Needlestick Injuries Research Articles

Blood tests after needlestick injury

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Development and Validation of the Needlestick Injury Prevention (N-SIP) Module.

Needlestick injuries (NSIs) pose a significant occupational hazard to healthcare workers (HCWs), with potential risks of exposure to bloodborne pathogens. The development of effective training modules is crucial to addressing NSI prevention and enhancing HCWs' knowledge and risk perception. This study aims to develop and validate the Needlestick Injury Prevention Module (N-SIP) using the ADDIE model (Florida State University, FL),which stands for Analysis, Design, Development, Implementation, and Evaluation, to improve NSI-related knowledge and risk perception among House Officers (HOs) in healthcare settings. The study utilized approaches comprising literature review, module development using the ADDIE model, content validation by experts, and face validation among HOs. The N-SIP module addressed various aspects of NSI prevention, including background information, bloodborne viral infections, infection prevention practices, and occupational safety. The evaluation involved content validation by expert panels and face validation by HOs. The content validity of the N-SIP module was rigorously evaluated through expert review and validation by subject matter experts and HOs. The experts' feedback ensured the quality, relevance, and comprehensiveness of the module's instructional materials. Furthermore, face validity was assessed among HOs to ensure the module's clarity, appropriateness, and perceived effectiveness in addressing NSI prevention. The positive response from HOs indicated favorable perceptions of the module's content and instructional design, affirming its potential to effectively enhance perceptions related to NSI prevention among HCWs. The development and evaluation of the N-SIP represent a significant advancement in addressing NSIs among HCWs. Through a structured approach informed by the ADDIE model, the N-SIP module offers a comprehensive and tailored learning experience aimed at enhancing NSI-related knowledge and risk perception among HOs. The study findings underscore the importance of effective training interventions in promoting a culture of safety and reducing occupational hazards in healthcare settings.

Needlestick injuries among health care worker: A narrative review

Needlestick injuries among health care worker: A narrative review

A Fatal Case of Powassan Virus Encephalitis

The Powassan virus (POWV) is part of the Flaviviridae family. It is mainly transmitted via tickbite but can rarely be spread person-to-person through blood transfusions. Initial symptoms include fever, headache, and vomiting. It can cause severe symptoms, including confusion, aphasia, and seizures. Approximately 1 out of 10 people with severe disease die. From 2010 to 2020, 194 Powassan virus cases have been reported to the Center for Disease Control (CDC), with 22 of them resulting in death. In this case report, we discuss a 39-year-old female who presented with fever, myalgia, and confusion. During her hospitalization, she developed tonic-clonic seizures, which required sedation and intubation. A central venous catheter was inserted due to poor intravenous access, and in the process of placing it, the provider sustained a needle stick injury. The patient was eventually diagnosed with POWV encephalitis and transferred to a higher level of care, where a brain perfusion study showed an absence of brain flow consistent with brain death. After a discussion with the family, the decision was made to extubate the patient terminally. The provider who sustained the needle stick injury reported no concerning symptoms two years after the event.

ChatGPT in hospital infection prevention and control – assessing knowledge of an AI model based on a validated questionnaire

Introduction and aim. An AI model like ChatGPT is a good source of knowledge. We can explore the potential of AI models to complement the expertise of healthcare professionals by providing real-time, evidence-based information in infection prevention and control (IPC). Material and methods. This study involved 110 queries related to IPC, validated by subject experts in IPC. The responses from ChatGPT were evaluated using Bloom’s taxonomy by experienced microbiologists. The scores were divided as 4 as a good response. Statistical analysis was done by correlation coefficient and Cohen’s Kappa. Results. The overall score was 4.33 (95% CI, q1 3.65–q3 4.64) indicating ChatGPT’s substantial IPC knowledge. A good response (i.e.>4 score) was found in 70 (63.6%) questions, while in 10 (9%) questions, it showed a poor response. The poor response was seen in needle stick injury and personal protective equipment (PPE) doffing-related questions. The overall correlations were found to be significant. Cohen’s Kappa confirmed moderate to substantial agreement between evaluators. Conclusion. ChatGPT demonstrated a commendable understanding of IPC principles in various domains and the study identifies specific instances where the model may require further refinement especially in critical scenarios such as needlestick injuries and PPE doffing.

Knowledge Regarding Needle Stick Injury Among Nurses of Tertiary Care Hospitals of Lahore

Knowledge Regarding Needle Stick Injury Among Nurses of Tertiary Care Hospitals of Lahore

Hepatitis B immunisation and immune status of nurses in a regional hospital in central South Africa.

