Occurrence Of Needle Stick Injuries Research Articles

Analysis of factors associated with needlestick injuries of clinical nurses by applying a human factor analysis and classification system: A nationwide cross-sectional survey.

This study aims to investigate the current situation of needlestick injuries (NSIs) of clinical nurses and identify associated factors by using the theoretical framework of the human factors analysis and classification system (HFACS). A nationwide cross-sectional survey was conducted. Multi-stage sampling was used to investigate 3336 nurses in 14 Chinese hospitals. Descriptive statistics and univariate and multivariate logistic regression were employed to reveal the rate of NSIs and their associated factors. A total of 970 nurses (29.1%) reported having experienced at least one NSI in the past year. The multivariate logistic regression analysis showed that good hospital safety climate and clinical nurses in intensive care unit (ICU) and emergency department had protective effects against NSIs compared with nurses in internal medicine department. The nurse, senior nurse, and nurse in charge have significantly increased the risk for NSIs compared with the associate chief nurse or above. Patients with poor vision but wearing glasses and poor vision but not wearing glasses were more prone to have NSIs. Working in the operating room compared with internal medicine, average weekly working time of >45 h compared with ≤40 h and poor general health led to increased risk of NSIs. The rate of NSIs in clinical nurses was high in China. Individual factors including professional title, department, visual acuity and general mental health and organisational factors including weekly working hours and hospital safety atmosphere were significantly correlated with the occurrence of NSIs. Nursing managers should focused on physical and psychological conditions of clinical nurses, and organisational support is required to enhance the hospital safety atmosphere. Contributions from patients or the public are irrelevant because this study aims to explore current situation and factors associated with NSIs in clinical nurses.

Determination and prioritization of factors affecting the occurrence of needle stick injuries among healthcare workers using techniques of Delphi and fuzzy analytical hierarchy process (FAHP)

IntroductionNeedlestick injuries (NSIs) are a major hazard in the workplace for healthcare workers. To prevent these injuries, it is essential to determine the important factors affecting the occurrence of them. This study aimed to identify, classify and prioritize these factors using techniques of Delphi and fuzzy analytical hierarchy process (FAHP).MethodsThis descriptive-analytical study was conducted in 2022. Firstly, the factors affecting the occurrence of needlestick injuries were identified by the literature review. Moreover, the Delphi technique was used to identify the factors. 20 experts (physicians, nurses, and occupational health experts) participated in the steps of the Delphi method. Then, these factors were grouped into six groups. In the next step, the fuzzy analytical hierarchy process (FAHP) was applied to prioritize the factors. For this purpose, the pairwise comparison questionnaire was designed and filled out by 20 experts. Finally, data were analyzed using MATLAB software (version 2018a).Results42 factors (31 factors extracted from the literature review and 11 factors obtained from the Delphi technique) were identified in this study. These factors were categorized into six groups. Based on the results, the relative weight of non-demographic personal factors, tool and technology factors, job factors, organizational factors, demographic personal factors, and environmental factors were computed by 0.200, 0.185, 0.184, 0.157, 0.142, and 0.133, respectively.ConclusionThese results determined the importance of the factors affecting the occurrence of needlestick injuries. These findings can be useful for planning preventive measures.

KNOWLEDGE, ATTITUDE AND PRACTICE TOWARDS NEEDLE STICK INJURY AMONG HEALTH CARE WORKERS IN A PRIVATE HOSPITAL-QUESTIONNAIRE BASED STUDY

