Prevalence Of Needlestick Injuries Research Articles

Incidence of needlestick injuries among medical students after implementation of preventive training

Structured training for the prevention of needlestick injuries (NSIs) among medical students was implemented in Singapore in 1998. In this study, we determined the incidence of NSIs and the knowledge and practice of managing and reporting NSIs among first-year clinical students in a medical school in Singapore, as well as the adequacy of the training provided for these students, 14 years after preventive training was instituted. All third-year medical students (n = 257) from the Yong Loo Lin School of Medicine, National University of Singapore, Singapore, who had completed their first clinical year posting were enrolled in this cross-sectional study. A self-administered questionnaire was answered by the students one month after completion of their last clinical posting. Students who repeated their first clinical year were excluded from the study. 237 students completed the questionnaire. However, 9 of these students were excluded because they repeated their first clinical year. The response rate was 91.9%. Although 8 (3.5%) students reported one NSI each, only 2 (25.0%) of these 8 students reported the incident to the relevant authority. Among the students surveyed, 65.8% reported using gloves at all times during venepuncture procedures, 48.7% felt that improvements could be made to the current reporting system and procedures, and 53.2% felt that the training provided before commencement of clinical posting could be enhanced. There was a decrease in the incidence of NSIs among medical undergraduates in their first clinical year when compared to the incidences reported in earlier studies conducted in the same centre (35.1% in 1993 and 5.3% in 2004). The current reporting system could use a more user-friendly platform, and training on NSIs could be improved to focus more on real-life procedures and incident reporting.

Epidemiology and risk factors of needle stick injuries

Epidemiology and risk factors of needle stick injuries

Awareness About Needle Stick Injures and Sharps Disposal: A Study Conducted at Army College of Dental Sciences

The present study aims to assess the knowledge and attitude about needle stick injuries and sharps disposal. A self designed questionnaire of 15 questions was handed out to 200 participants including undergraduate students (group 1), postgraduate students (group 2), faculty members (group 3) and auxiliary staff members (group 4). The data was collected and analyzed using Chi square test. Sixty-one percent of total participants reported of experiencing needle stick injury and 25.5% knew that there could be several causes for this. Only 22% of total population studied got the source tested. Immunization status of group 4 was very low and they also lacked the knowledge of sharps disposal and hepatitis C being spread by needle stick injuries. 57% participants confirmed that there was no reporting facility and 66% were not familiar with the guidelines of reporting. There is a definite scope of improvement in terms of reporting and prevention of needle stick injuries. There is a need to improve knowledge and awareness of dental health care workers about the post exposure protocol.

Status of knowledge, attitude and practice for needlestick injury prevention among clinical nurses and analysis of its influencing factors

Objective To understand the status quo of knowledge,attitude and practice of clinical nurses’ needlesrick injury (NSI) prevention and its influencing factors.Methods In our cross-sectional study,1020 clinical nurses in different levels of hospitals in Suzhou were recruited to participate the questionnaire survey by stratified cluster sampling.Results The average scores of knowledge,attitude,and practice about NSI prevention were (78.60+15.30),(78.88+8.31) and (70.60+13.86),individually.There was significant correlation among knowledge,attitude and practice.Stepwise regression analysis indicated that knowledge,occupational safety training,section,attitude,rifle,work environment and the level of hospital were the main influencing factors of NSI prevention practice.Condusions NSI prevention knowledge,attitude and practice among clinical nurses are unsatisfactory.Nursing administrators should pay close attention to the nursing staffs’ need of NSI prevention knowledge and provide targeted education to promote the formation of positive attitude,correct bad behaviors and promote healthy behaviors of NSI prevention. Key words: Nurses; Needlestick injury; Prevention; Knowledge-attitude-practice; Influencing factors

A discrete choice experiment to determine patient preferences for injection devices in multiple sclerosis

