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PubMed2001

New needlestick law means take steps now.

To comply with requirements from the Occupational Safety and Health Administration and a new federal law, you'll need to take steps to prevent and track needlestick injuries: The Needlestick Safety and Prevention Act requires you to keep a sharps injury log listing where and how the injury occurred, and the type and brand of device used. Review data to spot trends in needlestick injuries caused by equipment design flaws and behavior patterns. ED staff must be trained annually in needlestick injury prevention, including proper disposal of sharps, universal precautions, and what to do if a needlestick occurs. To enforce universal precautions, give staff verbal and written warnings and role-model appropriate behavior.

Emergency Service, Hospital↗
PubMedDate not supplied

[Analysis of needle stick injuries at a university hospital: situations of occurrence and trends].

Needlestick injuries remain the major source of risk of acquiring bloodborne diseases (AIDS, hepatitis B and C). Therefore, it is a priority discussing strategies of intervention based in sources of risk. The purpose of this study was to analyze needlestick injuries occurred at a university hospital. A data base construction made possible to identify the situations in which those accidents occur and standards of tendencies along the years. The data pointed out that the majority of needlestick injuries occurred while performing or assisting procedures. The introduction of the first prevention measures (universal precautions) reduced the total number of needlestick injuries. However, changes in needlestick-injury rates related to the recapping were not observed. Authors discussed the use of different prevention strategies: introduction of safety devices, changing the training focus, and the reorganization of the work environment and work practices.

Accidents, Occupational↗
PubMed2005

Creation of a safety culture: reducing workplace injuries in a rural hospital setting.

A newly organized employee safety program, with an 11-step design, has been introduced at Valley General Hospital in Monroe, Washington, with the intention of changing the "culture of safety." A 1-year report of the results indicates that the overall incidence of injury claims, lost-time injuries, and needlestick injuries were reduced after the program was implemented and timely reporting of claims within 24 hours was increased. The hypothesis, that by creating more visibility for the employee safety program a decrease in injury rates would occur, was confirmed.

Absenteeism↗
PubMed2002

Reducing sharps injuries among health care workers: a sharps container quality improvement project.

BACKGROUND: Many needlestick injuries at Vanderbilt University Medical Center were found to be related to the method of disposal in sharps containers. The "straight-drop" system allowed staff to stuff more needles into a full box, resulting in needlestick injuries. This was also a common problem elsewhere, as reflected in the literature. ANALYZING THE PROBLEM: A multidisciplinary committee reviewed other sharps containers, piloted one, found problems, and then piloted and selected another. Implementation was complex and difficult, but focus was kept on the goal of decreased needlestick injuries. Staff identified other problems, which were taken to the manufacturer of the sharps container selected and resulted in product design changes. RESULTS: Several months after implementation, data analysis showed that the needlestick injury rate was reduced by two-thirds, a statistically significant change (p = 0.002). Despite the increased cost of the sharps container, savings of prevented needlestick injuries represented a total cost savings to the medical center of more than $62,000 a year. DISCUSSION: This experience is an example of real-life implementation--and the problems institutions may have to overcome before success can be realized.

Cross Infection↗
PubMed2002

Are we getting the point? Needlestick injuries-an ongoing problem.

The pattern of glove perforation using hollow needles is unknown and the incidence, using sensitive electronic methods has not been described. We wished to identify the glove perforation rate following the use of hollow needles in our Emergency Department. Two hundred and eighty-nine gloves were collected over three months. These gloves were electronically tested and compared with one hundred unused control gloves. There were 28/298 perforations (9.7%) vs 1/100 in the control group (P<0.01 Fisher's exact probability). Most perforations were located on the thumb and index fingers. There were no needlestick injuries reported during this period. The glove perforation rate following hollow needle use in our Emergency Department is higher than previously reported. The pattern of perforation suggests injury by the needle held in the dominant hand.

Biopsy↗
PubMed1995

Efficacy and cost-effectiveness of a needleless intravenous access system.

