Sharps Injury Prevention Research Articles

Prevention of needle stick and sharp injuries among hospitals in Thailand

Purpose: Epworth HealthCare amalgamated the renal dialysis and day oncology units in 2012 in a purpose built area within a 700 bed acute hospital. Infection Prevention has monitored the patient infection rates and outcomes before and after the amalgamation to understand the impact of co horting the specialties. Methods: The planning to combine the two areas began in 2010 with major research investigation and networking review to identify previous infection related outcomes from similar specialty amalgamations. Nil evidence was identified. Epworth planned and built this model of care around a zoned separation using four chair areas. The remainder of the unit is a shared space including waiting areas, clean and dirty utility rooms, medication and pantry areas. The unit has share staff services for cleaning, food delivery, laundry and waste management. The area consists of twelve dedicated dialysis chairs and twenty oncology chairs with a four chair that can be used for either specialty with in excess of 280 patient attendances per week. All infections are reviewed including bacteraemias and multi resistant organisms using definitions accepted for hospital surveillance to define either community acquired or hospital acquired. The method used is daily pathology results review, daily area rounding and an automated weekly readmission with infection report. There has been twice yearly ad hoc microbiology plating undertaken in the area. Results: The review of all patient infections resulted in none that was attributable to the patient placement in the unit. Prior to the unit amalgamation there were two line related infections identified in twelve months. There was no clinical practice change in the three years. Conclusions: Although we cannot say there is no risk, there is no evidence to date to recommend the cohabitation should not continue.

Sharp Injuries Among Medical Students.

Introduction:Sharp injuries threaten the health of healthcare employees. They cause the transmission of many diseases such as hepatitis B and C, AIDS, etc., which can increase the associated costs associated with them. The aim of this study was to investigate the frequency of sharp injuries among the students of Hormozgan University of Medical Sciences.Method:This cross-sectional study was conducted during 2012-2013 in Hormozgan University of Medical Sciences, IR Iran. The target population consisted of the medical, nursing, midwifery, operating room technician, and medical laboratory students in the 2012-2013 academic year. Census sampling was conducted, and accordingly, 500 students participated in the study Data was collected using modified questionnaire of the University of San Diego’s injury report form. The collected data were entered into SPSS V.19 and analyzed using descriptive statistical tests.Findings:Finally 377 students (75.4%) returned the questionnaire. Among the studied students, 184 students (39.3%) had had sharp injuries. The frequency of damaging Vein puncture was the most common mechanism of injuryDiscussion and Conclusion:The prevalence of sharp injuries is high among students which can increase the risk of disease and its subsequent risks, and thus, increase the cost and stress among students. It seems that holding workshops and increasing students’ awareness and skills to face these risks can be effective in mitigating them.

Sharp truth: health care workers remain at risk of bloodborne infection.

In 2013, new regulations for the prevention of sharps injuries were introduced in the UK. All health care employers are required to provide the safest possible working environment by preventing or controlling the risk of sharps injuries. To analyse data on significant occupational sharps injuries among health care workers in England, Wales and Northern Ireland before the introduction of the 2013 regulations and to assess bloodborne virus seroconversions among health care workers sustaining a blood or body fluid exposure. Analysis of 10 years of information on percutaneous and mucocutaneous exposures to blood or other body fluids from source patients infected with a bloodborne virus, collected in England, Wales and Northern Ireland through routine surveillance of health care workers reported for the period 2002-11. A total of 2947 sharps injuries involving a source patient infected with a bloodborne virus were reported by health care workers. Significant sharps injuries were 67% higher in 2011 compared with 2002. Sharps injuries involving an HIV-, hepatitis B virus- or hepatitis C virus (HCV)-infected source patient increased by 107, 69 and 60%, respectively, between 2002 and 2011. During the study period, 14 health care workers acquired HCV following a sharps injury. Our data show that during a 10-year period prior to the introduction of new regulations in 2013, health care workers were at risk of occupationally acquired bloodborne virus infection. To prevent sharps injuries, health care service employers should adopt safety-engineered devices, institute safe systems of work and promote adherence to standard infection control procedures.

