Needlestick Injuries In Healthcare Workers Research Articles

Needlestick Injuries With Insulin Injections: Risk Factors, Concerns, and Implications of the Use of Safety Pen Needles in the Asia-Pacific Region.

Globally, health care workers (HCWs) are at a high risk of occupational exposure to needlestick injuries (NSIs). Needlestick injuries not only are associated with an increased risk of infections caused by bloodborne pathogens but are also a primary source of emotional distress and job burnout for HCWs and patients. Insulin injection-related NSIs are common among HCWs working in hospitals in the Asia-Pacific (APAC) region and impose a significant burden. Insulin pen needles have a high risk of transmitting infections (at both the patient-end and cartridge end of the sharp) after use. Recapping a needle after administering an insulin injection poses a major risk to HCWs. Currently, several safety-engineered needle devices (SENDs) are available with active or passive safety mechanisms. Passive insulin safety pen needles with dual-ended protection and automatic recapping capabilities have resulted in a significant drop in accidental punctures to HCWs while administering insulin to patients with diabetes. In this article, we have reviewed the burden and common causes of NSIs with insulin injections among HCWs in the APAC region. We have discussed current approaches to address the issues associated with NSIs and the benefits of introducing SENDs in health care settings, including long-term care facilities, nursing homes, and home care settings where patients may require assisted insulin injections. This review also summarizes key strategies/recommendations to prevent NSIs in HCWs and patients with diabetes in the APAC region.

Global, regional and national incidence and causes of needlestick injuries: a systematic review and meta-analysis.

Needlestick injuries (NSIs) are one of the most serious occupational hazards for healthcare workers (HCWs). The aim of this study was to evaluate the incidence and causes of NSIs globally. A systematic review and meta-analysis of data from January 2000 to May 2020 collected from Scopus, PubMed, Embase, Web of Science, and Google Scholar. The Newcastle-Ottawa Scale was used to assess the quality of the included articles. The data obtained were analysed by R version 3/5/0, and 113 articles were retrieved. There were 113 studies with a total of 525 798 HCWs. The incidence of NSIs was 43%. Africa had the highest rate of these injuries of 51%, and the World Health Organization (WHO) African Region had the highest incidence among WHO regions of 52%. Women were more frequently affected by NSIs than men. Hepatitis C virus infection was the disease most commonly transmitted via NSIs (21%). The highest rates of NSIs according to causes, devices, hospital locations, occupations and procedures were for recapping of needles, needles, general wards, nurses and waste disposal, respectively. The incidence of NSIs is gradually decreasing. The findings of this study can contribute to improving the decision-making process for reducing NSIs in HCWs.

Keeping our staff safe (preventing acquisition of blood borne viruses) – Reducing needle-stick injuries in healthcare workers

Keeping our staff safe (preventing acquisition of blood borne viruses) – Reducing needle-stick injuries in healthcare workers

Clinical, economic, and humanistic burden of needlestick injuries in healthcare workers

IntroductionNeedlestick injuries (NSIs) from a contaminated needle put healthcare workers (HCWs) at risk of becoming infected with a blood-borne virus and suffering serious short- and long-term medical consequences. Hypodermic injections using disposable syringes and needles are the most frequent cause of NSIs.ObjectiveTo perform a systematic literature review on NSI and active safety-engineered devices for hypodermic injection.MethodsMEDLINE, EMBASE, and COCHRANE databases were searched for studies that evaluated the clinical, economic, or humanistic outcomes of NSI or active safety-engineered devices.ResultsNSIs have been reported by 14.9%–69.4% of HCWs with the wide range due to differences in countries, settings, and methodologies used to determine rates. Exposure to contaminated sharps is responsible for 37%–39% of the worldwide cases of hepatitis B and C infections in HCWs. HCWs may experience serious emotional effects and mental health disorders after a NSI, resulting in work loss and post-traumatic stress disorder. In 2015 International US$ (IntUS$), the average cost of a NSI was IntUS$747 (range IntUS$199–1,691). Hypodermic injections, the most frequent cause of NSI, are responsible for 32%–36% of NSIs. The use of safety devices that cover the needle-tip after hypodermic injection lowers the risk of NSI per HCW by 43.4%–100% compared to conventional devices. The economic value of converting to safety injective devices shows net savings, favorable budget impact, and overall cost-effectiveness.ConclusionThe clinical, economic, and humanistic burden is substantial for HCWs who experience a NSI. Safety-engineered devices for hypodermic injection demonstrate value by reducing NSI risk, and the associated direct and indirect costs, psychological stress on HCWs, and occupational blood-borne viral infection risk.