Background : An occupational injury is loosely termed as needle stick injury(NSI) , though it included injury through needle or other sharps and splashes4.They constitute major source of blood borne pathogens especially HIV, HBV, HCV. The risk of transmission after NSI is highest for HBV (2-40%), followed by HCV (2.7-10%), least for HIV (0.3%) 5. Purpose 1. To assess the occurrence of NSI among different categories of HCWs 2. To study various factors responsible and the circumstances under which they occur 3. To prevent these through improvement in knowledge, attitude and practice. Methods: A cross-sectional, questionnaire-based study was conducted among health care workers (HCWs) in a Private Hospital (Shanthi hospital and research centre) in Bengaluru from Jan to March 2023. This study included all HCW (50), who come in contact with patients, thus exposed to sharps and other occupational hazards. Data collection was carried out using standardized questionnaire, created based on review of the literature Results: out of 50, 21 were males and 29 were female. Maximum were in the age group of 20-40 yrs. 50 % of the HCWs are nursing staff, followed by 20% doctors, 18% housekeeping, 12% technicians. Needle stick injury was seen in 10% of HCWs. Out of 5 HCWs, only one has sustained 2 NSIs, remaining 4 HCWs had NSI only once. It was common in nursing staff as they will be dealing with sharps frequently. Interpretation & Conclusion: NSI rate is relatively low in this study compared to many other studies, even HBV Vaccination rate is good in this study. To improve the knowledge, attitude and practice towards NSI repeated training with pre and post test questionnaire is very important. More knowledge is required regarding needleless safety devices.

The predictors of occupationally related injury in employees of Pasteur Institute of Iran

Background: Needlestick Injuries (NSI) are a critical occupational risk for healthcare workers. Therefore, the present study investigated the incidence and risk factors of NSI among employees of the Pasteur Institute of Iran, one of the largest and oldest biological research institutes in the country, who are at high risk of occupational exposure to biological agents. Methods: This cross-sectional study included all personnel (565 individuals) of the Pasteur Institute of Iran. Participants answered some questions related to demographic and occupational characteristics as well as occupational exposure to blood and biological products, and occupational protection. Findings: A total of 448 questionnaires were completed. The mean age (SD) and work experience of the participants were 35.62 (9.20) and 9.72 (1.30) years, respectively. A total of 150 individuals had a history of NSI. The mean (SD) ages of participants with and without a history of NSV were 37.40 ± 9.03 and 34.41 ± 8.80 years, respectively (p < 0.001). The occurrence of NSI was related to work experience of more than five years and drinking, eating, or smoking while working. In addition, changing gloves while using the telephone was significantly related to reporting the occurrence of NSI to the department manager. Conclusion: Our findings indicated the relatively high frequency of NSI among the respondents. Despite the importance of personnel training, we did not find the occurrence of NSI or reporting it to be related to attending training courses. Hence, designing efficient preventive and protective measures requires the assessment of the attitudes of the mentioned institute’s personnel toward NSI and its prevention and management.

Knowledge, Attitude, and Practices towards Needle-stick Injuries among Nurses in a Public Hospital, Malaysia

Needle-stick injuries (NSI) pose a significant occupational hazard for nurses worldwide. With appropriate knowledge, attitudes, and practices (KAP), the occurrence of NSI can be minimized. This study aimed to assess the KAP of Malaysian public hospital nurses towards NSI. A cross-sectional study was conducted involving 208 nurses who completed self-administered questionnaires measuring NSI KAP. Results showed that most nurses had good knowledge, attitudes, and practices towards NSI. The study recommends NSI education, including handwashing, post-prophylaxis, and safe work practices, to increase KAP and reduce NSI incidence among Malaysian public hospital nurses.

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.

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.

Factors associated with needlestick injuries among healthcare workers: implications for prevention

BackgroundOur study sought to determine the frequency of Needlestick injuries (NSIs) among Healthcare Workers (HCWs) working at governmental hospital and to study the factors that associated with occurrence of NSIs, and to develop recommendations for a comprehensive program for prevention.MethodsRetrospective study of all reported cases of NSIs in the period from April 2016 to May 2018 among healthcare workers at a governmental hospital.ResultsIncidence of NSIs over 26 months was 8.4% among all participants. Nurses were the most affected staff (52.5%) resulted commonly from disposing syringes (58.9%). In contrast, the incidence of NSIs among physicians was 24.9% where surgical devices were the primary source of NSIs among them (40%). Failure to complete all required hepatitis B vaccination was common among expatriates of the participants of this study.ConclusionsNSIs was common among HCWs participated in this study. Preventive measures should be implemented including adequate hepatitis B immunization.