Epidemiology of sharp instruments injuries at a dental school in Sudan

Dental practice represents an occupational hazard for injuries and transmission of serious infections and dental students are generally considered at a higher risk because they undertake exposure prone techniques during their training years. No published literature is available on sharp injuries among dentists in Sudan. The aim of this survey was to describe the epidemiology of sharp instruments injuries in dental students at a dental school in Sudan. An anonymous self-administered questionnaire was used to collect data on prevalence, protective strategies, hepatitis B immunization, health status following injuries and post-exposure prophylaxis. The response rate was 100% and females constituted 89.1% (41) of the sample. Thirty-two (69.6%) students reported being exposed to a sharp instruments injury and most injuries (22, 68.8%) occurred in the conservative dentistry department. The main tools causing injury are the syringe needle (16, 50%) and endodontic file (16, 50%). Endodontic treatment was the principle procedure causing injury (15, 46.9%). Twenty-five (78.1%) of students did not report their injury. None have tested for a blood borne virus after injury. Anxiety and stress was reported by 19 (59.4%) students. Thirty-five (76.1%) students were fully vaccinated against hepatitis B. Seven (15.2%) were aware of full details on standard precautions. Forty-two (91.3%) students practiced needle re-capping. The findings of this survey indicate the need for efficient training of dental students that encourages prevention of sharp injuries; compliance with standard precautions; preclinical HBV testing, immunization and efficacy testing; reporting of injuries and follow-up with provision of PEP.

An evidence based practice approach to sharps injury prevention in primary care

An evidence based practice approach to sharps injury prevention in primary care

Sharps practice in focus.

The EU Sharps Directive on the prevention of sharps injuries in the healthcare sector (see resources ) was incorporated into the national law of all EU member states on May 11 2013.

Prevention of Needlestick and Sharp Injuries Among Hospitals in Thailand: A National Survey

percutaneous exposure to infected blood. According to the CDC, an estimated 385,000 percutaneous injuries occur in HCW annually. Transmission of hepatitis B (HBV), hepatitis C (HCV), or human immunodeficiency virus (HIV) after mucous membrane or nonintact skin exposure to blood has also been reported. PROJECT: Risk of BBP transmission following occupational exposures depends on the HCW’s immune status, source patient factors, and the type of injury and quantity of blood transferred to the HCW. Prevention of transmission requires prompt reporting, expert postexposure assessment, and rapid dispensing of post-exposure prophylaxis medications (PEP). A body substance exposure (BSE) hotline was implemented by our healthcare organization in 1997, staffed by trained nurse specialists with infectious disease physician oversight and standing HIV PEP orders. The hotline is answered 24-7, and procedures are in place at all entities for source patient lab testing, HIV PEP, and employee testing. RESULTS: Six hotline nurse specialists serve the hotline at least 8 weeks per year, taking call for a week at a time. The hotline services 11 inpatient facilities, 3 long-term care facilities, 3 occupational health clinics, 2 physician medical groups, 1 orthopedic surgery center, 1 behavioral health agency, 1 home care agency, external healthcare agencies, and first responders. A total of 4,682 hotline calls have been managed (Figure 1) from 2000 to 2013, and HCW self-reported BSE are collected in an electronic data repository. The annual increase in the number of calls represents an increase in hotline customers. LESSON LEARNED: The BSE hotline provides a regional service to support exposed employees with after-hours expertise avoiding employee visits to the ER. Standardized training, assessment tools, standing orders, protocols, and expert physician guidance provides consistent exposure management for exposed HCW by nurse specialists. The hotline services over 28,000 employees and calls are responded towithin 10 minutes. Specialists provide HIV PEP within two hours of warranted exposures for BBP exposure prevention.

In Reply to: Comments on Behavior of Healthcare Workers After Injuries From Sharp Instruments.

Dear Editor, After the publication of our previous study (1), Alavian submitted a letter which emphasized the importance of postinjury follow-ups (2). Consistent with our previous reports, Alavian has noticed that health care workers are at higher risk of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, through the contact with blood and infected fluids following injuries caused by sharp instruments. In addition to our finding, around 90% of cases enrolled in the study had received hepatitis B vaccination; Alavian enquired why the authors did not present any data regarding the post-vaccination titer of anti-HBs antibody of the enrolled subjects. Though it is important to determine the post-vaccination anti-HBs antibody level (as an important determinant of transmission risk), we did not address this issue in our study and it may be considered as a limitation of our study. Alavian has also referred to another finding in our study that 38.3% of the enrolled subjects had a history of injury from needles and sharp instruments in the last six months. Then, he mentioned higher rates of sharp instrument injuries reported in the literature. Although this is true, the rates of sharp instrument injuries vary among healthcare workers in different countries. For instance, the incidence of sharp instrument injuries varies from 31.4% in Germany to 79% in India (1, 3, 4). Such differences may be related to many factors such as the knowledge and approaches of healthcare works toward this issue, their workloads, and also the performance of the supportive and supervisory systems in establishing and executing the protocols used for prevention of these dangerous injuries. Such differences may also be observed in different healthcare settings. For example in a study by Shokuhi et al. the highest prevalence of sharp instrument injuries was reported among medical residents (5), while in a report published by the world health organization, the highest number of injury per healthcare worker each year was among nurses (6). However, sharp instrument injury reports are underestimated, because of the different reasons such as recall bias, response rate and low rate of reporting (1). We agree with Alavian that it is necessary to educate healthcare workers especially nurses and midwives, because most sharp instrument injuries occurred among this group. However, it seems that some regulatory mandates are needed to be implemented for the prevention of sharp instrument injuries, because as the recent study showed, nurses do not follow the precautions for preventing needlestick injuries unless such regulatory rules and regulations are implemented (7).