Needlestick Injuries in Healthcare Workers in the North East of Iran

Introduction: Needle-stick injuries are the second most commonly reported adverse incident and constitute a major hazard for the transmission of blood transmitted diseases. The incidence of Needle stick is higher than the reported cases in different countries. Reporting of these exposures is often a challenge for HCWs (health care workers). This article describes the prevalence of occupational injuries caused by contacting patients with needle and sharp objects and fluids of the patients’ body fluids in HCWs. Materials and Methods: This cross-sectional study has been conducted in 4 hospitals affiliated to Mashhad University of medical sciences, Iran during 2008-2015. We assessed self-reported occupational exposures in HCWs includes nurse, physician, medical student and other. Results:Among the HCWs with NSIs, other personnel includes paramedics, assistants, crew, midwife, operation room personnel, and laboratory, radiology and physiotherapy personnel had the highest percentage of needle stick contact , followed by nurses. Self-reporting of needle-stick has been growing in this period. In this study, the hepatitis B immunity in sharps injury recipients was 90-95% in 2015. Conclusion: The prevalence of needle stick in HCWs is high. Preventive strategies had to be devised. Use of safety engineering devices, to encourage recording and reporting of incidents, hepatitis B immunity, serological tests, follow-up post exposure, training in precaution standard is necessary for HCWs and medical students.

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.

Nurse-led educational campaign on blood borne pathogens and proper sharps disposal at an urban tertiary hospital in Dar Es Salaam, Tanzania

In Africa, where the regional prevalence of HIV is the highest in the world, the rate of needlestick injuries in healthcare workers is also the highest, despite the fact that such injuries are vastly underreported. Needlestick injuries pose a significant risk to healthcare workers and are the most common source of occupational exposure to blood. Due to recurrent needlestick injuries in healthcare workers at the site, nurses from the Muhimbili National Hospital Emergency Medicine Department (MNH EMD) in Dar Es Salaam, Tanzania initiated a campaign to teach health assistants, nurses, and medical doctors the hazards of needlestick injuries, and to enforce proper sharps disposal for prevention. We conducted a 2-week educational campaign on hazards and prevention of needlestick injury. To evaluate the acquisition and retention of lessons from this campaign, 61 participants underwent an immediate and delayed (at 2 months distance) post-training exam. To evaluate the impact of the campaign, we collected data on the rate of overfilled sharps boxes, before, during and after the campaign. Scores on both immediate and delayed testing on bloodborne pathogen transmission and proper sharps disposal were very high. The number of overfilled safety boxes dramatically decreased during and immediately following the training phase of this campaign, but exceeded pre-intervention levels only 2 weeks after the completion of the campaign. The results of this study suggest that even with very high levels of immediate and delayed retention of educational content as measured by exam, the impact of an educational intervention on behavioural change may be much more short-lived. This has implications regarding the need for continuous education to support for workplace safety campaigns.

Safety of positive-pressure valve connectors in arterial catheters inserted into critically ill patients

Needleless valve connectors were introduced to avoid needlestick injuries in healthcare workers but some concerns exist about their microbiological safety. A randomised controlled trial was performed to assess hub colonisation affecting positive-pressure valve connectors (PPVCs) compared to conventional caps used for radial arterial catheters inserted into critically ill patients. Patients were randomly assigned either to the PPVC (Smartsite Plus positive bolus valve) or to the conventional cap group. Only catheters inserted for >24h were analysed. Of 100 consecutive arterial lines, 80 were inserted for >24h (mean insertion duration 5.8 days), 41 in the PPVC group and 39 in the conventional cap group. Catheter hubs were colonised in eight cases in the control group (20.5%) and in one case in the PPVC group (2.4%). Hub colonisation was caused by coagulase-negative staphylococci in all cases. No attributable bacteraemia was observed. In multivariate analysis, PPVC (odds ratio: 0.09; 95% confidence interval: 0.1-0.79; P=0.03) and use of the line for continuous haemodynamic monitoring (0.16; 0.03-0.89; P=0.037) were independently associated with a lower incidence of hub colonisation.