Prevalence, student nurses\u2019 knowledge and practices of needle stick injuries during clinical training: a cross-sectional survey

BackgroundThe incidence of needle stick injuries is higher among nurses with a low level of knowledge on the prevention of needle stick injury, and who have not received the relevant training during their undergraduate study. The aim of this study was to determine the level of knowledge of the prevention guidelines and the prevalence of needle stick injury among students in Oman.MethodsAn online cross-sectional survey using a questionnaire and involving 167 students from a governmental university was conducted. The questionnaire consists of 30 questions; eight general questions, knowledge related questions, and questions about risk factors, prevention measures, and actions in a case of needle stick injury. Ethical approval was obtained and the link to the survey was shared with students using their university email portal.ResultsOf the participants, 81.2% were females; mean age was 23.3 (SD = 4.5) years. The mean total knowledge score was 6.6 out of 10 (SD = 2.1). In addition, 18.2% (n = 32) of the students experienced needle stick injury. Most of the injuries 71.9% (n = 24) occurred during medication preparation and administration. The main cause of NSI as reported by students was recapping the needles (59%, n = 19).ConclusionsThis study demonstrates that student nurses have a moderate level of knowledge about needle stick injury prevention measures and lack many facets of safe infection control practice. These findings require the collaborative effort of nursing administrators from both academic and clinical areas, to develop effective strategies to reduce or eliminate the occurrence of needle stick injury.

English

BACKGROUND Health care workers are more prone to occupational hazards, like needlestick injuries, blood, and body fluid exposures. Needlestick injuries (NSI) are responsible for the transmission of serious infections like HIV, HBV and HCV. The occurrence of needlestick injuries is highest among the nurses. The objective of the study was to assess the knowledge, attitude and practice regarding needlestick injuries among nursing faculty in Justice K. S. Hegde Charitable Hospital, Mangalore. METHODS A cross-sectional survey was conducted among the nursing faculty working in a tertiary care hospital based on a structured questionnaire, and the obtained data were further analysed statistically. RESULTS The percentage of needle stick injury was 13.3 % among 75 nursing faculty. 94.7 % of the nurses were aware of the universal precaution guidelines and 84 % knew about post-exposure prophylaxis (PEP). 36 % of nurses knew the preventive guidelines' full details, but 50.7 % of the nurses were unaware of it. Many participants were aware that NSI transmits HIV (92 %) and Hepatitis B (68 %). The leading cause of NSI might be heavy work (54.7 %) followed by hurried procedures (41.3 %). 29.3 % of the nurses were still inclined to recapping the needle after use. 68 % of the nurses were mindful of washing hands with only water post exposure. 28 % were not willing to report a NSI. 80 % of nurses were fully immunised against Hepatitis B. CONCLUSIONS The best way to reduce NSI is to impart knowledge and awareness to the faculty. Our study showed that the knowledge, attitude, and practice among the nursing faculty were promising but requires to be further strengthened. KEY WORDS Needlestick Injury, Nursing Staff, Knowledge, Attitude, Practice

Post exposure prophylaxis for HIV among healthcare workers due to occupational exposure: a record based study at a tertiary care teaching hospital of Kolkata