Cementing Sharps Safety in the European Union: The Importance of Complying with the 2010 EU Council Directive on Sharps Injury Prevention

The EU Directive on Sharps Injury Prevention in the Healthcare and Hospital Sector (Council Directive 2010/32/EU came into force in all EU member states on 11th May 2013. To ensure its success it is important that all medical and surgical personnel across Europe are aware of, and comply with, the legislation that has come into force as a result. This article discusses the impact that sharps injuries can have on a healthcare worker and their employer, the requirements of the EU Directive, as well as the best practices that healthcare organisations should adopt in order to create a safe working environment for their staff.

Implementing AORN Recommended Practices for Sharps Safety

Prevention of percutaneous sharps injuries in perioperative settings remains a challenge. Occupational transmission of bloodborne pathogens, not only from patients to health care providers but also from health care providers to patients, is a significant concern. Legislation and position statements geared toward ensuring the safety of patients and health care workers have not resulted in significantly reduced sharps injuries in perioperative settings. Awareness and understanding of the types of percutaneous injuries that occur in perioperative settings is fundamental to developing an effective sharps injury prevention program. The AORN “Recommended practices for sharps safety” clearly delineates evidence-based recommendations for sharps injury prevention. Perioperative RNs can lead efforts to change practice for the safety of patients and perioperative team members by promoting the elimination of sharps hazards; the use of engineering, work practice, and administrative controls; and the proper use of personal protective equipment, including double gloving.

PHP10 - Economic Analysis of the Prevention of Medical Sharps Injuries with Safety-Engineered Devices: A Systematic Review

PHP10 - Economic Analysis of the Prevention of Medical Sharps Injuries with Safety-Engineered Devices: A Systematic Review

Implementing a Sharps Injury Reduction Program at a Charity Hospital in India

Health care workers in India are at high risk of developing bloodborne infections from needlestick injuries. Indian hospitals often do not have the resources to invest in safety devices and protective equipment to decrease this risk. In collaboration with hospital staff, the primary author implemented a sharps injury prevention and biomedical waste program at an urban 60-bed charity hospital in northern India. The program aligned with hospital organizational objectives and was designed to be low-cost and sustainable. Occupational health nurses working in international settings or with international workers should be aware of employee and employer knowledge and commitment to occupational health and safety.

Epidemiology and risk factors of needle stick injuries

Epidemiology and risk factors of needle stick injuries

P311: A cross-sectional survey on the incidence of sharps injuries among healthcare workers at 26 hospitals in China

Sharp injuries (SIs) among healthcare workers (HCWs) are an under-recognized problem in China. Prevention of SIs is particularly challenging, in part due to a dearth of information regarding SIs incidence in China.

