Needlestick And Sharps Injuries Research Articles

Biosafety in Health Care Workers

Health care workers (HCWs) are among those at highest risk of occupational biohazards, as they are exposed to human body fluids daily. They are exposed to blood-borne infections by pathogens, such as human immunodeficiency virus (HIV), hepatitis B (HBV), and hepatitis C (HCV) and other blood-borne pathogens [1]. Needlestick and sharps injuries (NSSIs) have been one of the major issues in the protection of health care workers, and vigorous preventive action has been practiced worldwide in recent decades. NSSIs are an important occupational hazard in health care, and the distribution of risk does not occur at random [2]. The Centers for Disease Control and Prevention [3] have strongly supported the prevention of occupational sharps injuries. However, there are many countries like Portugal where biosafety is still a challenge and there is still a long way to go since there are very few studies conducted in this area. In a recent study of a hospital in this country, 53.7% of HCWs did not identify the symbol of biohazard and 44.9% reported about not having enough knowledge about universal precautions (unpublished data). Biosafety refers to the application of knowledge, techniques and equipment in order to prevent worker exposure to potentially infectious agents or biohazards. The differences in use of universal precautions by HCWs are influenced by their level of knowledge. The use of procedures to control infection and universal precautions is effective in preventing cross-contamination. Risk of exposure is greatly minimized by the use of personal protective equipment, such as masks, lab coats and gloves [4]. A good understanding of the circumstances contributing to injuries among HCWs is also necessary. The availability of open access journals such as Biosafety journal from OMICS Group journals helps researchers in getting an easy access to knowledge in this health care field. Providing free access to all materials published is a strong contribution to health promotion for the health care workers.

Ergonomic evaluation of novel tool for snap-off the neck of ampoule

Needlestick and Sharps Injuries (NSI) represent an important workplace issue in contemporary health care. Present study provided the new method to snap-off the neck of sealed ampoule. The idea of novel opener tool is prepare the grinding slice inside rubber ring, so users could put the ampoule inside the rubber ring and then rotated the rubber ring to snap-off the neck of ampoule. The purpose of present study was evaluated the methods of snap-off and sizes of ampoule on forearm muscle activities, wrist postures and performance. The pronator teres muscle were heavier load as increased the sizes of ampoule. For performance analysis, Duncan's multiple range tests indicated that time of snap-off were longer in 10 ml and 20 ml of ampoule. The EMG of pronator teres muscle was significantly affected by methods of snap-off. Duncan's multiple range tests indicated that lower load was experienced on forearm muscles while using grinding slice with glove. For wrist posture, the ranges of motion for wrist were significant lower while using the novel tool. Present study provided the novel tool effectively to snap-off the ampoule to decrease forearm workload and sharp injuries.

Needle stick and sharps injuries among health care workers in Gondar city, Ethiopia

BackgroundAll employees in health care settings handling needles or other sharps are at risk for needle stick and sharps injuries (NSSIs). Health care workers in under developed countries are at greater risk of infection from blood borne pathogens because of the lack of safety devices and the high prevalence of these pathogens. ObjectivesThe aim of this study was to assess the prevalence of NSSIs and associated factors among health care workers in government health institutions in Gondar city, Ethiopia. MethodsInstitution based cross sectional study was conducted from May–December, 2010. The study included 344 health care workers who were selected from the source population using simple random sampling technique. Data were collected through interviews using structured and pre-tested questionnaire and the collected data were entered and analyzed using SPSS version 16.0. ResultsThe prevalence of NSSIs among health care workers in the preceding 12months was 106 (30.8%), of which 58 (54.7%) was reported by females. Lack of training on occupational health and safety, working more than 48h/week, dissatisfaction with work environment and work culture, greater than 10years of work experience and having low and moderate perception of risk were found to be significantly associated with NSSIs. ConclusionThe study found high prevalence of NSSIs among health care workers. Effective training, ongoing awareness on the risk of hazards, preventive measures such as engineering control, and post-exposure prophylaxis following NSSIs are essential to reduce the risk of such injuries.

Needle stick and sharp injuries (NSSI) in health care workers in Ulaanbaatar

The study’s main objectives were to analyze the prevalence and assess the knowledge, attitude and practices (KAP) of health care workers regarding needle stick injuries in hospitals in Ulaanbaatar, Mongolia. In addition we also tried to determine the circumstances and type of injuries from needle sticks (such as from syringes, scalpels etc).