Background: Healthcare workers (HCWs) regularly face the risk of exposure to sharp injuries and splashes as an occupational hazard, which presents major risk for acquiring blood-borne infectious agents like human immunodeficiency virus (HIV) which can be minimized by taking post exposure prophylaxis (PEP) measures. There are limited studies from India documenting details of PEP for HIV. This record-based study aimed to determine the occurrence of needle stick injuries (NSIs) and other high-risk occupational exposures to blood and body fluids (BBFs) among HCWs in a tertiary care hospital, Kolkata. We aimed to study details of PEP regimens used among HCWs exposed to HIV.Methods: Hospital record was analyzed from reported incidences of occupational exposures to BBFs occurred during the period of October 2013 to March 2019. Information on self-reported incidence of occupational exposure, and post-exposure management were collected.Results: A total of 105 incidents of occupational exposure were registered during study period. Interns (37, 35.2%) were most frequently exposed, followed by physicians (22, 21.0%) and nurse (21, 20.0%). 88 (83.8%) of the personnel sustained NSIs, and 17 (7.2%) had splashes to skin, mucus membranes. There was no significant difference between subjects with splashes to skin, mucus membranes and needle-stick cases regarding discontinuation of post exposure prophylaxis (PEP) (11.8% versus 19.3%, p<0.548). No cases of sero-conversion were reported.Conclusions: In spite of high incidences of exposures to HIV source, good efficacy of PEP was observed with no sero-conversion. PEP for HIV was well tolerated. Study emphasized the need for creating awareness about timely reporting of incidence.

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Introduction: Needlestick injuries (NSIs) are one of the most frequent routes of the transmission of bloodborne pathogens in health care settings and the substantial source of occupationally acquired bloodborne infections. They remain a significant problem for developing countries that lack the ability to implement more reliable technologies and available guidance because of the economic situation. The objectives of the study were to determine the frequency of NSIs among healthcare workers (HCWs) and supporting staff in primary health care, to investigate the factors that caused these injuries and to evaluate a set of implemented guides. Methods: A retrospective study of the Department of infection control records of NSIs between January 2003 and January 2016 was conducted. Incidence proportion (rate of injury risk) was calculated for each profession with reported NSIs. Results: A total of 156 NSIs and sharp injuries were reported to the Department of infection control during the 12-year period. Among the group of HCWs, medical nurses/technicians (54.49%) were the most common injured workers, and the lowest numbers were reported by a physical therapist and dental technicians (0.64%). In a total number of cases, support staff accounted for 16.67%. The most incidents occurred during the use of needles, in 146 (90.6%) cases. Calculated incidence proportion for medical doctors is 0.24%, 5.33% for dentists, and 13.8% for medical and dental nurses/technicians and laboratory technicians. For support staff, the calculated rate is 6.04%. Conclusions: At the primary health care level, the NSIs frequency among all employee profiles is lower and it is suggesting the possibility of underreporting cases. Healthcare facility management should consider introducing new and more reliable technologies to reduce the number of NSIs especially among nurses/technicians, laboratory technicians, and cleaning staff. Additional training and preventive measures should be directed towards the proper disposal of medical waste. Management of the Institution presented engagement to prevent the occurrence of NSIs, and it is a positive example for all countries in transition.

An investigation of insulin injection-related needlestick injuries among clinical nurses in Hunan, China

Objective: To investigate the incidence rate of insulin injection-related needlestick injuries, links causing such injuries, and reporting of occupational exposure among nurses in the wards of general hospitals in Hunan, China. Methods: From January 2017 to March 2019, stratified cluster sampling was performed to select 4368 nurses as respondents from 54 hospitals at different levels in 14 prefectures and cities of Hunan. The current status of insulin injection-related needlestick injuries was investigated, including the high-risk links causing insulin injection-related needlestick injuries during the use of insulin syringe (pen) , time and number of needlestick injuries, infection after needlestick injuries, and reporting of needlestick injuries, and a statistical analysis was performed. Continuous data were described as mean±standard deviation, and categorical data were described by percentage (%) . Results: Among the 3697 nurses who were investigated, 1419 (38.4%) once had needlestick injuries related to insulin injection, among whom 413 (29.1%) had needlestick injuries in the past 1 year. The mean number of insulin injection-related needle stick injuries was 1.92±1.80, with a mean number of 0.57±1.18 caused by insulin syringe, 1.30±1.15 caused by the anterior segment of insulin pen, and 0.32±0.81 caused by the posterior end of insulin pen. Among the 1419 nurses with a history of needlestick injuries, 90 (6.3%) had related infection, mainly HBV infection, and after the occurrence of needlestick injuries, 26.0% (369/1419) of these nurses reported it every time and 15.2% (215/1419) never reported it. "Fear of trouble" was the main reason for no reporting (69.1%, 980/1419) , followed by "the thought of no risk" (43.2%, 613/1419) and "no related policy in hospital" (10.9%, 154/1419) ". Among these 1419 nurses, 49.8% (706/1419) were treated according to the standard process for needlestick injuries in hospital every time, and 3.6% (51/1419) did not know such process or there was no such standard process. Conclusion: The current situation of insulin injection-related needlestick injuries is not optimistic among clinical nurses in Hunan, and the incidence rate of needlestick injuries cannot be ignored.

