Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Needlestick Injuries”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 361 records · Page 20Linked to original sources
PubMedDate not supplied

Legal aspects of infusion practice: trends and issues.

Inserting intravenous catheter lines, giving injections, handling and discarding sharps, and assisting with sterile procedures.these, and many other high-risk procedures are an ordinary part of the daily practice regimen for many nurses, especially those specializing in infusion therapy. In addition, nurses engaged in an infusion practice are subject to exposure to bloodborne diseases that can prove to be career-ending and fatal. Despite the frequency with which these high-risk procedures are performed, developing case law reveals the perils associated with these activities. Courts around the country have dealt with a number of issues that may be of interest to nurses who start IV catheters, give injections, handle and discard sharps, and assist with sterile procedures. In addition, a growing number of cases are focusing on the rights and responsibilities of healthcare professionals and patients who have been exposed to blood and blood products. This article will explore a number of those issues: the distinction that courts make between nonclinicians and professionals who suffer needlestick injuries or who are exposed to blood and blood products; the intersection between needlestick injuries and exposure to blood and blood products and the worker's compensation system; product liability causes of action; and emotional distress causes of action filed by healthcare professionals and others. It is hoped that this information will be instructive, and that the issues discussed herein will be considered when practice expectations are identified. If that happens, the clinical environment can be safer for nurses and patients.

Blood-Borne Pathogens↗
PubMed1992

Compliance with a nonrecapping needle policy.

Compliance with nonrecapping needle policies is poor. Accidental needlestick injuries account for up to 80% of reported occupational needle exposures, and 45% of needlestick injuries occur at recapping. To determine the degree of compliance with in-house nonrecapping and needle disposal policies, the authors undertook an unannounced survey of needles disposed in designated sharps disposal containers and, via a questionnaire, surveyed attitudes to policies. The results show between 46 and 77% of needles were being recapped with 9 to 20% of bloodstained needles recapped before disposal. Recapping devices were rarely used and two-handed recapping techniques predominated. Highest rates of recapping were seen in intensive care, intermediate care and medical care units. Common reasons for recapping include inability to dispose immediately of needles properly, and sharps containers being too far away. Awareness of the risks of recapping was widespread with over 90% of respondents having been instructed in proper needle disposal techniques. While few health care professionals disagreed with non-recapping and needle disposal policies, many--for various reasons--persist in hazardous needle disposal practices.

Health Knowledge, Attitudes, Practice↗
PubMed2001

Occupational exposure of interns to blood in an area of high HIV seroprevalence.

OBJECTIVE: To determine the epidemiology of work-related exposure to blood among interns. DESIGN: Interns were invited to complete anonymously a questionnaire concerning their past percutaneous and mucocutaneous exposures to blood. SETTING: Chris Hani Baragwanath Hospital, Soweto, and Johannesburg Hospital, Gauteng, where HIV infection is common among patients. RESULTS: Ninety-eight interns (96%) were surveyed. Sixty-nine per cent of interns reported one or more percutaneous exposures to blood during the intern year, and 33% of interns recalled accidental percutaneous exposure to HIV-infected blood. Forty-five per cent recalled a mucocutaneous exposure to HIV-positive blood. Only 28 (64%) of 44 percutaneous injuries from HIV-infected patients were reported. During their student clinical training, 56% of interns had suffered a penetrating injury, and 18% recollected needlestick injuries involving HIV-infected patients. The most common mechanisms of injury included unexpected patient movement (23%), needle recapping (17%), and withdrawal of the needle (17%). Half of the injuries occurred during the first 4 months of internship. Only 22% of intern percutaneous exposures could have been avoided by following universal precautions. CONCLUSIONS: Intern and medical student exposure to blood is extremely common, but is markedly underreported. Strict compliance with universal precautions will not prevent the majority of exposures. Priorities should be the introduction of safer techniques and equipment, skills training and methods of reporting blood exposures.

Attitude of Health Personnel↗
PubMed2003

A survey of doctors' and nurses' knowledge, attitudes and compliance with infection control guidelines in Birmingham teaching hospitals.