BACKGROUND: Needlestick injury has been identified as a major cause of exposure to blood and body fluids. The heparin-lock intermittent intravenous procedure was implicated in the largest number of needlestick-related exposures (26%) at this 1100-bed tertiary care hospital, and replacement of this system was imperative. Cost concerns, however, necessitated that replacement products not increase overall hospital costs. METHODS: A needleless intravenous access system (Interlink i.v. Access System; Baxter Healthcare Corp., Parenterals Division, Deerfield, Ill.) was introduced. Effectiveness and cost-benefit of this system were analyzed by comparing needlestick injuries and their associated costs, as well as costs of relevant products and procedures, for the year before introduction of the new product with those for 1 year after implementation of the new system. RESULTS: During the study period, the needleless access system was 78.7% effective in reducing intravenous line-related needlestick injuries. There was an overall reduction of 43.4% in total needlestick injuries from all procedures and events. The incremental cost to this hospital ranged from a 5.3% additional cost to a 5.7% savings, without even considering the less quantifiable benefits associated with avoidance of needlestick injury, time saved by using this product, and decreased infection rate. CONCLUSION: When used as intended, this system was extremely effective in reducing intravenous line-related needlestick injuries, and the system does pay for itself.

Cost-Benefit Analysis↗
PubMed1991

Occupational exposure to HIV: frequency and rates of underreporting of percutaneous and mucocutaneous exposures by medical housestaff.

PURPOSE: To study the frequency of work-related exposures to human immunodeficiency virus (HIV)-infected blood and reporting of exposures among medical housestaff. SETTINGS: Three teaching hospitals where HIV infection is prevalent among patients. SUBJECTS: Internal medicine interns and residents in training in 1988-1989. METHODS: In a cross-sectional survey, house officers were asked to complete anonymously a questionnaire reviewing their past percutaneous and mucocutaneous exposure to blood products. RESULTS: Nineteen percent of the respondents (16 of 86) recalled accidental exposure to HIV-infected blood, and 36% (31 of 86) recalled exposure to blood from patients at high risk for having HIV infection. Of the exposures recalled in the 12 months prior to the survey, 81% (47 of 58) of all needlestick injuries and all (nine of nine) needlestick injuries from HIV-infected blood occurred in postgraduate year 1 or 2 trainees. Only 30% (31 of 103) of the needlestick injuries recalled by subjects were reported. The principal reasons for not reporting were time constraints, perception that the percutaneous injury did not represent a significant exposure, lack of knowledge about the reporting mechanism, and concern about confidentiality and professional discrimination. CONCLUSIONS: Medical housestaff are at substantial risk for occupational infection with HIV. A large proportion of internal medicine housestaff recall accidental exposure to blood during medical school and residency, and the majority of exposures were not reported. Hospitals may be able to increase rates of reporting of percutaneous exposures to HIV by developing programs that are easy to access, efficient, and strictly confidential.

Adult↗
PubMed1993

The use of needles in the practice of anesthesiology and the effect of a needleless intravenous administration system.

Anesthesia personnel are at risk for occupationally acquired blood-borne infections transmitted through needlestick injuries. To formulate strategies for the prevention of needlestick injuries, it is necessary to identify the types of needles used by anesthesia personnel and the devices associated with injuries. The introduction of a needleless intravenous (i.v.) administration system provided an opportunity to assess its effect on needle usage in the practice of anesthesiology. The contents of needle disposal containers placed in the preoperative holding area and five operating rooms before (control) and after the introduction of a needleless administration system (study) were categorized by needle type. The information on needles used by anesthesia personnel was compared with that on needles purchased for the entire hospital. During the control period, most of the needles used were 18-23-gauge hollow needles (51.6%), i.c. catheter stylets (23%), and 25-26-gauge small-bore hollow needles (17.1%). There was no difference in the total number of needles collected after the introduction of the needleless administration system, but there was an increase in capped 18-23-gauge hollow needles. Anesthesia personnel used a relatively greater number of small-bore hollow needles (25-26 gauge), i.v. catheters, and spinal and epidural needles, but fewer hollow needles (18-23 gauge) than were purchased for hospital-wide use. Small-bore hollow needles (25-26 gauge) were responsible for 31.6% of the 19 needlestick injuries reported by anesthesia personnel to the Employee Health Service.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesiology↗
PubMed2001

Mechanical and pathologic consequences of induced concentric anular tears in an ovine model.