Burden of needle stick injuries among healthcare workers in primary health centers of Mandya district, Karnataka

Background: Needle stick injuries (NSIs) are wounds caused by sharps such as hypodermic needles, blood collection needles, intravenous cannulas or needles. The health care workers (HCW’s) are at an increased risk of accidental needle stick and sharps injuries, because of the environment in which they work. About 30 diseases like hepatitis B, hepatitis C, HIV can be transmitted by NSI. The incidence of NSI is considerably higher than current estimates, due to gross under-reporting. The objectives of present study was to determine the burden of NSIs among various categories of health care workers (HCWs) at primary health centres (PHC’s) of Mandya district, to determine the factors influencing NSIs and to assess awareness regarding NSIs among various categories of HCWs.Methods: This cross-sectional study was conducted at PHC’s of Mandya district for a period of 6 months. Interview method was used to collect information regarding socio demographic details, occurrence of NSI, factors influencing NSI and awareness regarding NSI by using a pretested semi-structured questionnaire on HCWs.Results: Of the 621 HCWs working during the study period, 366 participated in the study. 93 (25.41%) of the HCWs had at least one episode of NSI in the past 1 year. The common category of HCWs who experienced NSI was the medical officers 39 (41.94%). Majority 48 (51.61%) of NSI’s occurred while vaccine/drug administration followed by withdrawing of drug from the bottle 23 (24.73%). The medical officers and staff nurses had better knowledge regarding the diseases spread through NSI.Conclusions: Among the HCW’s, doctors and nurses are more prone for NSI. Vaccine/drug administration and withdrawing of drug from the bottle are circumstances where NSIs commonly occur hence education regarding safe injection practices are necessary.

A cross sectional study on needle stick injuries, its associated factors and prophylactic measures among nursing staffs and students of a tertiary care hospital in Chennai

Introduction: Nurses have the highest rate of Needle Stick Injuries (NSIs) among health care workers. Objectives: 1. To determine the prevalence of NSIs in the past three months among nursing staffs and students of a Tertiary Care Hospital and the factors associated with it. 2. To assess the pre and post exposure prophylactic measures related to NSIs followed by them. Methodology: This cross-sectional study was conducted between May and June 2017 among 354 subjects including 218 staff nurses and 136 nursing students of a Tertiary Care Government Hospital in Chennai City.After the Institutional Ethics Committee approval, subjects were interviewed with a pre-designed semi structured questionnaire. Data was analysed using relevant descriptive and inferential statistics with trial version of SPSS.v.25.0 Results: Prevalence of NSIs in the past three months was 29.7% (n=105). Majority 79 (58.1%) nursing students had experienced NSIs. Two handed recapping of syringes was significantly associated withNSIs (P = 0.001, OR = 4.363, 95% C.I = 2.033 – 9.364). Around40 (38.1%) of the NSIs had occurred most commonly at the In-patient wards. Majority 62 (59%) of them had never reported about their NSI while only 25 (23.8%) had reported regularly. Among those who got vaccinated with HBV vaccine (n = 57) for pre-exposure prophylaxis,only 13(22%) had taken three doses of HBV. Conclusion:Two handed recapping of syringes, non-usage of gloves, lack of assistance and inattentiveness during procedures, especially among nursing students are the major associated factors for occurrence of NSIs.