Needlestick and sharps injuries among Turkish nursing students: A cross‐sectional study

Irmak Z, Baybuga MS. International Journal of Nursing Practice 2011; 17: 151–157 Needlestick and sharps injuries among Turkish nursing students: A cross‐sectional study This cross‐sectional study was performed to investigate the prevalence of and other factors associated with needlestick and sharps injuries (NSIs) among nursing students in Turkey. A total of 60 (19.4%) nursing students reported NSIs during the past 1 year. The most common item causing injury was from a syringe needle (54.0%). Among nursing students, giving intravenous/intramuscular injections (60.0%) was the most common cause of NSIs. In total, 31.7% were not using gloves when injured. A total of 68.3% of NSIs were said to have gone unreported in any official report. A total of 43.5% of the nursing students had not received the hepatitis B vaccine. Finally, no single sociodemographic variables were shown to be significant as a risk factor for needlestick and sharps injury during logistic regression analysis. To decrease NSIs among nursing students, an education programme related to NSIs and standard precautions must be provided and immunized against hepatitis B before beginning clinical practice.

Occupational exposure to blood and body fluids among a group of Turkish nursing and midwifery students during clinical practise training: Frequency of needlestick and sharps injuries

To ascertain the number of needlestick and sharps injuries (NSSIs) in nursing and midwifery students and to assess the use of universal precautions among injured and non-injured students. A survey of a representative sample of nursing and midwifery students who did clinical practise in a hospital was conducted. In total, 203 students met the inclusion criterion of the study. Of these, 141 (69.46%) provided useable data. The survey form was designed by the researcher after reviewing the relevant literature. The data frequency, percentages, and χ(2) -values were examined. According to the data, 35.5% of the participating students had experienced a NSSI, 54% of the students had received one NSSI, and 36.0% had two NSSIs. Sixty-six percent of the injured students had been injured by an ampoule and the majority of injuries occurred in the treatment room. Most of the students had washed their injury with antiseptic solution and 84% had not told anyone about their injury. While 86.5% of the students threw away used needles in the special sharps containers disposal box, 89.4% also stated that they always recapped used needles. Almost all the students had received the hepatitis B vaccine. Only 14% of the students stated that they always wore gloves. This study shows that a significant percentage of nursing and midwifery students receive NSSIs. It is very important to frequently review information about preventive measures so that the students practise them during clinical practise every semester. Moreover, the instructors should monitor if the students are taking the necessary preventive measures without fail.

Analysis of needlestick injuries among nursing students in Hong Kong

Background Research has shown that nursing personnel are exposed to the serious risk of contracting bloodborne diseases from needlestick and sharps injuries (NSIs). Only a few studies have examined the problem among nursing students. In Hong Kong, there is an equal lack of research in this area. Methods A review of accident reports in one university was employed to determine the injury rate, causation, and epidemiological profile of NSIs. Descriptive statistics, prevalence, incidence density, cumulative incidence, and Fisher's exact test were used to analyze the data. Results From January 2002 to December 2006, there were a total of 51 reported cases of NSIs (43 needlestick injuries and 8 sharps injuries). The annual prevalence of NSIs in four academic years from 2002–2003 to 2005–2006 ranged from 0.6 to 1.6 cases while the incidence rate was one new case per 100 nursing students per academic year. The cumulative incidence of NSIs for year-one, year-two and year-three students were 0, 0.03 and 0.004 respectively. The majority of needlestick injuries ( n = 25; 58.14%) were from contaminated needles. Procedures involved in the needlestick injuries were giving injection ( n = 22; 51.16%), collecting urine specimen ( n = 5; 11.63%), removal of urinary catheter ( n = 4; 9.30%), and checking blood glucose using glucometer ( n = 3; 6.98%). Giving injection ( n = 5; 62.50%) also accounted for the highest percentage of sharps injuries. Specific activities that were identified were opening the needle cap, opening ampoules, inserting the needle and mixing dirty and clean material in one kidney dish. Conclusions Results showed that nursing students are at high risk of occupational exposure to bloodborne pathogens because of NSIs. A hierarchy control involving engineering, administrative and personal behavioral activities is recommended to reduce the occurrence of NSIs among nursing students.