Objective:Relapsing-remitting multiple sclerosis (MS) is usually managed with disease modifying drugs (DMDs), most commonly administered via self-injection. The aim of this study was to estimate the influence that different treatment-related attributes have for MS patients on their choice of MS DMD device. By establishing the relative importance of these characteristics for patients it should be possible to better understand the acceptability of a given device and to optimize the development of future devices.Methods:A discrete choice experiment (DCE) survey was developed on the basis of a review of published literature. Attributes identified for inclusion in the survey were: ease of use; comfort of use; presence of additional functions, needle visibility; practicality and efficacy. Choice sets were presented as pairs of hypothetical treatments based upon a fractional factorial design. One-hundred device-using MS patients completed the survey online. Analysis was conducted using a mixed-logit approach.Results:Analysis of the DCE data revealed that all attributes significantly predicted treatment choice. Efficacy exhibited the largest effect on treatment selection and this provided context for understanding the magnitude of impact for the other attributes. Reducing the discomfort associated with device use and eliminating the necessity for assembly or drug reconstitution were highly valued. The addition of reminder and time-stamping functions, improved needlestick injury prevention, and reduction in device size were secondary concerns but still deemed desirable.Conclusion:Efficacy is of primary importance to MS patients, but characteristics of drug delivery devices can play an important role in treatment decision-making. Not all device characteristics could be included, and results are based upon 100 participants only. Findings suggest there is significant potential value in developing self-injection devices that are not only efficacious but also convenient and comfortable to use. Reducing barriers to adherence could potentially translate into improved treatment outcomes for patients with MS.

English

BACKGROUND: Because of the environment in which they work, many health care workers are at risk of accidental needle stick injuries (NSI). OBJECTIVES: To study prevalence and response to needle stick injuries among health care workers. METERIALS AND METHODS:STUDY DESIGN: Cross-sectional study. SETTING: A tertiary care hospital in Hyderabad. PARTICIPENTS: 400, senior residents, junior residents, interns, undergraduate medical students, staff and student nurses and staff and student laboratory technicians. STATISTICAL ANALYSIS: proportions and chi-square test. RESULTS: The commonest clinical activity to cause the NSI was blood withdrawal (55%), followed by suturing (20.3%) and vaccination (11.7%). The practice of recapping needles after use was still prevalent among HCWs (66.3%). Some HCWs also revealed that they bent the needles before discarding (11.4%). It was alarming to note that only 40 per cent of the HCWs knew about the availability of PEP services in the hospital. CONCLUSIONS: The occurrence of NSI was found to be quite common. Avoidable practices like recapping of needles were contributing to the injuries. Prevention of NSI is an integral part of prevention programs in the work place, and training of HCWs regarding safety practices indispensably needs to be an ongoing activity at a hospital.

English

INTRODUCTION: Needle stick injuries are one of the greatest risks faced by the front line healthcare workers in the light of HIV/ AIDS, Hepatitis B and C. Yet, these exposures have often been considered as part of the job and neglected. OBJECTIVE : 1. To study prevalence of needle stick injury among health care workers of a private tertiary care hospital. 2. To assess the knowledge, attitude and practices of needle stick injury among them. METHODOLOGY : Hospital based cross sectional study was carried out with preformed pretested questionnaire on all (42) health care workers of a private tertiary care hospital. RESULTS: Results showed that out of 42 subjects 35(83.3%) had a history of needle-stick injury but only 11% reported the injuries to the hospital authority and received PEP prophylaxis against HIV. Only 11 HCW's (26.2%) were aware about where to report the NSI incident. 4.8% and 95.3% of health care workers, respectively, were unaware of the fact that hepatitis B and hepatitis C can be transmitted by needle-stick injuries. Only 21.5% were in the habit of using gloves for phlebotomy procedures all the time. 40.5% were of the impression that needle should not be recapped after use but 21.5% of them didn't implement it. Only 38.1% were aware of Universal Precaution Guidelines. 18 subjects (42.9%) had been vaccinated against hepatitis B; while 26 subjects (47.6%) were not vaccinated against hepatitis B.23 subjects (54.8%) knowing their HBsAg status. Majority of HCW (95.3%) were demanding training and awareness of NSI. CONCLUSION: The study revealed that knowledge among health care workers about the risk associated with needle-stick injuries and use of preventive measures was inadequate. Standard operating procedure (SOP) should be formulated and followed by them.