Nursing Students’ Awareness and Occurrence of Needle Stick Injury

Needle stick injuries caused by needles or sharps are one of the common accidental health hazards for the health care professionals. The present study is aimed to assess the awareness and occurrence of needle stick injuries among the nursing students. The research approach used was quantitative and the research design used was non experimental descriptive design to achieve the objectives of the study. The study participants were 134 students studying B. Sc Nursing in a selected college, Perinthalmanna. Structured questionnaire to assess the awareness regarding NSI and determine the occurrence of NSI was used to collect the data. The findings of the study indicate that majority of the students (61%) had inadequate awareness. Out of 134 nursing students, 44 students (33%) had experienced NSI; the most common device involved was the needle on the disposable syringe. The findings of the study indicate the need to enhance the awareness of the student nurses regarding NSI, safe practices, post exposure prophylaxis, protocols and guidelines of the institution, universal safety precautions and safe disposal of sharp items through educational interventions at their entry level of clinical practice.

Effectiveness of quality improvement on occurrence of needle stick injuries (NSIs) in Harare city, Zimbabwe, 2017: A quasi-experimental study

Background: Globally, healthcare workers (HCWs) incur an estimated two million needle stick injuries (NSIs) per year and 90% of these injuries occur in Africa. In Zimbabwe, neither the prevalence nor the factors associated with HCW-acquired NSI are known. Harare city recorded an increase in NSIs among nurses from 1% in 2013 to 7% in 2016, highest being from the Southern District. We designed and evaluated the effectiveness of a quality improvement (QI) approach towards reduction of NSI incidence. Methods: We conducted a quasi-experimental study purposively among 83 nurses in southern District. We designed and implemented an intervention package comprising training, deployment of social behavioral change materials and workflow re-organisation. We measured effectiveness of the intervention using Plan, Do Check Act cycle. Data on intervention effectiveness was collected pre and six months post-implementation, using structured questionnaires. Analysis was presented with frequencies, means, and proportions. Results: Lack of knowledge 99% (82/83), unorganised activities 60% (50/83) and limited space in the treatment rooms 59% (49/83), were the major reasons for NSI before intervention. Pre-intervention, 10% (8/83) of the nurses had good knowledge level while 96% (80/83) had good knowledge level post- intervention. The NSI incidence rates pre-intervention was 0.97 NSI/month and 0.17 NSI/month post-intervention, a decline rate of 82% (p< 0.01). Total cost saved by the intervention was $5 777.00. Conclusions: Lack of knowledge on occurrence of NSI, unorganised activities, and limited working space in the treatment rooms were the major reasons for NSIs before the intervention. The QI intervention was effective in reducing incidence of NSI. We recommend HCW trainings on NSI, promotion of socio-behavioral change and workflow re-organisation in order to offset economic efforts directed at managing NSIs.

A multicentre study on epidemiology and prevention of needle stick injuries among students of nursing schools.