Knowledge, attitude and practices on needle-stick and sharps injuries in tertiary care cardiac hospital: A survey

One of the potential hazards for health care workers (HCWs) is needle-stick and sharp injuries (NSSIs). The objective of the study was to assess the knowledge and attitude of health care workers about the NSSIs. This was a cross-sectional survey conducted in the tertiary care cardiac center. The participants were health care workers including doctors, nurses, technicians, and housekeeping staff from the different areas of the hospital. This cross-sectional survey was conducted in the institute using a self-administered validated questionnaire. The participants consisted of a total of 190 HCWs namely doctors, nurses, technicians, and housekeeping staff. Nil. Results showed maximum participant were in the age group of 20-30 years. 94.7% were aware about standard precautions. 91.5% knew about the procedure for reporting of NSSIs. Only 50.2% HCWs gave correct answers regarding disease transmission through needle stick and sharp injury. The prevalence of NSSIs was highest among nurses (38.4%), and needle on the disposable syringe (76.9%) was the most common source of NSSIs. The survey revealed few gaps in the knowledge amongst HCWs about NSSIs like risks associated with needle-stick injuries and use of preventive measures, disassembling of needles prior to disposal. These gaps can be addressed by extensive education. As nurses were the most affected victim for the NSSIs, more emphasis should be given towards them for reducing the NSSIs.

Hospital Safety Climate, Psychosocial Risk Factors and Needlestick Injuries in Japan

To investigate the interactions between safety climate, psychosocial issues and Needlestick and Sharps Injuries (NSI), a cross-sectional study was undertaken among nurses at a university teaching hospital in Japan (89% response rate). NSI were correlated with various aspects of hospital safety climate including supporting one another at work, the protection of staff against blood-borne diseases being a high management priority, managers doing their part to protect staff from blood-borne disease, having unsafe work practices corrected by supervisors, having the opportunity to use safety equipment to protect against blood-borne disease exposures, having an uncluttered work area, and having minimal conflict within their department. In conclusion, this study has demonstrated the importance of hospital safety climate in Japanese health care practice, particularly its relationship with NSI. Although the provision of safer devices remains critical in preventing injuries, ensuring a positive safety climate will also be essential in meeting these important challenges for nurses' occupational health.

Workplace Hazards Among Australian Dental Students

Workplace Hazards Among Australian Dental Students

Organizational climate and its relationship with needlestick and sharps injuries among Japanese nurses

Although certain aspects of organizational climate have been shown to influence needlestick and sharps injuries (NSI) among nurses, this issue has not been adequately investigated in Japan. Our study involved a modified version of the Hospital Safety Climate Scale, which was distributed to a large cross section of nurses in a Japanese teaching hospital. Various aspects of safety climate were associated with a reduced NSI risk, such as being involved in health and safety matters (odds ratio [OR], 0.13; 95% confidence interval [CI]: 0.02-0.65) and being properly trained in risk control procedures (OR, 0.32; 95% CI: 0.12-0.78). Nurses working in departments in which health and safety information was readily available were more likely to report any NSI they sustained (OR, 4.91; 95% CI: 1.30-18.51), whereas nurses working in departments with minimal conflict were less likely to underreport their NSI (OR, 0.45; 95% CI: 0.22-0.87). Overall, this study suggests that hospital safety climate has an important influence on NSI injury rates and reporting behavior among Japanese nurses. Given the multifaceted nature of identified risk, a comprehensive approach to infection control is clearly required and one that encompasses preventive strategies in both the cultural and physical domains.

Exposure rate of needlestick and sharps injuries among Australian veterinarians.

BackgroundNeedlestick and sharps injuries (NSI) represent an important occupational health issue in veterinary practice. Little is known about the distribution and correlates of NSI among Australian veterinarians.MethodsA questionnaire-based NSI survey was mailed to 1094 veterinarians registered with the Veterinary Surgeons Board of Queensland during 2006.ResultsA total of 664 surveys were returned from 1038 eligible participants (response rate 64.0%) with 56.8% being male, around one-third in the >50 years age group and about half aged 31-50 years. Just over two-fifths were working in small animal practice only. Around three quarters (75.3%) reported suffering at least one NSI in the previous 12 months, while 58.9% reported suffering from at least one contaminated NSI during the previous 12 months, which crudely extrapolates to an exposure rate of 75.3 and 58.9 NSI per 100 person-years respectively. Risk factors for contaminated NSI were female gender, working in small or mixed animal practice, being less experienced, seeing more patients per week and working longer hours per week. The most common causative devices were syringes (63.7%), suture needles (50.6%) and scalpel blades (34.8%).ConclusionThe exposure rate of NSI is high for Queensland veterinarians and clearly remains a major occupational health problem. Current guidelines and strategies to reduce NSI in veterinary practice should be promoted, but appear to be adapted from human health care. Studies to understand why veterinarians have such high NSI rates are required to not only identify risk factors for NSI, but also to determine attitudes and beliefs about NSI. From these studies specific strategies for veterinarians can be designed and trialed to develop evidence-based guidelines and policies that are effective in decreasing the exposure rate of NSI in veterinary practice.