P300: Blood splatters induced by using safety intravenous catheters

Various intravenous catheter (IC) products with safety mechanisms for prevention of needle stick injury are commercially available in Japan. However, risk of blood-borne infections to health care workers (HCWs) due to scattering blood when using these ICs has been pointed out.

Awareness of medical students in a medical college in Mangalore, Karnataka, India concerning infection prevention practices

Healthcare-associated infections (HCAIs) are an important public health problem. It is estimated that approximately 1 out of every 20 hospitalized patients will contract an HCAI. The risk is substantial not only to patients but also to healthcare workers, who may contract deadly blood-borne infectious diseases. Hence, it is essential for healthcare professionals to have adequate knowledge regarding infection prevention practices (IPPs) to reduce the burden of these illnesses among patients seeking care. This cross-sectional study was conducted among 268 medical students at Kasturba Medical College, Mangalore. Information regarding important IPPs such as hand hygiene (HH), needle-stick injuries (NSIs), and standard precautions (SPs) was collected using a semi-structured questionnaire. The collected information was analyzed using SPSS v.11. Fisher's exact test was used to test the association between variables of interest. Overall, knowledge levels regarding HH were low in aspects such as healthcare workers' hands as sources of infection (40%) and the minimum time needed to apply hand rubs (45.7%), whereas knowledge levels were high in aspects such as indications for using HH. Regarding NSI prevention, knowledge levels were low in aspects such as activities with the highest NSI risk (56%). However, knowledge levels were high in relation to SPs. The knowledge levels regarding infection practices were not adequate among the participants, particularly in the case of hand hygiene methods. Other important aspects, such as needle-stick injuries and use of standard precautions, were better understood, although many aspects still require improvement. These findings suggest the need to consider strengthening the training related to IPPs as a separate entity in the existing curriculum.

A prospective trial on a new sutureless securement device for central venous catheters

To the Editor, We share our experience with a new catheter securement device called the (Interrad Medical, Plymouth, MN, USA). It utilizes small folding subcutaneous nitinol tines that anchor an intravenous catheter at the insertion site (Figure, panels A and B). The anchor is designed to be atraumatic, and it is magnetic resonance imaging compatible. An instructional video provided by the manufacturer is available at http://interradmedical. com/video-short-demo. We conducted a multicentre observational postmarketing study to evaluate the effectiveness of successful catheter securement with this device. The study was approved by the Research Ethics Board of each participating institution (listed below) and was registered at www.clinicaltrials.gov (NCT00903539). Physicians were trained by the manufacturer on the use of the SecurAcath, and consenting patients 18 yr or older requiring a 7Fr central venous catheter (CVC) in the internal jugular vein were enrolled in the study. Seventyfour subjects were included from June 23, 2010 to January 4, 2011. The primary outcome, successful securement, was achieved in 72 (97%) of the cases. Two patients experienced catheter dislodgement, attributed to improper coupling of the two device components. These were identified within 24 hr of catheter placement. No other device-related malfunction occurred. There were no device-related adverse events, such as catheter migration within the device, difficulties with removal, cellulitis at the site, or erosion at the anchor securement site. The immediate procedural success rate was 100%. The mean (standard deviation) time to secure the catheter was 62.5 (97.3) sec, and 91% of the devices were deployed within 2.5 min. Mean catheter indwelling time was 3.1 (5.1) days. Discomfort analogue score (scale 1-10) during device use and at removal was 0.9 (1.6) and 1.6 (2.1), respectively. Fourteen of the 15 patients with previous CVC or a peripherally inserted central catheter experience considered SecurAcath to be as or more comfortable than a sutured catheter. Six of the eight healthcare professionals questioned thought that maintenance of the device site was somewhat or much easier than with a sutured catheter, and all stated they would recommend this device to other professional colleagues. Anesthesiologists commonly perform CVC placement, and most often this is sutured for stabilization. The American Society of Anesthesiologists (ASA) believes that the literature is currently insufficient to evaluate the usefulness of sutureless stabilization; therefore, the ASA Task Force suggested that the decision should be determined on an institutional basis. By contrast, multiple medical societies advocate sutureless securement devices in order to reduce the risk of infection. It is believed that skin disruption near the catheter entry site is associated with increased risk of infection. Furthermore, avoidance of suturing is consistent with prevention of needlestick injury (NSI). The use of staples addresses the issue of NSI but still results in skin disruption. Adhesive-based securement systems appear to have better efficacy and safety profiles compared with sutures. A subset of patients, however, may be unsuitable for skin adherence because of hair growth, skin lesions, allergy to the adhesive, or diaphoresis. In addition, both adhesive-based and staple-based devices pose similar hygiene challenges during dressing changes as D. Cordovani, MD (&) ! R. M. Cooper, MD Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, ON, Canada e-mail: dancordovani@hotmail.com