New recommendations for diabetes injection safety

British Journal of Healthcare ManagementVol. 19, No. Sup1 Policy and GuidanceNew recommendations for diabetes injection safetyKenneth StraussKenneth StraussSearch for more papers by this authorKenneth StraussPublished Online:16 Aug 2013https://doi.org/10.12968/bjhc.2013.19.Sup1.3AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Costigliola V, Frid A, Letondeur C, Strauss K (2012) Needlestick injuries in European nurses in diabetes. Diabetes Metab 38(Supp.1): S9–14 Crossref, Google ScholarEU Commission for Employment, Social Affairs and Inclusion (2010) New legislation to reduce injuries for 3.5 million healthcare workers in Europe. Available at: www.saferneedles.org.uk/news/pdf_articles/Directive_press_statement.pdf (accessed 20 December 2012) Google ScholarEuropean Biosafety Network (2012) Prevention of sharps injuries in the hospital and healthcare sector. Implementation guidance for the EU Framework Agreement, council directive and associated national legislation. Available at: www.europeanbiosafetynetwork.eu/EU%20Sharps%20Injuries%20Implementation%20Guidance.pdf (accessed 20 December 2012) Google ScholarFIT4Safety (2012) Injection Safety in UK and Ireland; Safety of Sharps in Diabetes Recommendations. 1st edn. Available at: www.fit4diabetes.com/files/1413/4727/6994/BD4224_FIT_Safety_STG07_AW2_PP.pdf (accessed 20 December 2012) Google ScholarHealth and Safety Executive (2010) Management and prevention of sharps injuries: Inspection of NHS Trusts 2010/2011 by Occupational Health Inspectors. Available at: www.hse.gov.uk/foi/internalops/sectors/public/071001.htm (accessed 20 December 2012) Google ScholarMondy K, Overton ET, Grubb J, Tong S, Seyfried W. Powderly W, Yarasheski K (2007) Metabolic syndrome in HIV-infected patients from an urban, Midwestern US outpatient population. Clin Infect Dis 44: 726–34 Crossref, Google ScholarOfficial Journal of the European Union (2010a) Council Directive 2010/32/EU. Available at: http://europeanbiosafetynetwork.eu/OJEU.pdf (accessed 20 December 2012) Google ScholarOfficial Journal of the European Union (2010b) Council Directive 2010/32/EU. L134/71. Available at: http://europeanbiosafetynetwork.eu/OJEU.pdf (accessed 20 December 2012) Google Scholar Perry J, Parker G, Jagger J (2007) EPINet Report: 2004 Percutaneous Injury Rate. International Healthcare Worker Safety Center, Virginia. Available at: http://healthsytem.virginia.edu/internet/safetycenter/ (accessed 20 December 2012) Google ScholarPHASE study group (2003) Rischio biologico e punture accidentali negli operatori sanitari. Series Lauri Edizioni, Milano 2001 and 2003 Google ScholarSafer Needle Network (2003) Memorandum submitted by the Safer Needle Network to the Select Committee on Public Accounts. Available at: www.publications.parliament.uk/pa/cm200203/cmselect/cmpubacc/704/3051214.htm (accessed 20 December 2012) Google ScholarStrauss K (2012) WISE (Workshop on Injection Safety in Endocrinology) New Injection Recommendations. Diabetes Metab 38(Supp.1): S1 Crossref, Google ScholarYazdanpanah Y, DeCarli G, Migueres B et al. (2005) Risk factors for hepatitis C virus transmission to health care workers after occupational exposure: a European case-control study. Clin Infect Dis 41: 1423–30 Crossref, Google Scholar FiguresReferencesRelatedDetails 1 January 2013Volume 19Issue Sup1ISSN (print): 1358-0574ISSN (online): 1759-7382 Metrics History Published online 16 August 2013 Published in print 1 January 2013 Information© MA Healthcare LimitedPDF download

Remembering the importance of preventing blood‐borne infections in the critical care setting

Remembering the importance of preventing blood‐borne infections in the critical care setting

FIT4Safety: recommendations in the diabetes care setting

Sharps injuries pose a serious threat to health professionals, patients, and downstream workers. FIT4Safety is an initiative that seeks to promote safety and best practice in the diabetes setting. An Introduction to FIT4Safety and its Recommendations for the Safety of Sharps in the Diabetes Care Setting explains how and why the FIT4Safety initiative was formed, what it aims to achieve, and the importance of ensuring safety in the diabetes care setting. Outputs from FIT4Safety include Injection Safety in UK and Ireland: Safety of Sharps in Diabetes Recommendations. These recommendations were developed to provide a resource for all those directly involved in, or overseeing, diabetes care. The main topics and guidance detailed within the recommendations are discussed, as well as EU Directive 2010/32 on sharps injury prevention and the UK's Health and Safety (Sharp Instruments in Healthcare) Regulations 2013.

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.

Chinks in the armor: Percutaneous injuries from hollow bore safety-engineered sharps devices

Despite their overwhelming efficacy, safety-engineered sharp devices (SESDs) cause a residual fraction of injuries. Although the fraction of injuries from SESDs is less than that reported for nonsafety devices, it remains a "preventable fraction" and is a sizable target for further advances. A retrospective review of 3,297 percutaneous injuries from hollow bore safety-engineered devices occurring between 2001 and 2009 was conducted examining the Exposure Prevention Information Network (EPINet) needlestick surveillance data. Nurses sustain 64.6% of all SESD injuries. 42.9% Of SESD injuries occur after device use and are likely preventable through consistent and effective use of safety-engineered technology. Excluding injuries that occurred during device use or between procedural steps, 71.8% (n/N = 28/39) of physician injuries, 58.2% (n/N = 645/1,109) of injuries to nurses, and 45.8% (n/N = 88/192) of injuries to phlebotomists occurred when an available SESD was not fully activated. Passive devices that do not require action on the part of the end user to engage a safety feature currently represent a small portion of the SESD market. Wider dissemination of a broader array of passive SESDs coupled with continual education of end users is essential to an effective sharps injury prevention program.

Caring hands on harm's way: sharp injuries in hospital settings in United Arab Emirates

BackgroundSharp injuries predispose health care workers (HCWs) to serious infectious diseases. Data is lacking regarding sharp injuries among doctors and nurses working in trauma and surgical units in the United...