This study investigated knowledge about infection control amongst doctors and nurses through a cross-sectional survey conducted between March and May 2001 in three Birmingham, UK teaching hospitals. Seventy-five doctors and 143 nurses, representing 7% and 4%, respectively, of potential respondents, participated in the study measuring knowledge of, attitudes towards, and compliance with universal precautions. Overall knowledge of risks of blood-borne virus (BBV) transmission from an infected patient after needlestick injury was low [44.0% for hepatitis B virus (HBV), 38.1% for hepatitis C virus (HCV), 54.6% for human immunodeficiency virus (HIV)]. There were significant differences between doctors and nurses concerning the estimations of HBV (e-antigen +) (P=0.006) and HIV (P<0.001) transmission risks. Eighty-six percent of nurses stated that they treat each patient as if they are carrying a BBV compared with 41% of doctors. Doctors and nurses differed significantly in their attitudes about and reported compliance with washing hands before and after patient contact and with wearing gloves when taking blood (P<0.001 for all). Doctors consistently de-emphasized the importance of, and reported poor compliance with, these procedures. Doctors were also more likely to state that they re-sheath used needles manually than were nurses (P<0.001). Thirty-seven percent of respondents reported that they had suffered a needlestick injury with a used needle, with doctors more likely to be injured than nurses (P=0.005). Twenty-eight percent of these doctors and 2% of the nurses did not report their needlestick injuries (P=0.004). Education, monitoring, improved availability of resources, and disciplinary measures for poor compliance are necessary to improve infection control in hospitals, especially amongst doctors.

Adult↗
PubMed1994

Prevention of occupational transmission of human immunodeficiency virus and hepatitis B virus among anesthesiologists: a survey of anesthesiology practice.

In light of the increasing prevalence of the human immunodeficiency virus (HIV) and hepatitis B virus (HBV), anesthesiologists are now likely to see more patients who are at high risk for these viruses. Therefore, it is important that they adopt infection control policies aimed at preventing occupational transmission of these and other pathogens during their clinical practice. This study was designed, using a questionnaire format, to evaluate anesthesiologist compliance with Centers for Disease Control (CDC) guidelines for the prevention of occupational transmission of HIV and HBV. A total of 1149 questionnaires were mailed to anesthesiologists randomly selected from the members' directory of the American Society of Anesthesiologists (ASA). Of these, 493 (44%) were completed and returned. Eighty-eight percent of respondents reported that they always complied with CDC guidelines when presented with an HIV-infected patient, but only 24.7% adhered to the guidelines when the patient was considered low risk (P < 0.01). This trend was also reflected in the use of gloves and other protective wear in the perioperative period. Although 70% of respondents indicated that they recapped needles on a regular basis, this practice was not associated with an increased incidence of needlestick injuries. However, anesthesiologists who reported recapping needles using the one-handed technique were less likely to sustain a needlestick injury than those who recapped using the two-handed technique. Thirty-one percent and 72% of respondents respectively reported a clean or contaminated needlestick within the preceeding 12 mo. Only 45.4% of those receiving a contaminated needlestick sought treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesiology↗
PubMed1993

Fighting the needlestick battle without needles.

Institutions may face heavy fines by 1997 for not providing employees with safe sharps devices to prevent the spread of bloodborne pathogens to health care workers. One hospital decided to eliminate IVPB needles, which are responsible for the majority of needlestick injuries nationwide. To achieve this goal, medical-surgical nurses evaluated safe IVPB systems and chose one that decreased their needlestick injury rate by 68.6%.

Accidents, Occupational↗
PubMed1994

Application of cost-effectiveness methodology to the consideration of needlestick-prevention technology.

Data from the study of needlestick-prevention devices in 10 New York State hospitals enabled application of cost-effectiveness analysis techniques for determining relative benefits of various safety interventions. This article introduces to infection control practitioners several economic concepts related to cost-effectiveness methodology and provides two examples of how they may be applied for decision-making purposes. A critical aspect of the analysis described is the determination of a base cost of needlestick injury. By applying decision analysis to experience-based data aggregated from participating institutions, base expected cost of needlestick injury was determined to be $363.

Cost-Benefit Analysis↗
PubMed2004

Complying with the Occupational Safety and Health Administration's Bloodborne Pathogens Standard: implementing needleless systems and intravenous safety devices.