Evaluating the implementation of health and safety innovations under a regulatory context: A collective case study of Ontario’s safer needle regulation

BackgroundImplementation effectiveness models have identified important factors that can promote the successful implementation of an innovation; however, these models have been examined within contexts where innovations are adopted voluntarily and often ignore the socio-political and environmental context. In the field of occupational health and safety, there are circumstances where organizations must adopt innovations to comply with a regulatory standard. Examining how the external environment can facilitate or challenge an organization’s change process may add to our understanding of implementation effectiveness. The objective of this study is to describe implementation facilitators and barriers in the context of a regulation designed to promote the uptake of safer engineered medical devices in healthcare.MethodsThe proposed study will focus on Ontario’s safer needle regulation (2007) which requires healthcare organizations to transition to the use of safer engineered medical devices for the prevention of needlestick injuries. A collective case study design will be used to learn from the experiences of three acute care hospitals in the province of Ontario, Canada. Interviews with management and front-line healthcare workers and analysis of supporting documents will be used to describe the implementation experience and examine issues associated with the integration of these devices. The data collection and analysis process will be influenced by a conceptual framework that draws from implementation science and the occupational health and safety literature.DiscussionThe focus of this study in addition to the methodology creates a unique opportunity to contribute to the field of implementation science. First, the study will explore implementation experiences under circumstances where regulatory pressures are influencing the organization's change process. Second, the timing of this study provides an opportunity to focus on issues that arise during later stages of implementation, a phase during the implementation cycle that has been understudied. This study also provides the opportunity to examine the relevance and utility of current implementation science models in the field of occupational health where the adoption of an innovation is meant to enhance the health and safety of workers. Previous work has tended to focus almost exclusively on innovations that are designed to enhance an organization’s productivity or competitive advantage.

Prevalence of needle stick injuries among nurses in a tertiary care hospital and their immediate response

Context: Needle stick injuries (NSIs) are wounds caused by needles in health care setup that accidentally puncture the skin and may result in exposure to blood or other body fluids. NSI is a major occupational health and safety issue faced by health care professionals globally. Nurses have the highest rate of needle stick injury among health care workers. Aims: To determine the prevalence of needle stick injuries (NSIs) among the nurses, to determine the association between NSI and selected variables like age, marital status, years in service, educational qualification and to assess the measures undertaken by the respondents after the NSI. Materials and Methods: A cross sectional study was conducted in a tertiary care hospital in Imphal among nurses from October to November 2011. Self-administered questionnaire was used for data collection. Descriptive statistics were used. Chi square test was used to see the association and a P-value of Results: The prevalence of NSI within the last one year was found to be 28.1% (N=86). Of them 49(46.5%) had two or more NSIs in the last one year. More than half of the NSIs occurred during intravenous (IV) injection, 16.3% during intramuscular (IM) injection and only 1.6% during recapping of the needle. Eighty three (96%) of them did not were gloves during NSI. Forty (46.5%) of them washed the injured part with water and soap as immediate measure. Thirty seven (43%) did not report it. Though 251(82%) knew about the free availability of Post Exposure Prophylaxis (PEP) in the hospital, only 5(5.7%) took PEP. Conclusion: Needle stick injury is an important occupational health hazard among the nurses. Reporting to the concerned authorities, screening after NSI and promotion of safety measures should be greatly encouraged.