Needlestick and sharps injuries in a tertiary hospital in the Republic of Korea

The high incidence of hepatitis B virus (HBV) in the Republic of Korea has focused attention on monitoring the occurrence and characteristics of needlestick and sharps injuries (NSIs) as part of an effort to reduce the occupational exposure to bloodborne pathogens such as HBV. This study investigated NSIs reported in a tertiary referral hospital in Busan, Republic of Korea over a 6-year period (2001 to 2006). Data on the number of NSIs, places where NSIs occurred, devices causing injury, purpose of using sharps, and circumstances surrounding NSIs were collected from the study hospital's NSI database. The incidence of NSIs per 100 full-time equivalent (FTE) employees was calculated by year and by profession. A total of 221 NSI cases were reported during the study period. Overall incidence was 2.6 cases per 100 FTE employees per year, with the highest rate occurring in interns (17.7 cases per 100 FTE interns per year). Some 34% of cases occurred in the ward, needles were the most common device causing injury (73%), and the most common circumstance surrounding an NSI was after sharps use and before disposal (24%). The pattern of NSI occurrence found in this study was comparable to that reported in previous studies. However, the overall incidence of NSIs was significantly lower than that in previous studies, apparently related to underreporting of NSIs. Further research to investigate reasons for this underreporting is recommended. Considering the high incidence of NSIs in interns, in-service training for this group should be enhanced.

Epidemiology of Needlestick and Sharps Injuries Among Professional Korean Nurses

Although needlestick and sharps injuries (NSI) are known to affect professional nurses at high rates, most studies depend on officially reported data and few have been undertaken in Korea. Thus, we surveyed a large cross-section of nurses from a hospital in Gangneung (response rate, 97.9%). Four hundred thirty-two incidents of NSI were reported by 263 nurses (79.7%) in the previous 12-month period (average, 1.31 events/nurse/year). Syringe needles were the most common devices, affecting 67.3% and comprising 52% of all NSI events. Sixty percent of all NSI events involved contaminated devices. Opening an ampoule or vial was the most common cause (affecting 35.2% of all nurses and accounting for 15.9% of all NSI events). Logistic regression indicated that nurses working in "other" departments were 5.4 times more likely to suffer any NSI (odds ratio [OR] = 5.4; 95% confidence interval [95% CI] = 2.0-15.2; P < .05) and 4.7 times more likely to incur a syringe-needle injury than nurses in intensive care units or inpatient departments (OR = 4.7; 95% CI = 2.0-11.6; P < .05). Younger-than-average nurses (< 27 years) were 4.5 times more likely to suffer NSI (OR = 4.5; 95% CI = 1.7-12.6; P < .05) and 3.1 times more likely to incur a syringe-needle injury (OR = 3.1; 95% CI = 1.4-7.0; P < .05). Working mixed shifts also increased the risk of any NSI (OR = 4.0; 95% CI = 1.7-10.4; P < .05) or syringe-needle NSI (OR = 4.4; 95% CI = 2.0-10.1; P < .05). Overall, our study suggests that NSI are common among Korean hospital nurses and represent a significant occupational burden for this large Asian demographic. Intervention and preventive strategies to help reduce their NSI exposures are urgently required in this country.

Epidemiology of needlestick and sharps injuries among nurses in a Japanese teaching hospital

