instruments causing sharp injuries in HCWs were syringes, scalp steel needles, surgical suture needles, vacuum blood collection needles, and glass slides. Drug administration, double-handed loop needle cap, blood extraction, surgical suture needle, and arteriovenous needle extraction were high-risk operations causing sharp instrument injuries in HCWs. Conclusion The incidence of sharp injuries among HCWs from 36 hospitals in Shandong Province in October 2019 was significantly lower than that in October 2012. Sharp injuries were a common type of occupational exposure for HCWs. The occurrence of sharp injuries should be effectively reduced by changing wrong habitual behavior and implementing standard protective measures.

The Epidemiology of Sharp Injuries in Healthcare Workers at a Trinidadian Community Hospital

OBJECTIVE To describe the epidemiology of sharp injuries, in healthcare workers, at the Sangre Grande Hospital (SGH) in Trinidad. A secondary analysis of non-sharp injuries was also done. Sharp injuries predispose staff to blood borne infections and thus are occupational infection prevention and control matters. Sharp injuries were observed to be a problem at the SGH. This study served to gather data for informed decision making. METHODOLOGY A retrospective descriptive study was done by reviewing all IPC reporting forms from reported healthcare worker injuries at the Infection Prevention and Control (IPC) Department for the period 2007-2017. All persons recorded as having being injured by sharps and secondarily, non-sharp occupational exposures, at the IPC department were included. We looked at employee case management including testing for blood borne Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and C virus (HCV), management and treatment. Simple descriptive statistics were used to present the findings. RESULTS All 148 notes were reviewed after which entries having greater than 10 missing data points or fields were excluded from the study analysis, leaving 138 notes. Age ranges were between 20 – 62 years with the mean age of the affected population being 33 years. A total of 104 (75.4%) females were injured compared to 32 (23.2%) males. Persons injured were mainly from the wards (n=81, 58.5%): internal medicine (n=46, 33.3%) and general surgery (n=22, 15.9%). Accident & Emergency (A&E) accounted for 10.1% (n=14) of the cases. Registered nurses (n=37, 26.8%), physicians (n=22, 15.9%) and students (n=20, 14.5%) were the main categories of staff affected. The highest number of events occurred between 10:00-11:00 in the morning [am] (n=29, 20.6%). The majority of these incidents (n=123, 89.1%) were first reported to SGH A&E. Most injuries occurred while disposing of needles (n=17, 12.3%). It was noted that 73 (52.9%) of the documented cases occurred on fingers. HIV, HAV & HBV tests were done in 136 (98.6%) of the 138 staff members recorded. In 120 (87%) events the source patient was tested. A total of 114 (84.4%) persons had been vaccinated for HBV; 77 (58.8%) persons had post exposure prophylaxis (HIV) for one month. One (1.3%) person reported seroconversion after six months to positive HIV status. CONCLUSION Sharp injuries in employees were common in internal medicine and general surgery wards. These injuries were common in the late morning, on the fingers. Only one exposed employee seroconverted over the entire period.

Moral injury in health-care workers during COVID-19 pandemic.

The COVID-19 pandemic forces frontline health-care workers to make difficult medical decisions that may result in moral injury Understanding the extent to which physicians, nurses, and other health-care workers experience moral injury while working in a pandemic is of critical importance to establish preventative measures and trauma-informed treatment A national sample of health-care workers (n = 109) participated in the study The results of a multiple regression analysis indicated secondary traumatic stress was significantly associated with moral injury Contrary to existing literature, the role of burnout and compassion fatigue in this study was nonsignificant Mental health professionals may reduce treatment barriers by offering flexible sessions, nontraditional hours, and short-term interventions through tele-mental health platforms to support health-care workers experiencing trauma symptoms (PsycInfo Database Record (c) 2020 APA, all rights reserved)

ANALYSIS OF WORK RELATED SHARP OBJECT INJURIES AFFECTED BY THE HEALTH STAFF WORKING IN THE OPERATING ROOM AND INTENSIVE CARE