Needle-stick injuries in primary care

Needle-stick injuries in health-care workers are almost completely preventable by improving

Needleless and Needle Protection Devices: A Second Look at Efficacy and Selection

Needlestick injuries (NSI) in healthcare workers (HCWs) are an increasingly common and costly problem. Approximately 800,000 NSI occur in the United States per year, which cost the institutions in which they occur an estimated $405 per injury.1 Of these costs, 60% are attributed to hepatitis B virus (HBV) screens, 23% to human immunodeficiency virus (HIV) screens, and 9% to employee health personnel time.1 This cost does not include the possible costs of zidovudine (AZT) prophylaxis or the direct and indirect costs of seroconversion to acquired immunodeficiency syndrome (AIDS). Several studies have examined these costs and found the price tag for the direct cost of medication, evaluation, and follow-up for AZT to range from $900 to $2,000; personal medical care for an AIDS patient to be $32,000; and the indirect cost of morbidity and mortality to total $13,000 and $210,000, respectively.2 Because of the AIDS epidemic, NSI in HCWs have been well described in the literature and are becoming an important subject of epidemiologic research. NSI frequently have been related to needle recapping, heparin lock and intravenous (IV) medication administration, IV set-up, and improper disposal of needles. Nurses (particularly in the emergency room and intensive care unit), medical students, house staff, attending physicians, and even housekeeping personnel and emergency medical technicians are at increased risk for NSI. Although the literature suggests that many HCWs are at risk for NSI in the healthcare setting, underreporting of NSI makes the true magnitude of the problem difficult to assess. Several researchers have concluded that accidental needlesticks represent the single greatest threat of exposure to HBV and HIV among HCWs. The risk of an HCW contracting HBV at work is much greater than the risk of acquiring HIV; however, the cost of AIDS, if it develops, is much greater in both human suffering and healthcare dollars. Increasing pressure from healthcare worker union organizations and the Occupational Safety and Health Administration (OSHA) for safety in the workplace has escalated the marketing, purchase, and use of expensive devices for needle protection in the healthcare setting. Many organizations, including The Society for Hospital Epidemiology of America (SHEA) and the Association for Practitioners in Infection Control (APIC), are calling for safety devices that both reduce and prevent risk of puncture injuries to HCWs.3 They urge healthcare facility decision-makers to move expeditiously to implement devices that incorporate technology-based approaches that prevent injuries by the nature of the design of the devices. Many organizations and individuals have contributed to the effort to protect HCWs and reduce risk from NSI. The American Hospital Association (AHA), Service Employees International Union (SEIU), the Centers for Disease Control and Prevention, OSHA, and the Food and Drug Administration (FDA) all have collaborated to provide healthcare facilities with the necessary support to move toward needle-safe and needle-free devices. Congressmen Pete Stark and Ronald Wyden each have expressed increasing support for adoption of safer medical devices. Many manufacturers have introduced needleless and needle protection devices in order to reduce the

Needleless and Needle Protection Devices: A Second Look at Efficacy and Selection