The hepatitis B virus (HBV) is one of the most important biological occupational hazards for healthcare workers. A high percentage of HBV infections are attributable to percutaneous occupational exposure. This study aimed to describe the HBV immunisation and current immune status of all the nurses employed in a regional hospital in central South Africa. A descriptive record review included all the nurses (N= 388) employed in a regional hospital in central South Africa from 01 January 2018 to 31 January 2020. A total of 289 health records were included in the study. Data were analysed using descriptive statistics. Logistic regression analysis was used to establish factors associated with full immunisation. Most nurses were females (87.9%), working in medical (27.0%) wards. Only 20.4% of nurses received one dose of vaccine, while 51.2% received the three prescribed doses. However, 91.2% of nurses did not receive the vaccine at the correct intervals. Most of the tested nurses (71.0%) were immune. Immunisation status was significantly associated with religion (p 0.001) and schedule (p= 0.003). Nurses who were non-Christians were 35.9% less likely to be fully vaccinated compared to Christians. Half of the nursing staff received three doses as prescribed. All nurses should receive the vaccine against HBV and their immune status monitored to minimise the risk of an infection. It is therefore recommended that proof of immunity should be a requirement.Contribution:This study found a high percentage of nurses with HBV antibodies, which will ensure workplace safety.

Prevalence and associated factors of needlestick and sharp object injuries among healthcare workers in Ethiopia: a systematic review and meta-analysis.

Needlestick and sharp object injuries affect healthcare workers. However, there are limitations in the evidence available for informed decision-making by stakeholders, as individual research shows inconsistent results. Therefore, this study aims to assess the pooled prevalence of needlestick and sharp object injuries and their associated factors. MEDLINE/PubMed, EMBASE, Web of Science, Google Scholar, and other databases were searched from 5 September 2023 to 10 October 2023 using the following search terms: "Prevalence" OR "Burden" OR "Magnitude" AND "Associated factors" OR "related factors" OR "Risk factors" OR "determinants" OR "Predictors" AND "Needle stick Injury" OR "Sharp Injury" OR "Health care Workers" OR " Health Care Personnel" OR "Nurses" OR "Professional" AND "Ethiopia". The pooled prevalence of needle sticks and sharp objects injury was 40.5 (95% CI: 35.0, 45.9). Needle-stick (AOR, 2.3; 95% CI: 1.6, 3.3, P < 0.001], absence of routine precaution [AOR, 2.3; 95% CI: 1.1, 4.5, P < 0.01] and lack of training (AOR = 2.4; 95% CI: 1.4, 4.1, p < 0.001) had increased odds of needle-sticks and sharp objects injury. Forty percent of healthcare workers in Ethiopia have experienced needlestick and sharp object injuries. The identified factors included recapping, absence of routine precautions, and lack of training. PROSPERO, identifier (CRD42023462311).

Incidence, Knowledge, Attitude and Practice of Healthcare Workers Regarding Needle Stick Injuries at a Tertiary Care Hospital in Riyadh, Saudi Arabia

Background: A needle stick injury is a serious occupational health hazard in health care settings. Health care workers are at risk of bloodborne diseases and the psychological consequences of these injuries. Objectives: we aimed in this study to assess the prevalence of NSI among health care workers in King Saud Medical City and to assess their knowledge, attitude and practices regarding needle stick injuries. Methods: A cross-sectional study was conducted from 17th August 2022 until 30th November 2023. A structured questionnaire from Saudi Ministry of Health guidelines was used to collect the data. The content validity was evaluated by four academics from King Khalid University in Abha, and some minor changes were made. Results: As regard the prevalence of NSI, out of 220 participants, 132 individuals did not report any needle-stick injuries (NSI). While 92.3% of participants accurately defined NSI and acknowledged blood-borne disease transmission risks, only 39.1% followed preventive measures like recapping needles and proper disposal. There were knowledge gaps observed, with varying awareness levels on Hepatitis B and C prevention. Participants demonstrated awareness of post-exposure guidelines but lacked knowledge on immediate actions to take post-injury. Attitudes towards NSI varied, with a significant percentage 44.1% prioritizing patient care over healthcare worker safety. Interestingly, significant support was shown for immediate reporting of sharp injuries and the belief that NSIs are preventable. In terms of practice, adherence to safe needle practices varied, with the majority 90.9% using assigned disposal containers and being vaccinated against Hepatitis B, but not all receiving recent training on safe devices. Conclusion: This study revealed that NSIs remain a prevalent occupational health hazard among healthcare workers. Although a significant number of participants demonstrated adequate knowledge and awareness of NSIs and bloodborne disease transmission risks, there were noticeable gaps in their implementation of preventive measures and immediate post-injury actions. Attitudes towards NSIs varied, with some prioritizing patient care over healthcare worker safety. However, there was strong support for the immediate reporting of sharp injuries and belief in the preventability of NSIs.