Preventing the transmission of bloodborne pathogens to healthcare workers has been a mission and a challenge of the healthcare industry for over 20 years. The development of the Occupational Safety and Health Administration Bloodborne Pathogens Standard in 1991 and the passing of the Needlestick Safety Act in 2000 mandated hospitals to develop an Exposure Control Plan to protect workers from these pathogens. Children's Hospital Boston began implementation of a needleless system in 1993. Employees readily accepted these systems into practice, because they were convenient and easy to use. A marked decrease in exposures to bloodborne pathogens naturally followed, which is consistent with the national data. The transition to intravenous (i.v.) safety devices at Children's Hospital began in 2000 and proved to be more of a challenge. First, the clinicians must choose a safety product, which requires developing and implementing a trial plan with potential catheters. This selection process is especially difficult in pediatrics where successful placement of the smallest-gauge catheter, no. 24, is imperative. After choosing an i.v. safety product, successful transition is dependent upon the thoroughness of i.v. safety device training and a commitment by the clinicians to the use of these products. Although the number of needlestick injuries and subsequent transmission of bloodborne pathogens have been further reduced with the use of i.v. safety devices, needlestick injuries still occur. This results from a lack of familiarity with the engineering of the device and therefore poor technique or a failure to activate the safety mechanism. Staff resistance due to loss of expertise with the new device and patient care concerns are additional barriers to the use of these new products. Addressing these obstacles and providing adequate training for all clinicians were required for successful implementation of these i.v. safety devices.

Attitude of Health Personnel↗
PubMed1993

Risk factors for hepatitis C virus infection among health care personnel in a community hospital.

OBJECTIVE: To determine the prevalence of and risk factors for antibody to the hepatitis C virus in hospital employees. METHODS: Retrospective testing of serum samples obtained from 1677 hospital employees during a prehepatitis B vaccination program in a private teaching community hospital. RESULTS: Twenty-three employees (1.4%) were found to have antibody to hepatitis C virus. The prevalence of antibody to hepatitis C virus was higher in blacks (3.4%) than in whites (1.1%, p = 0.03) and Hispanics (2.6%, p = 0.88). In a logistic regression model, factors significantly associated with antibody to hepatitis C virus seropositivity included antibody to hepatitis B core antigen (p = 0.002), a history of blood transfusion (p = 0.03), and needlestick injuries (p = 0.04). CONCLUSION: Although the prevalence of antibody to hepatitis C virus in health care workers was not high, needlestick injuries were associated with an increased risk for acquiring hepatitis C virus infection.

California↗
PubMed1999

Scleral perforation during retrobulbar and peribulbar anesthesia: risk factors and outcome in 50,000 consecutive injections.

PURPOSE: To measure the frequency of scleral perforation and identify related risk factors during local anesthetic injection for intraocular surgery. SETTING: Multispecialty eye hospital. METHODS: All patients (n = 50,000) having retrobulbar (26,857) or peribulbar (23,143) injections at the King Khaled Eye Specialist Hospital were reviewed. Cases of scleral perforation were analyzed for potential technical and ophthalmic risk factors, management of injuries, and visual and anatomic outcomes. Mean follow-up was 14.4 months (range 8 to 24 months). RESULTS: Seven (0.014%) needlestick injuries were identified, all of which had posterior staphyloma as the only identifiable risk factor. Applying a previously measured prevalence of 10.7% for posterior staphyloma in our surgery patients gave a scleral perforation rate of 0.13% (7 of 5350) for staphylomatous eyes. All perforated globes had originally planned cataract extraction within 8 weeks of injury. Additional management consisted of observation (2 cases), cryotherapy (2 cases), and vitreoretinal procedures for retinal detachment (3 cases) and subretinal hemorrhage (1 case). At last follow-up, all retinas were attached and 3 cases (42.8%) had a visual acuity of worse than 20/160. Both cases requiring multiple retinal detachment surgeries developed proliferative vitreoretinopathy and poor visual acuity. CONCLUSIONS: Eyes with posterior staphyloma sustained needlestick injuries at a rate of 1 in 760 compared with 0 injection perforations in more than 44,000 nonstaphylomatous eyes.

Adult↗
PubMed2005

Needlestick and sharps injuries among nursing students.