Amaç: 
 Hastanemiz ameliyathane ve yoğunbakımlarında çalışan personelin kesici delici aletle yaralanmalarının analizini yaparak alınabilecek önlemleri belirlemek ve tekrarını önleyecek planlamaları yapmak.
 Yöntem:
 2016-2019 yılları arası Ankara Eğitim ve Araştırma hastanesi ameliyathane ve yoğunbakımlarında bildirim yapılan kesici delici alet yaralanmalarının kayıtları analiz edilerek, elde edilen veriler sayı ve yüzdelik olarak değerlendirmeye alındı.
 Bulgular:
 Olayın meydana geldiği yerin; 2016 yılında %41,9 ameliyathane %58,1 yoğunbakım, 2017’de %29,6 ameliyathane %70,4 yoğunbakım, 2018’de %29,4 ameliyathane %70,6 yoğunbakım, 2019’da %33,3 ameliyathane %66,7 yoğunbakım olduğu, olaya maruz kalan meslek grubunun; 2016 yılında %3,2 doktor %29 hemşire, 2017 yılında %22,2 doktor %14,8 hemşire, 2018 yılında %17,6 doktor %41,2 hemşire, %23,8 doktor %33,3 hemşire olduğu, yaralanmaya sebep olan aletin; 2016 yılında %83,9 iğne ucu %16,1 diğer aletlerle, 2017 yılında %74,1 iğne ucu %25,9 diğer aletlerle, 2018 yılında %88,2 iğne ucu %11,8 diğer aletlerle, 2019 yılında %76,2 iğne ucu %23,8 diğer aletlerle olduğu, yaralanmaya sebep olan aletin; 2016 yılında %96,8 kirli %3,2 temiz, 2017 yılında %96,3 kirli %3,7 temiz, 2018 yılında %100 kirli, 2019 yılında %100 kirli olduğu, yaralanma esnasında personelin kişisel koruyucu ekipmanı; 2016 yılında %96,8 var %3,2 yok, 2017 yılında %96,3 var %3,7 yok, 2018 yılında %100 var, 2019 yılında %90,5 var %9,5 yok olduğu tutulan kayıtlardan anlaşılmıştır.
 Sonuç:
 Risklerin azaltılmasında önlem, kayıt ve bildirim önemlidir. Hastane idareleride riski az ve koruyucu ekipman bulundurmak için gerekli alt yapıyı sağlamalıdır. Personelin yaralanmalar ve sonuçları ile ilgili mutlaka eğitilmesi be bilgilendirilmesi gerekmektedir

Needle stick injuries in healthcare workers of a secondary Care Hospital, Pakistan.

Needle Stick Injury (NSI) is a percutaneous piercing wound typically dealing with sharps. Needle stick injuries are the most common health care workers issue worldwide. The causes include various factors like type and design of needle, recapping activity, handling/transferring specimens, collision between HCWs or sharps, during clean-up, manipulating needles in patient line related work, passing/handling devices or failure to dispose of the needle in puncture proof containers. NSIs may transmit other bacterial, fungal, or viral infections, including blastomycosis, cryptococcosis, diphtheria, herpes, malaria, mycobacteriosis, spotted fever and syphilis. Objectives: To determine frequency of needle stick injury among health care workers. Study Design: Cross-sectional study. Setting: District Headquarter Hospital Layyah. Period: Jan to March 2019. Material & Methods: Sample size was 161. A structured pre-tested questionnaire containing both open and close-ended questions was administered during the period of Jan-March 2019. Results: Out of 161 participants, 114 (70.8%) reported having a needle stick injury at least once during their clinical practice and the frequency of NSIs was significantly higher among nurses (76.7%) as compared to Doctors (50%), Laboratory staff (45.5%) and waste handlers (70.8 %). Conclusion: Study concludes that in absence of the routine collection of accurate data on NSIs, small studies have been useful in highlighting which groups of HCWs are most at risk from NSIs.

Effect of Repositioning Aids and Patient Weight on Biomechanical Stresses When Repositioning Patients in Bed.

ObjectiveThe aim of the study was to estimate the risk of injury when repositioning patients of different weight with commonly used repositioning aids.BackgroundRepositioning dependent patients in bed is the most common type of patient handling activity and is associated with high rates of musculoskeletal disorders in healthcare workers. Several studies have evaluated repositioning aids, but typically for a single patient weight and often without estimating risk of injury based on biomechanical analysis.MethodTen nurses performed four repositioning activities on three participants (50, 77, 141 kg) using three repositioning aids (pair of friction-reducing sheets [FRS], turn and position glide sheet, air-assisted transfer device) and a draw sheet. Motion capture, hand forces, and ground reaction forces were recorded. Spine loading was estimated using a dynamic biomechanical model.ResultsHand forces and spine compression exceeded recommended limits for most patient weights and repositioning tasks with the draw sheet. FRS and glide sheet reduced these loads but still exceeded recommended limits for all but the 50-kg patient. Only the air-assisted transfer device reduced forces to accepted levels for all patient weights. Physical stresses were relatively low when turning patients.ConclusionMost repositioning aids are insufficient to properly mitigate risk of musculoskeletal injury in healthcare workers. Only the air-assisted transfer device was sufficient to adequately mitigate the risk of injury when moving patients of average or above-average weight.ApplicationTo safely move dependent patients, a robust solution requires mechanical lifts and may utilize air-assisted transfer devices for patient transfers.