Canadian Physicians’ Use of Ultrasound in Spasticity Treatment: A National Cross-Sectional Survey

ObjectiveTo identify potential barriers and obstacles preventing clinicians from adopting ultrasound for spasticity management. DesignA prospective, cross-sectional national survey. SettingWeb-based platform. ParticipantsThirty-six physicians and surgeons from across Canada. InterventionsSurvey completion. Main Outcome MeasuresThe use of ultrasound in clinical spasticity practice, perceived barriers, and risks associated with its implementation. ResultsIn total, 36 Canadian physicians and surgeons responded. A total of 91% reported using the US in their practice. Nearly all of them used ultrasonography (US) to guide injections and reported using more than 1 guidance technique for their injections. Less than half of the survey respondents reported using the US for muscle architecture assessment or longitudinal evaluation of muscle echo intensity. A total of 47% of survey respondents reported that they believe there are disadvantages associated with US use in spasticity practice. Disadvantages included increased time requirements resulting in discomfort for the injector and patient, the risk of infection after the procedure, and the risk of needle-stick injury. The most important barrier identified was the increased time demands of US compared with other guidance techniques. Other barriers included a lack of feedback on identifying a spastic muscle compared with electrical guidance techniques, a lack of additional remuneration to complete injections under ultrasound guidance, and a lack of adequate training. ConclusionsFuture educational efforts should address clinicians’ lack of familiarity with US purposes outside of injection guidance. This survey has highlighted the need for a curriculum shift in spasticity education to improve physician's scanning and injection technique, to address concerns about increased time requirements for injecting under ultrasound guidance and to address perceived disadvantages from clinicians.

Seroprevalence of Hepatitis C Virus Among Blood Donors in a Tribal-Preponderant Region of India.

Hepatitis C isa global health burden with significant morbidity and mortality. It primarily affects the liver and causes acute hepatitis, chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma. Common modes of transmission of hepatitis C virus (HCV) infection are blood transfusion, needlestick injury, and mother-fetus transmission, among which transmission, blood transfusion is one of the most important causes. Blood transfusion is one of the pillars in the management of patients that saves lives and improves morbidity. Blood donation in India is done by voluntary and replacement blood donors of both sexes.The aim of this study is to determine the seroprevalence of HCV among blood donors in the Jharkhand state, a tribal-preponderant region of India, and to see the trend over the years. This is a nine-yearretrospective observational study from 2015 to 2023 that screened for anti-HCV antibodies (third-generation kit: Abbott Diagnostics) using the chemiluminescence technique. In this study, in total, 249,461 units of blood were collected, of which the majority of donations were by male and replacement donors (RDs) comprising230,757 (92.50%) and 188,047 (75.38%), respectively. The meannumber of blood donations by replacement and male donors (MDs) was more than for voluntary donors (VDs) and female donors (FDs) (20894.11 ± 3041.71 RDs vs. 6823.77 ± 2332.96 VDs, p < 0.0001 and 25639.66 ± 2810.08 MDs vs. 2078.22 ± 828.16 FD, p < 0.0001), respectively. The overall prevalence of HCV was 0.63%, and all seropositive donors were male. Replacement blood donation contributes to the major part of blood donation and is primarily done by males in this tribal population-dominant region of India. Seroprevalence of HCV is high in the population of this part of India, and there is a constant or slightly upward trend in hepatitis C infection among individuals.

Postexposure prophylaxis for occupational exposure to selected pathogens for healthcare personnel.