A Study on Prevalence of Needle Stick Injuries among Junior Doctors and Nursing Students in Kims, Hubli

Background: Junior doctors and nursing students as well as health care workers belong to high risk group for blood- borne infections including HBV, HCV and HIV. The risk of occupational exposure is caused by lack of experience and professional skill in invasive procedures performed during clinical education. Objectives: 1) to determine the prevalence of needle stick injury among junior doctors and nursing students. 2) to assess the causes, work place and mode of the needle stick injury. 3) to check the awareness about NSI among health workers. Materials and methodology: A cross sectional study conducted among the junior doctors and nursing students by a pre tested questionnaire. Results: Out of the 200 study sample, 125(62.5%) got needle stick injury. Junior doctors are four times more affected than nurses. Most of the NSI among junior doctors(32) occurred in the casualty and for nursing students(18) in medicine wards. Maximum NSI occurred during suturing(40%) followed by recapping (29.6%) ,injections(26.4%), blood withdrawal(24.8%) and cannula insertion(9.6%). 56.3% had no awareness about needle safety devices. Conclusion: In this study population, junior doctors are at higher risk than the nursing students. Majority of them are not aware of needle safety devices and proper method of recapping the needles, so regular courses, seminar and management trainings should be conducted. Reporting of needle stick injuries should be mandatory to higher official.

Investigation of a safety-engineered device to prevent needlestick injury: why has not StatLock stuck?

ObjectiveThis article sought to define whether an alternative safety-engineered device (SED) could help prevent needlestick injury (NSI) in healthcare workers (HCWs) who place central venous catheters (CVCs).DesignThe study involved three...

Effect of Sharps Injury Prevention Program on the Incidence and Reporting of Sharp Injury among Nurses

2 2 , Yangsan, Korea Background: This study aimed to identify the effects of a multifaceted needlestick injury (NSI) prevention program on changes in knowledge about bloodborne infectious diseases and postexposure coping, attitudes toward postexposure reporting, preventive measures, the number of NSIs, and postexposure reporting pre- and post-intervention among nurses. Methods: A total of 429 and 420 nurses participated in the pre- and post-intervention periods, respectively. The intervention was performed from April to September 2007, comprising NSI guideline education, the of containers with enhanced engineering, and the supply of safety devices. Results: The average score of knowledge about bloodborne infectious diseases increased significantly from 8.3 to 8.9 out of 14 points (P<0.001), but the change in score of knowledge about postexposure coping was insignificant. The average score of attitude toward postexposure reporting increased significantly from 8.9 to 9.6 out of 12 points (P <0.001). Preventive measures such as gloves are provided whenever needed (P<0.001), use one-hand technique (P<0.001), and needle containers are provided whenever needed (P=0.031) increased significantly. The number of NSIs decreased by 40.4%, and the postexposure reporting rate increased by 552.8%. Conclusion: The multifaceted NSI prevention program positively affected knowledge about infectious diseases and postexposure coping, attitudes toward postexposure reporting, preventive measures, the number of NSIs, and postexposure reporting after intervention. Therefore, we recommend that this program be applied to various healthcare workers in hospitals.