An innovative experiential interprofessional education activity using physical therapy students to teach medical students how to safely handle patients

Abstract Safe patient handling is important for preventing neuromusculoskeletal strain and injuries in healthcare workers and in patients. Physical Therapists often use their knowledge of proper body mechanics, ergonomic safety, injury and fall prevention to train members of the multidisciplinary health care team in safe patient handling and movement. In order to be effective educators and design appropriate training programs, physical therapists need to be knowledgeable about other healthcare team members’ job duties and work environments. When medical students begin clinical rotations they are confronted with the task of assisting patients to move from the interview chair to the exam table or helping a bedridden patient sit up on the side of the bed and then stand, but these skills are rarely if ever included in the medical curriculum. In order to introduce medical students to safe patient handling and movement techniques we designed a novel experiential interprofessional education (IPE) session in which physical therapy students developed teaching materials and taught medical students how to safely manage patient mobility from bed to standing to chair and from exam table to and from chair. After a single 90-min session, the medical students demonstrated improved knowledge and confidence in safe patient handling and movement skills. In addition, both groups of students interacted professionally and learned about each other's disciplines.

Impact of safety-engineered devices (SEDs) on the prevention of percutaneous injuries

Abstract Background Needlestick injuries represent a major occupational hazard for healthcare workers as they lead to exposure to biological fluids, with higher risk of bloodborne pathogen infections. In order to minimise this risk, safety-engineered devices (SEDs) have been developed and introduced into the daily hospital practice. An annual survey, conducted by the Department of Public Health Sciences of the University of Turin since 1999, has been evaluating the number of percutaneous accidents in the hospitals of Piedmont (Italy), assessing also the impact of the introduction of SEDs on the injury incidence rate. The aim of this study is therefore to evaluate the efficacy of SEDs in preventing needlestick injuries. Methods Data about percutaneous injuries and needle consumption were obtained from 42 hospitals of Piedmont for the years 2014-2017, concerning all the types of needles and sharps most commonly used in the departments. After considering the overall trend of percutaneous events, standardised rates for 100000 needles were computed for both SEDs and conventional devices. The same analysis was performed considering all sharps except standard needles, which are mainly used for procedures not involving contact with patients (e.g. drug dilution). Results The comparison between the incidence rates with SEDs and conventional devices showed a slightly protective effect of SEDs in 2014, 2016 and 2017, with an incidence rate ratio ranging from 0.78 to 0.97. However, by removing the confounding effect of standard needles, the analysis yielded strong statistical evidence of the protective effect of SEDs for all years (RR = 0.28-0.63). Moreover, the total number of percutaneous events shows a trend of general decrease. Conclusions Safety devices have proved to be significantly effective in the prevention of needlestick injuries, and their introduction into the daily practice is one of the factors who could contribute to a reduction of percutaneous events. Key messages Safety-engineered devices are a very important tool in the prevention of injuries in healthcare workers, and their introduction into hospital practice has reduced the number of percutaneous injuries. Safety-engineered devices are significantly protective against percutaneous injuries compared to conventional ones, especially for procedures involving contact with patients (therefore at high risk).

Patient and healthcare worker safety risks and injuries. Learning from incident reporting

Objectives: Learning from incident reporting systems is one core strategy to develop a culture of safety for healthcare workers and patients. The aim of this retrospective study was to explore patient injuries focussing on falls. Furthermore, on healthcare workers incidents, injuries and the situations they occurred.Method: A total of 65,749 patient risks and incidents were registered in the incident reporting system between 2011 and 2014. Of these, 11,006 were classified as an injury to a patient. Risks and incidents were registered and analysed for 1702 healthcare workers.Results: Fifteen percent of the patient injuries required treatment. Falls were reported in 17% of the cases. Patients fell mainly in unassisted situations. Healthcare workers’ incidents and injuries were registered mainly by nurses and assistant nurses. Sixteen percent of the injuries required treatment. Prevalence of incidents was on an average 3.5% each year. Common injuries were: needle stick, workplace violence, injuries during patient manual handling. The patient was present in 74% of all incidents.Conclusion: Patient and healthcare workers injuries are still prevalent in Swedish healthcare and a substantial part of the incidents involved a patient situation. Collaboration between employers, employees and patient representatives is needed to increase awareness of safety in healthcare.