Timely postexposure prophylaxis is important after an occupational exposure. Here we review select organisms, exposure opportunities in the healthcare setting, and postexposure prophylaxis regimens. Needlestick injuries pose a risk of exposure to bloodborne pathogens, such as HIV, Hepatitis B, and Hepatitis C. Risk mitigation strategies should be reexamined in light of newer vaccines and therapeutics. Increased vaccine hesitancy and vaccine denialisms may foster the re-emergence of some infections that have become extremely uncommon because of effective vaccines. With increasing occurrences of zoonotic infections and the ease of global spread as evidenced by COVID-19 and mpox, healthcare exposures must also consider risks related to emerging and re-emerging infectious diseases. Early recognition and reporting of occupational exposures to pathogens with available postexposure prophylaxis is key to mitigating the risk of transmission. Providers should be able to evaluate the exposure and associated risks to provide prompt and appropriate postexposure prophylaxis.

EVALUATING THE OCCURRENCE OF NEEDLE STICK INJURIES AMONG NURSING STUDENTS

Needlestick injuries (NSIs) pose significant occupational hazards for nursing students, who are at high risk due to their clinical practice. Understanding their knowledge, attitudes, and practices towards NSIs is crucial for developing effective prevention strategies. Objective: To assess the prevalence of NSIs among nursing students and evaluate their knowledge, attitude, and practice towards NSIs. Methods: This descriptive study was conducted at Sheikh Zayed Hospital Rahim Yar Khan from January 2023 to December 2023. Nursing students from the 2nd to final year were included, given their clinical exposure and high risk of NSIs. Data were collected through an online questionnaire based on previous studies, and distributed via email. Descriptive statistics were used to analyze the data, with means and standard deviations calculated for continuous variables and frequencies and percentages for categorical variables. Results: A total of 280 students participated in the survey. Sixty-seven students (23.9%) experienced NSIs, primarily during recapping (74.6%) and injections (21%). Most students (76.1%) did not report the incidents. The mean NSI knowledge score was 6.5 ± 1.3, and the mean attitude score was 27.5 ± 4.13, indicating a generally positive attitude. One hundred ninety-six students (70%) had received the Hepatitis B vaccine, 152 (54.2%) were worried about NSIs, 201 (71.7%) believed NSIs are preventable, and 150 (53.5%) felt NSIs are neglected. The mean practice score was 14.2 ± 2.1, indicating poor practice. Additionally, 140 students (50%) reported recapping needles before discarding, 98 (35%) wore gloves before injections/venipuncture, 64 (22.8%) practised one-handed recapping, 168 Conclusion: (60%) used personal protective equipment (PPE), and 56 (20%) rinsed with water and soap after an NSI. Nursing students demonstrated good knowledge and a satisfactory attitude towards NSIs; however, their practice levels were low. Enhanced training and strict adherence to safety protocols are needed to improve their practices and reduce the incidence of NSIs.

Exploring Biomedical Waste Management Practices Among Healthcare Professionals: A Study From a Tertiary Care Teaching Hospital in Eastern India.

The generation of biomedical waste (BMW) in hospitals presents a significant hazard to both healthcare workers (HCWs) and the environment. The management of BMW is a challenge regarding inappropriate behavior among HCWs, leading to improper segregation of the BMW, which deserves attention.The indiscriminate BMW management issue in India has attracted the attention of the highest judicial bodies. The rise in the incidence of needle stick injuries is a severe threat to waste handlers and is mainly due to improper segregation practices. This study aimed to identify the challenges in BMW management in the institute and develop a strategy to improve the knowledge and practices of healthcare professionals (HCPs) in BMW management. A process-based intervention was developed and implemented that involved facility inspection rounds, focused group discussions with HCWs, preparation of information, education, and communication (IEC) materials, signage, staff training, and improved infrastructure and supplies for waste collection. A questionnaire-based evaluation of the staff's knowledge of BMW management was conducted, and the impact of the intervention was assessed from the hospital infection control audit reports. Multiple reasons for poor compliance with BMW segregation practices were identified, and it improved from 57% to 91% with interventions. A significant difference was noted in the knowledge level of staff before and after the interventions.Post-intervention score was highest among the nurses (98.5%), followed by sanitation staff (92.7%), doctors (89.25%), and paramedics (81.7%). Incorrect segregation practices of BMW and incidents of occupational exposure to blood and body fluids are reduced with interventions in the study. Robust supply chain management with regular training of staff is vital to ensure compliance in BMW management.