STUDY DESIGN: Relations between induced concentric tears in the sheep disc and the mechanics of the intervertebral joint and vertebral body bone were analyzed. OBJECTIVE: To examine the effect of concentric disc tears on the mechanics of the spine. SUMMARY OF BACKGROUND DATA: Degeneration of the intervertebral disc results in changes to the mechanics and morphology of the spine, but the effect of concentric disc tears is unknown. METHODS: In this study, 48 merino wethers were subjected to surgery, and discs were randomly selected for either a needlestick injury or induction of a concentric tear in the anterior and left anterolateral anulus. Sheep were randomly assigned to groups for killing at 0, 1, 3, 6, 12, and 18 months. From each sheep, two spine segments were mechanically tested: one with a needlestick injury and one with a concentric tear. Macroscopic disc morphology was assessed by three axial slices of the disc. Sagittal bone slices were taken from cranial and caudal vertebral bodies for histologic analysis. RESULTS: Induced concentric tears decrease the stiffness of intact spine segments in left bending and the disc alone in flexion. In all other mechanical tests, the needlestick injury had the same effect as the induced concentric tear. In the isolated disc, the disc stiffness at 6 months was increased for right bending, as compared with the response at 1 month. This was associated with increased anterior lamellar thickening and increased vertebral body bone volume fraction. CONCLUSIONS: Concentric tears and needlestick injury in the anterior anulus lead to mechanical changes in the disc and both anular lamellar thickness and vertebral body bone volume fraction. A needlestick injury through the anulus parallel to the lamellae produces progressive damage.

Animals↗
PubMed1993

Evaluation and implementation of a needleless intravenous system: making needlesticks a needless problem.

A needleless intravenous (IV) system with blunt plastic cannulas and specially designed injection sites was introduced at Olive View Medical Center to reduce needlestick injuries, particularly IV-related needlesticks. IV-related needlestick injuries decreased 72% during the first 8 months of use, costs were reduced $1.85 for a typical IV piggyback administration set-up by revising the IV piggyback procedure, and a staff survey revealed satisfaction with the new system.

California↗
PubMed1993

A study of needle stick injuries among medical undergraduates.

A study was conducted to determine the incidence and causes of needlestick injuries among 158 medical undergraduates who had completed their first clinical year. A response rate of 97.5% (154 out of 158 students) was obtained, of which 54 students (35.1%) reported at least one needlestick injury. The commonest cause of injury was during the process of venepuncture (27%), followed by uncapping of needles (22.2%) and recapping of used needles (19.8%). The highest incidence of injury occurred during a medical posting (33/154 students), followed by surgical posting (14/154 students) and elementary clinics (9/154 students). Formal training on handling of used needles was reported by only 15-23% of the students in the various postings. The awareness of risk of contracting diseases from needlestick injuries was high (84.4%).

Bloodletting↗
PubMedDate not supplied

[Accidental pricking by a needle in a third-level hospital: associated factors].

The needlestick injuries are the most frequent accidents among hospital staff. The aim of this study is to identify some factors associated with accidents caused by needlestick injuries at hospitals, so as to measure the risk that they present. A case-control study has been made, the subject of which is the nurses working at "Reina Sofía" Hospital in Córdoba and within the period June 30, 1990 and June 30, 1991. A more significant factor in relation to needlestick injuries was the recapping of the needle after being used. The risk of injury being 3.95, 7.68 an 17.85 times higher between those who recapped sometimes, frequently and always, respectively, versus those who had never recapped needles. Professional experiences resulted in being a protector factor against the needlestick injuries (OR = 0.93; 95% CI = 0.89; 0.97;) it's estimated that the risk injuring is less than half among personnel having ten years of experience. Knowing these risk factors is important for the development of specific prevention programs. Nevertheless, it is still important to identify other risk factors.

Accidents, Occupational↗