Needlestick injuries (NSI) in healthcare workers (HCWs) are an increasingly common and costly problem. Approximately 800,000 NSI occur in the United States per year, which cost the institutions in which they occur an estimated $405 per injury.1 Of these costs, 60% are attributed to hepatitis B virus (HBV) screens, 23% to human immunodeficiency virus (HIV) screens, and 9% to employee health personnel time.1 This cost does not include the possible costs of zidovudine (AZT) prophylaxis or the direct and indirect costs of seroconversion to acquired immunodeficiency syndrome (AIDS). Several studies have examined these costs and found the price tag for the direct cost of medication, evaluation, and follow-up for AZT to range from $900 to $2,000; personal medical care for an AIDS patient to be $32,000; and the indirect cost of morbidity and mortality to total $13,000 and $210,000, respectively.2 Because of the AIDS epidemic, NSI in HCWs have been well described in the literature and are becoming an important subject of epidemiologic research. NSI frequently have been related to needle recapping, heparin lock and intravenous (IV) medication administration, IV set-up, and improper disposal of needles. Nurses (particularly in the emergency room and intensive care unit), medical students, house staff, attending physicians, and even housekeeping personnel and emergency medical technicians are at increased risk for NSI. Although the literature suggests that many HCWs are at risk for NSI in the healthcare setting, underreporting of NSI makes the true magnitude of the problem difficult to assess. Several researchers have concluded that accidental needlesticks represent the single greatest threat of exposure to HBV and HIV among HCWs. The risk of an HCW contracting HBV at work is much greater than the risk of acquiring HIV; however, the cost of AIDS, if it develops, is much greater in both human suffering and healthcare dollars. Increasing pressure from healthcare worker union organizations and the Occupational Safety and Health Administration (OSHA) for safety in the workplace has escalated the marketing, purchase, and use of expensive devices for needle protection in the healthcare setting. Many organizations, including The Society for Hospital Epidemiology of America (SHEA) and the Association for Practitioners in Infection Control (APIC), are calling for safety devices that both reduce and prevent risk of puncture injuries to HCWs.3 They urge healthcare facility decision-makers to move expeditiously to implement devices that incorporate technology-based approaches that prevent injuries by the nature of the design of the devices. Many organizations and individuals have contributed to the effort to protect HCWs and reduce risk from NSI. The American Hospital Association (AHA), Service Employees International Union (SEIU), the Centers for Disease Control and Prevention, OSHA, and the Food and Drug Administration (FDA) all have collaborated to provide healthcare facilities with the necessary support to move toward needle-safe and needle-free devices. Congressmen Pete Stark and Ronald Wyden each have expressed increasing support for adoption of safer medical devices. Many manufacturers have introduced needleless and needle protection devices in order to reduce the

A Five-Year Study of Needlestick Injuries

Objective:To decrease the numbers of needlesticks among healthcare workers.Design:All reported needlestick injuries at Santa Clara Valley Medical Center, San Jose, California, were reviewed, analyzed, and tabulated by the infection control department yearly from 1986 to 1990.Setting:A 588-bed county teaching hospital in San Jose, California, affiliated with Stanford University.Participants:All employees of Santa Clara Valley Medical Center who reported needlestick injuries on injury report forms.Interventions:From April to December 1987, more needle disposal containers were added to as many patient care areas and as close to the area of use as possible. Results of 1986, 1988, 1989, and 1990 analyses were communicated yearly to all personnel, extensive educational programs were conducted in 1987 and 1988, and educational efforts continued in 1989 and 1990.Results:In 1986, there were 259 needlestick injuries at our institution, 22% (32) from recapping. After needle disposal containers were added to all patient care areas, needlestick injuries for 1988 totalled 143, a 45% decrease in the total needlestick injuries and a 53% decrease in recapping injuries. Communication of results to all areas of the hospital and educational activities were started in 1987 and continued through the next 3 years. In 1989, there were 135 needlestick injuries, a decrease of 6% from 1988; recapping injuries decreased 40% from 1988. In 1990, there were 104 needlestick injuries, a 23% decrease since 1989, and a 33% decrease in recapping injuries. The total number of needlestick injuries from 1986 to 1990 decreased by 60%, and those injuries from recapping decreased by 81% to 89%.Conclusions:We have continued to monitor needlestick injuries, communicate findings to all personnel, and include needlestick prevention in educational programs. We contend that more convenient placement of needle disposal containers, communication of tidings, and education do decrease needlestick injuries in healthcare workers.

A five-year study of needlestick injuries: significant reduction associated with communication, education, and convenient placement of sharps containers.

To decrease the numbers of needlesticks among healthcare workers. All reported needlestick injuries at Santa Clara Valley Medical Center, San Jose, California, were reviewed, analyzed, and tabulated by the infection control department yearly from 1986 to 1990. A 588-bed county teaching hospital in San Jose, California, affiliated with Stanford University. All employees of Santa Clara Valley Medical Center who reported needlestick injuries on injury report forms. From April to December 1987, more needle disposal containers were added to as many patient care areas and as close to the area of use as possible. Results of 1986, 1988, 1989, and 1990 analyses were communicated yearly to all personnel, extensive educational programs were conducted in 1987 and 1988, and educational efforts continued in 1989 and 1990. In 1986, there were 259 needlestick injuries at our institution, 22% (32) from recapping. After needle disposal containers were added to all patient care areas, needlestick injuries for 1988 totalled 143, a 45% decrease in the total needlestick injuries and a 53% decrease in recapping injuries. Communication of results to all areas of the hospital and educational activities were started in 1987 and continued through the next 3 years. In 1989, there were 135 needlestick injuries, a decrease of 6% from 1988; recapping injuries decreased 40% from 1988. In 1990, there were 104 needlestick injuries, a 23% decrease since 1989, and a 33% decrease in recapping injuries. The total number of needlestick injuries from 1986 to 1990 decreased by 60%, and those injuries from recapping decreased by 81% to 89%. We have continued to monitor needlestick injuries, communicate findings to all personnel, and include needlestick prevention in educational programs. We contend that more convenient placement of needle disposal containers, communication of findings, and education do decrease needlestick injuries in healthcare workers.