Nurses Knowledge of Post Needle Stick Injury Prophylaxis at a Public Sector Hospital Karachi

Nurses Knowledge of Post Needle Stick Injury Prophylaxis at a Public Sector Hospital Karachi

Knowledge, Attitude and Practices (KAP) of Sterilization and Disinfection of Health Care Professionals in Bangladesh

&amp;lt;i&amp;gt;Background:&amp;lt;/i&amp;gt; Healthcare professionals face a constant risk of acquiring infections from patients. Exposure to blood, saliva, and sharp instruments increases their susceptibility to various infectious diseases. Proper sterilization and disinfection procedures are crucial for protecting both healthcare workers and patients. &amp;lt;i&amp;gt;Objective:&amp;lt;/i&amp;gt; This study aimed to assess the knowledge, attitude, and practices regarding sterilization and disinfection among healthcare professionals in Bangladesh.&amp;lt;i&amp;gt; Methods&amp;lt;/i&amp;gt;: A cross-sectional study was conducted at the National Institute of Cardiovascular Diseases &amp; Hospital in Dhaka, Bangladesh, from January to June 2023. A total of 81 healthcare professionals were randomly selected and participated in the study after providing verbal consent. Data collection involved a pre-structured questionnaire focusing on knowledge, attitude, and practices related to sterilization and disinfection. Statistical analysis was performed using SPSS software, and results were presented as frequencies and percentages. Ethical clearance was obtained before the study commenced. &amp;lt;i&amp;gt;Results: &amp;lt;/i&amp;gt;The study included healthcare professionals from various backgrounds, with the majority being young adults (21-25 years old). Knowledge assessment revealed a good understanding of sterilization methods, disinfection procedures, post-sterilization instrument management, and waste disposal practices. Additionally, most participants were aware of the hospital&amp;apos;s sterilization protocols and infection prevention policies. Regarding attitudes, a positive response was observed towards regular training for staff, proper use of personal protective equipment (PPE), and adherence to sterilization and disinfection guidelines. However, a minority expressed concerns about reusing disposable items. Practices reflected the positive knowledge and attitudes, with a high percentage of participants following hand hygiene protocols, using PPE, and opting for disposable equipment. However, a small number reported experiencing needle-stick injuries, highlighting a potential gap between knowledge and practice. &amp;lt;i&amp;gt;Conclusions:&amp;lt;/i&amp;gt; the study found that a majority of healthcare professionals in this setting demonstrated good knowledge, positive attitudes, and appropriate practices regarding sterilization and disinfection. However, a small knowledge, attitude, and practice gap was identified, particularly concerning needle-stick injuries. These findings suggest a need for ongoing education and reinforcement of safe practices to ensure optimal infection prevention and control in healthcare facilities.

Assessment of Needlestick and Sharps Injuries (NSSIs) Amongst Orthopaedic Surgeons in Clinical Practice: A Pan-India Cross-Sectional Study.

Needlestick and sharps injuries (NSSIs) represent an existential occupational hazard risk to orthopaedic surgeons during their career due to the interaction with various devices, instruments and bone fragments. Consequently, NSSIs have the potential to transmit infections such as Hepatitis B (HBV), Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV) leading to serious illness. The purpose of this cross-sectional study was to identify the clinical settings predisposing orthopaedic surgeons to NSSIs and assess their adherence to safety protocols in the Indian context. An online cross-sectional survey of 618 orthopaedic surgeons in India, stratified by experience into two groups: under five years and with 5years or more was undertaken. The data were collected via an expert-validated online questionnaire to evaluate demographic distribution, injury characteristics, knowledge of safety protocols, and adherence to these protocols. Descriptive statistics summarized the data, Chi-square tests assessed variable associations, and odds ratios were computed for significant variables. Ethical integrity was maintained via electronic informed consent and for confidentiality assurances. The study revealed that orthopaedic surgeons with less than 5years of clinical experience had higher risks for NSSIs as compared to those with 5 or more years of clinical practice. Conversely, the latter group was more susceptible to bone spike injuries and viral positive needlestick incidents. The analysis shows that whilst the more experienced practitioners displayed greater proficiency in the application of universal precautions and NSSI prevention, they were also less likely to report injuries, often due to discomfiture. Risk profiles were consistent across different practice settings and affiliations, regardless of experience level. This cross-sectional study reveals less experienced orthopaedic surgeons face higher risks of NSSIs, possibly due to inadequate education or awareness. More experienced practitioners encounter distinct risks, likely owing to long-term exposure and traditional practices. There is an immediate need to raise awareness of the potential risks of NSSIs, enhanced education, appropriate training, collaboration with the hospital risk management team and developing a culture of transparent reporting to mitigate these risks. The emphasis should be on reducing the incidence and fostering open reporting of NSSIs to protect clinicians and promote health safety.