AIMS: This paper reports the first investigation of the prevalence and nature of needlestick injuries among Australian nursing students. BACKGROUND: Needlestick and sharps injuries are the most efficient method of transmitting blood-borne pathogens between patients and healthcare staff. Although nurses are known to be a high-risk subgroup for these events, nursing students may be at even greater risk due to their limited clinical experience. Despite this fact, the epidemiology of needlestick and sharps injuries among nursing students has not been clearly elucidated in Australia. METHODS: A questionnaire-based methodology adapted from other international investigations was conducted among nursing students. We recruited a complete cross-section of students from a large university nursing school in North Queensland, Australia, in March 2004, and analysed needlestick and sharps events as a percentage of all students and also as a proportion of all cases. Risk factors were evaluated using logistic regression. RESULTS: From a group of 319 students, 274 successfully completed questionnaires were obtained (overall response rate 85.9%). A total of 38 students (13.9%) reported a needlestick or sharps injury during the previous 12 months. By causative item, 6.2% of students had been injured by a normal hollow-bore syringe needle, 3.6% by a glass item and 3.3% by an insulin syringe needle. Regarding prior usage, 81.6% of all injuring items were unused, 15.8% had been used on a patient and the status of 2.6% was unknown. Most needlestick injuries occurred either in the nursing laboratory (45%) or the teaching hospital (37%). Opening the needle cap was the most common causative event (28% of all cases). A total of 39.5% of needlestick injuries were not reported. The main reason for non-reporting was that the item was unused (42%). Logistic regression analysis revealed that students in the third year were 14.8 times more likely to have experienced a needlestick injury than their counterparts in other years (odds ratio 14.8, 95% confidence interval 5.2-50.3, P < 0.01). These injury rates were higher among Australian nursing students than in other international studies. CONCLUSIONS: Although hepatitis B vaccination coverage among the students was excellent, it is important that the principles of infection-control training and reporting of all needlestick and sharps continue to be emphasized throughout undergraduate nursing education.

Adult↗
PubMed1996

Influence of blunt needles on surgical glove perforation and safety for the surgeon.

BACKGROUND: Round-tipped blunt needle (BN) may decrease the risk of needlestick injuries and hand contamination. We prospectively determined the incidence of glove perforations in emergency abdominal procedures and the efficacy of BN in increasing the safety for surgeons. METHODS: Two hundred patients were randomized to undergo closure of the abdominal fascia using sharp needle (SN) or BN. Gloves were tested at the end of the procedure. RESULTS: Surgeons had 14 needlestick injuries and 76 perforations recorded in 69 pair of gloves. Sharp needles were responsible for all injuries and 58 (76%) perforations (P < 0.00004 and P < 0.00001, respectively). This difference was still higher when considering the perforations related to the abdominal fascia closure (BN 7% versus SN 50%; P < 0.0006). CONCLUSION: The risk of glove perforation is sevenfold greater if SN are used. Blunt needles reduce sharp injuries and improve safety for surgeons.

Accidents, Occupational↗
PubMed1999

Needleless intravenous systems: A review.

BACKGROUND: Needleless intravenous devices have now been implemented by many institutions worldwide. A rationale for their use has been a reduction in the number of needlestick injuries. OBJECTIVE: The aim of this review is to outline the possible benefits and dangers of needleless intravenous systems. REVIEW: Many early reports demonstrate a reduction in needlestick injuries after the implementation of a needleless intravenous device; however, not all such reductions are directly attributable to the device itself. Furthermore, good evidence suggests that needlestick accidents prevented by needleless intravenous devices pose little threat to health care workers. Finally, increasing reports associate bacteremias with the use of needleless intravenous devices. Early reports described devices used in the home care setting; however, recent reports are from acute health care settings, including intensive care units. CONCLUSION: Ongoing critical review of the benefits, risks, and costs of needleless intravenous devices is required.

Bacteremia↗
PubMedDate not supplied

Exposure to blood or body fluids: management for health care.

Health care workers are at risk of exposure to blood and body fluids from their patients through needlestick injuries or contamination of mucous membranes - a slash of blood in the eye, for example. Exposure to blood /body fluids is now the second biggest cause of occupational injury among NHS workers (UNISON, 2003). The first example of a case of occupational exposure of a health care worker to human immunodeficiency virus (HIV) and subsequent seroconversion following a needlestick injury was reported in the 1980s. This incident raised awareness of the risk that health care workers face when they are exposed to blood-borne viruses, in particular hepatitis B, hepatitis C and HIV.