A Study of Needle Sticks Injuries in a Medical College Hospital in Northern District of Karnataka

Background: Healthcare workers (HCW) are prone for accidental Needle Stick Injuries. Inspite of health education and interventions for prevention, needle stick injuries are still common. Methodology: We reviewed the surveillance data of NSI over a period of 2 years (March 2009 - Feb 2011) to identify the health groups affected, types of needles used, mechanisms of NSI, pattern of post-exposure prophylaxis and the complications. Results: 118 HCW reported the injuries. Among them were 42 (35%) nurses, 22 (19%) nursing interns/ students, Laboratory technicians 21 (18%), Cleaning staff 14 (12%), Medical interns 12 (10%) and Doctors 07 (06%). The devices mainly responsible for Needle Stick Injuries were hollow bore needles (n=90, 78%), solid 16 (17%) and others 4 (5%). Almost all injuries were caused during blood collection procedure and de-capping or re-capping of the needles. Post exposure prophylaxis for HCW's who reported injuries was provided. Subsequent follow up for Human immunodeficiency virus, Hepatitis B virus, Hepatitis C virus was negative except for one health care worker who was positive for Hepatitis B Surface Antigen(HBsAg). Conclusion: Proper education and appropriate waste disposal of the sharps are necessary to prevent Needle stick Injuries.

Effect of Warning Poster on Sharps Containers Use by Nurses

Effect of Warning Poster on Sharps Containers Use by Nurses Injuries caused by needles and sharp objects are among the main causes of blood deadly infections for healthcare providers. One of the effective ways to prevent needle stick injury is proper disposal of the needles and correct use of sharps containers. Despite abundant training given to nurses, different studies show that nurses are still indifferent to this matter. Thus, this study aimed to evaluate the effect of warning poster on the use of sharps containers by nurses working in Milad Hospital, Kashan, Iran, 2012.

English

BACKGROUND: Health care workers (HCWs) are always at greater risk of infection by needlestick injuries (NSIs) owing to their greater handling of sharps in various situations. OBJECTIVE: The main objective was to review the epidemiology of NSIs among HCWs, and describe the circumstances under which these injuries occurred. METHODS: A questionnaire based, cross sectional study was done during the month of January 2008 at 3 Kasturba Medical College (KMC) institutions, Mangalore. The data was computed and analyzed using SPSS statistical package. RESULTS: During the study period 272 HCWs were self administered questionnaire/interviewed and 102 HCWs reported (37.5%) incidents of injuries with needles during the past 12 months. Doctors were the most frequent victims (64.7%), followed by waste disposal staff (25.5%) and Nurses (7.8%). More than 50% of the victims had more than 3 pricks in the last 12 months. Hospital wards and operation theatre were the major locations of needlestick incidents (31.4% each). Most commonly, injuries occurred during suturing (41.1%) and when using solid bore or suturing needle (47.1%). Majority of them neither reported the injury (60.8%) nor received post-exposure prophylaxis (70.6%). Patient tested sero-negative was the major reason for not reporting the injury. Government hospital staff and waste disposal staff had significantly higher chance of NSI when compared to their counterparts. Conclusions: The study re-emphasized the importance of continued educational and prevention programmes for HCWs in the prevention of needle-stick injuries.

Needlestick Injuries in Dentistry

Needlestick injuries and other sharps-related injuries which expose health care professionals to bloodborne pathogens continue to be an important public health concern. Dentists are at increased risk of exposure to bloodborne pathogens, including Hepatitis B, Hepatitis C, and HIV. This article presents comprehensive information on Needlestick injuries (NSI), post exposure prophylaxis, precautions and suggestions for prevention of NSI in dentistry. Dentists should remember and apply many precautions to prevent the broad spectrum of sharps and splash injuries that could occur during the delivery of dental care.

Subcutaneous injections: preventing needlestick injuries in the community

Community nurses provide care to patients in a variety of settings, for example health centres, community hospitals, patients' homes, residential and nursing homes. Administering subcutaneous injections to patients in the community is an everyday activity for many nurses in clinical practice. Many problems related to being 'sharps safe' are common to both community nurses and hospital staff. The majority of subcutaneous injections administered in the community are for patients with diabetes. Reducing needlestick injuries after the administration of subcutaneous injections in the community remains paramount to all NHS staff. This article provides information on what national standards to employ when administrating subcutaneous injections and what safety practices should be undertaken for good sharps management. Staff administering subcutaneous injections in the community need to ensure that they are updated on the latest developments in safety needle devices in order to prevent needlestick injuries and provide safe, effective and individualised care for their patients.