Evaluation of a needle-free injection system for administration of cloprostenol for luteolysis in lactating dairy cows

Luteolytic drugs are critical for managing reproductive success in dairy cows. Currently prostaglandin analogs are only ap­proved for intramuscular injection. The utilization of a needle and syringe for administration of any drug can result in needle-stick injuries to workers. Furthermore, needle-free injection systems have been shown to eliminate transmission of blood­borne pathogens, such as anaplasmosis, in cattle. Data on the efficacy of needle-free injection systems and their application in an estrous synchronization protocol has not been reported. The objective of the present study was to evaluate the effective­ness of utilizing a needle-free injection system (Pulse Needle­Free Systems, Lenexa, KS) for the intramuscular delivery of clo­prostenol (Estrumate®, Merck Animal Health, Madison, NJ) for the purpose of estrous synchronization in lactating dairy cows.

THE PROBLEM OF REGULATING FUNGICIDES ON THE SKIN SURFACE FOR OCCUPATIONAL SKIN DISEASE IN AGRICULTURAL WORKERS’ RISK PREDICTION

The aim. To establish the norms of fungicides on the skin surface and predicting the risk of occupational skin pathology in agricultural workers to develop measures to prevent diseases caused by dermal exposure to pesticides. Materials and methods. The natural experiment was performed in accordance with modern requirements (European Food Safety Authority (2022), and the risk assessment was carried out according to the Recommendations (Approved by the Ministry of Health of Ukraine No. 324 issued on 13.05.2009) with different methods of spraying techniques: rod, air blast fan spraying, pre-sowing, aviation, knapsack treatment. 17 series of natural experiments were performed, and the air of the working zone area (n =56) and dermal exposure (n =56) were analyzed for each worker with different pesticide application methods. Quantitative determination of pesticide content was carried out by gas-liquid and high-performance liquid chromatography methods. The results were statistically processed using a package of licensed statistical programs MedStat v.5.2 (Copyright © 2003-2019) and Microsoft® Excel® for Microsoft 365 MSO. Results. It was established that there is pesticide contamination, mainly of the gloves of tank filling operators when preparing working solutions. No contamination of the skin surface was detected; only pesticide residues were present on the surface of the workers’ overalls. A comparison of the exposure dose in case of percutaneous exposure during the performance of technological operations with different methods of processing, dermal equivalents of Acceptable Operator Exposure Level of pesticide to workers’ skin (DE AOEL) and the allowable dermal dose for professional contingents (ADderm) and the hazard coefficients by dermal exposure (HCderm) showed that that dermal exposure during individual technological operations with different processing methods had a reliable difference between processing methods, but there is no difference within one application method. Conclusions. During the comparison of the hazard coefficients for dermal exposure, calculated according to different models, no significant difference was found between the risks calculated according to DE AOEL and ADderm for individual technological operations in various treatment methods, except for the operator who performed knapsack treatment and the risk calculated according to ADderm is significantly lower compared to the DE AOEL risk.

Enhanced efficacy of brucine dissolving-microneedles as a targeted delivery system in rheumatoid arthritis treatment: a comprehensive pharmacokinetic-pharmacodynamic analysis.

Our previous studies have shown the therapeutic efficacy of brucine dissolving-microneedles (Bru-DMNs) in treating rheumatoid arthritis (RA). Bru delivered via the DMNs can bypass some of the issues related to oral and systemic delivery, including extensive enzymatic activity, liver metabolism and in the case of systemic delivery via hypodermic needles, pain resulting from injections and needle stick injury. However, the underlying mechanism of Bru-DMNs against RA has not been investigated in depth at the pharmacokinetic-pharmacodynamic (PK-PD) level. In this study, a microdialysis-based method combined with ultra-performance liquid chromatography-tandem mass spectrometry was developed for the simultaneous and continuous sampling and quantitative analysis of blood and joint cavities in fully awake RA rats. The acquired data were analyzed by the PK-PD analysis method. Bru delivered via microneedles showed enhanced distribution and prolonged retention in the joint cavity compared to its administration in blood. The correlation between the effect of Bru and its concentration at the action site was indirect. In this study, we explored the mechanism of Bru-DMNs against RA and established a visualization method to express the PK-PD relationship of Bru-DMNs against RA. This study provides insights into the mechanism of action of drugs with potential side effects administered transdermally for RA treatment.