Body Fluids↗
PubMed1992

Phlebotomy practices/needles stick injuries/hepatitis B status/among interns in a Dublin hospital.

Needlestick injury is the most important risk event for human immunodeficiency virus (HIV) and hepatitis B Virus (HBV) transmission to health-care workers. We examined phlebotomy practices, the frequency of needle stick injuries, the reporting of such injuries and hepatitis B status among interns in St James's Hospital during a six month period. This study took the form of a questionnaire. The response rate was 100%. 72% had at least one needlestick injury during this time period, 23% had injuries from known HIV sero-positive or hepatitis B surface antigen positive patients, less than 5% of all injuries were reported and only 41% of interns were definitely hepatitis B immune. The majority (77%) resheated needles by hand.

Accidents, Occupational↗
PubMedDate not supplied

Reducing risks of infection during vascular access.

The insertion of an intravascular (i.v.) access device is a complicated, multistep procedure, posing risks of infection to both the patient and the healthcare worker. Patients are at risk for local or systemic bloodstream infections, and healthcare workers are at risk for occupationally acquired bloodborne pathogen infections from accidental needlestick injuries. This article summarizes the risks of i.v. device-related infectious complications in patients and highlights recommendations from the Centers for Disease Control and Prevention to reduce these risks. In addition, recent research data are presented on the risks of occupationally acquired bloodborne pathogen infections from accidental needlestick injuries from vascular access, the specific devices causing these injuries, strategies to reduce these risks, medical follow-up when injury does occur, and methods for conducting product evaluations.

Catheterization, Peripheral↗
PubMedDate not supplied

A review of needle-protective devices to prevent sharps injuries.

The risk of occupational transmission of blood-borne pathogens via sharp devices remains a significant hazard to both healthcare and ancillary workers. Previously, education, training, universal precautions and hepatitis B vaccination have been implemented in an attempt to reduce the risk. However, the most recent preventive strategy is needle-protective devices. These have been developed from conventional products but incorporate a safety mechanism that, when activated, covers the needletip and thus assists in the prevention of needlestick injuries and potential seroconversion to blood-borne pathogens. To date, a number of studies have been undertaken to evaluate these products, the majority of which show these devices to be safe and reliable in addition to potentially reducing associated needlestick injuries. However, to encourage the introduction of these devices in the UK, further studies are needed to either support or refute initial findings and to encourage the evaluation and subsequent implementation of needle-protective devices.

Accidents, Occupational↗
PubMed1993

Detection of hepatitis C virus markers and hepatitis C virus genomic-RNA after needlestick accidents.

BACKGROUND: Needlestick accidents are a problem among health care workers. Using sensitive new assays, we evaluated the prevalence and features of hepatitis C virus (HCV) infection following a needlestick accident. METHOD: The clinical outcome and evolution of serum HCV markers were assessed in 90 hospital employees (recipients) who sustained needlestick injuries (selected from 146 episodes) involving 92 patients with clinical non-A, non-B hepatitis (donors). RESULTS: Of the 92 patient donors, 62 (67%) and 88 (96%) were anti-C100-3 and second-generation anti-HCV positive, respectively, at the time of the needlestick accident. During the follow-up period (> or = 6 months), acute non-A, non-B hepatitis developed in three of 90 recipients about 1 month after the accident. The three respective donors were positive for serum HCV-RNA at the time of the accident. Two of the three recipients became HCV-RNA positive just after the onset of hepatitis, and subsequently, HCV antibodies developed. None of the remaining 87 recipients had any clinical or laboratory evidence of hepatitis during follow-up, or experienced seroconversion for anti-C100-3 or second-generation anti-HCV. We measured additional HCV markers in 20 of the 89 donors; 16 had evidence of HCV infection (HCV-RNA). However, none of the respective recipients of any of these 20 became positive for HCV markers during follow-up. CONCLUSION: Although transmission of HCV infection by needlestick injury may be infrequent, such transmission does occur. Appropriate precautions should be taken to protect health care workers.

Accidents, Occupational↗