Among the health professions with a long period of training, the students of the Nursing Bachelor's Degree are the most exposed to biological risk resulting from accidents, in particular with needles and cutting edges. The aim of the study was to estimate the frequency and the circumstances for the occurrence of needle stick injuries, as a knowledge base for targeted prevention interventions. The study was carried out between May and July 2017 in 11 Universities in Italy and 1 in Albania (associated with the "Tor Vergata" University of Rome). An anonymous semi-structured questionnaire was proposed to 1st (second semester), 2nd and 3rd year students of Nursing Bachelor's Degree. A total of 2742 questionnaires were collected. The average age of participants was 22.9 years (median 22, range 19-60 years), 73% of whom were females. A total of 381 injuries were reported. Three hundred and sixteen students (11.8%) underwent at least 1 injury (12.7% among females, 9.7% among males); 41 students declared two or more injuries; four students did not report the number of injuries occurred. The first injury occurred, as an average, 17 days after the start of the internship (median 15 days) and, in 25% of the cases, during the first 9 days. The highest percentage of accidents occurred during the first internship (25.3% of the total) and decreased with the progress of the training path. The injuries occurred in 38% of cases during drug preparation, 24% when disposing of sharp devices, 15% while re-capping needles, 13% during blood sampling and 10% in other circumstances. In 51.2% of cases, the needle was not sterile. Among the nursing students who suffered a needle stick injury, 58.1% declared that they had performed the post-exposure prophylaxis. 96% of students stated to be vaccinated against Hepatitis B virus. Amongst the students who had their serological status checked (74%), 18% stated the antibody titre was not protective. 49.8% of students answered to have been trained in advance on the correct procedures to avoid needle stick and cutting edges injuries in each clinical ward attended, 41.2% referred that this occurred only in some wards and 10% in no ward at all. The results of this study show a high percentage of needle stick injuries in students of the Nursing Bachelor's Degree. Therefore, there is a need for careful reflection on the most effective methods of targeted training acquisition of knowledge, skills and behavioural models useful for the exercise of the profession.

Risk Factors Associated with Needlestick Injuries among Health Care Workers in Menoufia Governorate, Egypt.

Background: Health care workers are at high risk of job-related blood-borne diseases due to needlestick injuries (NSIs). Objective: To assess the risk factors associated with NSIs among health care workers in Menoufia governorate, Egypt. Methods: This cross-sectional study was conducted on 2260 health care workers of 4 randomly chosen hospitals in Menoufia governorate. Using a predesigned data collection sheet, all staff members were asked about the occurrence of NSIs in the previous 3 months. The response rate was 95.3%. Logistic regression analysis was used to assess the factors associated with NSIs. Results: The risk of NSIs significantly increased with duration of work <15 years (OR 2.19, 95% CI 1.81 to 2.66), being female (OR 1.89, 95% CI 1.56 to 2.29), working as a para-medic (OR 1.49, 95% CI 1.03 to 2.25), working in surgical ward (OR 4.11, 95% CI 1.71 to 9.88), having more than 2 night shifts/month (OR 1.75, 95% CI 1.28 to 2.39), absence of educational sessions (OR 1.99, 95% CI 1.45 to 2.73), absence of hospital policies for NSIs (OR 2.23, 95% CI 1.99 to 2.49), absence of universal precautions (OR 1.66, 95% CI 1.10 to 2.50), recapping the needle after use (OR 2.63, 95% CI 2.12 to 3.26), recapping the needle with two hands (OR 3.08, 95% CI 2.04 to 4.65), not using protective clothes (OR 1.39, 95% CI 1.04 to 1.85), and increased working hours—8–12 hours (OR 2.14, 95% CI 1.34 to 3.44) and >12 hours (OR 2.28, 95% CI 1.17 to 4.44). Conclusion: The risk of NSIs is still high among health care workers that underlines the importance of comprehensive educational sessions to decrease the risk of job-related blood-borne diseases.

Factors Affecting Unsafe Acts by the Nurse in the Inpatient Unit of Surabaya Islamic Hospital Based on Loss Causation Model

The nurses are a hospital medical worker who has a high risk of harm compared to all workers in all category. The data of workplace accident in Surabaya Islamic Hospital is the Needle Stick Injury (NSI) on the nursing staff. The occurrence of NSI on the nurses is four cases and all of them are in the inpatient care unit. That accident possibly because of the weak supervision on the implementation of occupational health and safety in that hospital, individual characteristic, the work stress factor experienced by the nurse, and also the task complexity performed by the nurse.