The epidemiology of needlestick and sharps injuries (NSIs) was investigated among a complete cross-section of 1,162 nurses from a large hospital in southern Japan (response rate 74.0%). Forty-six percent had experienced an NSI in the previous year. Most were caused by ampoules or vials, which injured 32.3% of all nurses and accounted for 42.9% of all NSI events. Twenty-two percent of all NSIs involved a device that had been used on a patient prior to the NSI (contaminated device), while the usage status of a further 2.8% of devices was unknown. Logistic regression indicated that nurses younger than 25 years of age were 2.18 times more likely to have sustained a single NSI in the past 12 months [odds ratio (OR) 2.18, 95% confidence intervals (CI) 1.15-4.17] and 2.39 times more likely to have sustained multiple NSIs (OR 2.39, 95% CI 1.08-5.34). Working mixed shifts (rotating day and night, as opposed to day shifts alone) was associated with a 1.67-fold increased risk of sustaining any NSI (OR 1.67, 95% CI 1.01-2.85) and a 2.72 times greater risk of sustaining an NSI from a contaminated device (OR 2.72, 95% CI 1.71-4.44). Nurses who reported significant fatigue after work were 1.87 times more likely to sustain multiple NSIs (OR 1.87, 95% CI 1.13-3.13) and 1.94 times more likely not to report their NSIs (OR 1.94, 95% CI 1.03-3.71). Perceived high mental pressure was associated with a 1.75-fold increased risk of sustaining an NSI from a contaminated device (OR 1.75, 95% CI 1.07-2.88). Nurses who reported suboptimal staffing levels in their wards were 2.21 times more likely not to report any NSIs they sustained in the previous year (OR 2.21, 95% CI 1.06-4.89). Overall, this study suggests that NSIs represent a complex and multi-faceted problem for Japanese nurses. Intervention strategies should consider the emerging complicity of psychosocial factors on NSI among hospital staff in Japan, as elsewhere.

Needlestick and sharps injuries among nurses in a tropical Australian hospital

Although needlestick and sharps injuries (NSI) represent a major hazard in nursing practice, most studies rely on officially reported data and none have yet been undertaken in tropical environments. Therefore, we conducted a cross-sectional NSI survey targeting all nurses within a tropical Australian hospital, regardless of whether they had experienced an NSI or not. Our overall response rate was 76.7%. A total of 39 nurses reported 43 NSI events in the previous 12 months. The most common causative device was a normal syringe needle, followed by insulin syringe needles, i.v. needles or kits and blood collection needles. Half of the nurses' NSI events occurred beside the patient's bed: drawing up medication was the most common reason. Nurses working in the maternity/neonatal wards were only 0.3 times as likely to have experienced an NSI as their counterparts in the medical or surgical wards. Overall, our study has shown that NSI events represent an important workplace issue for tropical Australian nurses. Their actual rate might also be higher than official reports suggest.

Needlestick and sharps injuries among a cross-section of physicians in Mainland China

Although needlestick and sharps injuries (NSI) represent a significant occupational hazard for physicians worldwide, their epidemiology has not been previously examined in Mainland China. This study describes the prevalence, distribution, and risk factors for NSI among a cross-section of Chinese physicians. Data was obtained by an anonymous, self-reporting survey administered to all 361 physicians at a university teaching hospital, during 2004. Seventy-nine percent of the physicians responded. Among them, 64% had experienced an NSI in the previous 12 months, 50.3% of which involved contaminated devices. By device, 22.8% were caused by hollow-bore syringe needles, 19.1% by suture needles, and 12.1% by scalpel blades. Surgical procedures accounted for 27.9% of all injuries. Only 15.3% of physicians had officially reported their NSI to management, of which 10% went unreported because the individual felt they were not unlucky enough to get a disease. A statistically significant correlation was demonstrated between NSI and working in the intensive care unit (adjusted odds ratio: 5.3, 95% CI: 1.7-23.4). Although this study suggests that NSI are an important workplace hazard for Chinese physicians, future measures should consider the unique cultural beliefs of Chinese people and its effect on preventive behaviors. The concept of "luck," and its relationship with NSI reporting in particular, may also need to be addressed.

オーストラリアの医学生の針刺事故

We investigated the prevalence and distribution of Needlestick and Sharps Injuries (NSI) among a group of Australian medical undergraduates from 4 consecutive grades. Data was obtained by means of an anonymous, self-reporting survey. A total of 254 questionnaires were obtained (response rate 97.3%). Among them, 35 students (13.8%) had suffered a total of 41 NSI incidents. By gender, 71.4% of the NSI reporters were female and 28.6% were male. NSI prevalence varied significantly with respect to students' year of study (P for Trend=0.0106), ranging from 7.3% in the 1st year to 26.8% in the 3rd year. Of the 41 NSI incidents, 29.2% were caused by a glass item, 24.4% by a hollow bore needle, 24.4% by another device and 22.0% by a surgical device. The distribution by causative device also varied from year to year. Overall, this study has shown that NSI represent an important hazard for Australian medical students. As such, the importance of intervention strategies to reduce NSI exposures must remain an essential facet of medical education, worldwide. Future preventive measures will also need to consider the unique situation of medical students in Australia, as elsewhere.