Effect of Educational Programs, Rigid Sharps Containers, and Universal Precautions on Reported Needlestick Injuries in Healthcare Workers

To evaluate the effect of infection control programs on reported needlestick injuries in a general hospital. Surveillance of all reported needlestick injuries at the University of Cincinnati Hospital was maintained by the infection control department for five years, from 1985 through 1989. Data on individual workers were collected, tabulated on a monthly basis, and reviewed continually to monitor trends in injuries. During this time, the effects of each of three new infection control programs on reported injuries were evaluated sequentially. A 700-bed general hospital that serves as the main teaching hospital of the University of Cincinnati. All employees of University Hospital who reported to personnel health for management of needlestick injuries. In 1986, an educational program to prevent injuries was initiated and continued throughout the surveillance period. In 1987, rigid sharps disposal containers were placed in all hospital rooms. In 1988, universal precautions were introduced with an intensive inservice. Surveillance identified 1,602 needlestick injuries (320/year) or 104/1,000/year. After the educational program began, reported injuries increased rather than decreased, and this was attributed to increased reporting. Subsequently, after installation of the new disposal containers, reported injuries returned to the levels seen prior to the educational program, but recapping injuries showed a significant decrease from 63/year to 30, or 20/1,000/year to 10. This decrease was observed in nurses but not in other healthcare workers. After universal precautions were instituted, total injuries increased slightly, but recapping injuries remained at 50% of the levels reported prior to the use of rigid sharps disposal containers. The three infection control programs failed to produce a major reduction in reported needlestick injuries, except for a decrease in recapping injuries associated with the placement of rigid sharps disposal containers in all patient rooms. These observations indicate that new approaches are needed to reduce needlestick injuries.

Effect of Educational Programs, Rigid Sharps Containers, and Universal Precautions on Reported Needlestick Injuries in Healthcare Workers

AbstractObjective:To evaluate the effect of infection control programs on reported needlestick injuries in a general hospital.Design:Surveillance of all reported needlestick injuries at the University of Cincinnati Hospital was maintained by the infection control department for five years, from 1985 through 1989. Data on individual workers were collected, tabulated on a monthly basis, and reviewed continually to monitor trends in injuries. During this time, the effects of each of three new infection control programs on reported injuries were evaluated sequentially.Setting:A 700-bed general hospital that serves as the main teaching hospital of the University of cincinnati.Participants:All employees of University Hospital who reported to personnel health for management of needlestick injuries.Interventions:In 1986, an educational program to prevent injuries was initiated and continued throughout the surveillance period. In 1987, rigid sharps disposal containers were placed in all hospital rooms. In 1988, universal precautions were introduced with an intensive inservice.Results:Surveillance identified 1,602 needlestick injuries (320/year) or 104/1 ,000/ year. After the educational program began, reported injuries increased rather than decreased, and this was attributed to increased reporting. Subsequently, after installation of the new disposal containers, reported injuries returned to the levels seen prior to the educational program, but recapping injuries showed a significant decrease from 63/year to 30, or 20/1,000/year to 10. This decrease was observed in nurses but not in other healthcare workers. After universal precautions were instituted, total injuries increased slightly, but recapping injuries remained at 50% of the levels reported prior to the use of rigid sharps disposal containers.Conclusions: The three infection control programs failed to produce a major reduction in reported needlestick injuries, except for a decrease in recapping injuries associated with the placement of rigid sharps disposal containers in all patient rooms. These observations indicate that new approaches are needed to reduce needlestick injuries.