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 379 records · Page 21Linked to original sources
PubMed2000

[The problem of cross-infection during the administration of local anesthesia].

Serious infections can readily be transmitted in the dental situation when percutaneous injuries occur. In most cases needlestick injuries are responsible. In this way, dentists are at risk of professionally acquired infectious diseases with high morbidity and mortality, such as Human Immunodeficiency disease, Hepatitis B or C. Today, immunisation is only possible for HB virus and not for the other bloodborne infectious micro-organisms discussed. The transmission risk is influenced by the type and number of micro-organisms present in the blood, presence of visible blood on the needle, depth of the injury and size and type of needle used. Prevention is of paramount importance. Increased emphasis in the prevention of percutaneous injuries as part of infection control training is indicated.

Accidents, Occupational↗
PubMed2003

Injection practices in southern part of India.

The World Health Organization defines 'a safe injection' as one that does not harm the recipient, does not expose the provider to any avoidable risk, and does not result in any waste that is dangerous to the community. Irrational and unsafe injection practices are rife in developing countries. The objective of the present study was to assess the injection practices in the state of Tamilnadu, India, using the Rapid assessment and response guide of the Safe Injection Global Network of the World Health Organization. Thirty-nine prescribers, 62 providers, and 175 members of the general public were interviewed. The areas were chosen out of convenience while at the same time adhering to the guidelines. The study was carried out between April and June 2001. The per capita injection rate was 2.4 per year. The ratio of therapeutic to immunization injections was 6.5:1, and the proportion of injections given with a disposable syringe and needle was 35.4%. Knowledge about diseases transmitted by unsafe injections, for example involving human immunodeficiency virus and hepatitis B virus, was greater among all the study groups. The annual incidence of needlestick injuries among providers was 23.6, which is extremely high. It is concluded that there are deficiencies in practice such as an excessive, unwarranted usage of injections, a sizeable prevalence of unsafe injection practices, the short supply of injection equipment leading to a high incidence of needlestick injuries, a low proportion of hepatitis B virus immunization among providers, and a lack of adequate sharps containers and disposal facilities in this part of India. It is suggested that immediate and long-term remedial measures, such as the education of prescribers to reduce the number of injections to a bare minimum, an adequate supply of injection equipment, provider protection with immunization for hepatitis B virus, the provision of adequate sharps containers with safe disposal facilities and, not least, community education, be undertaken to avoid the future epidemic of transmissible diseases.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Safe inoculation of blood and bone marrow for liquid culture detection of mycobacteria.

BACKGROUND: Needlestick injuries confer an unnecessary risk of occupational bloodborne infections such as human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. After an accidental needlestick injury, procedures for inoculation of liquid culture media for rapid detection of Mycobacterium tuberculosis complex and other mycobacteria from blood and bone marrow specimens were reviewed. AIM: To identify a safer transfer device, which could replace the ordinary syringe in inoculation of liquid culture vials. METHODS: We identified a transfer device to transfer blood or bone marrow specimens from bedside tubes into liquid culture vials. CONCLUSION: The changed procedure will reduce the risk of needlestick accidents and be of benefit to other microbiological laboratories using the same or similar inoculation techniques.

Adult↗
PubMed2006

Selective transmission of hepatitis C virus quasi species through a needlestick accident in acute resolving hepatitis.

BACKGROUND: Little is known about the transmission of variant hepatitis C virus (HCV) genome through needlestick injuries. METHODS: To demonstrate how HCV quasi species are transmitted and adapt to the new host in acute resolving infection, we analyzed the nucleotide and deduced amino acid sequences of the hypervariable region 1 (HVR-1) in the E2 domain of HCV in both the source of the virus ("donor") and the person who received the virus through a needlestick accident ("recipient"). In addition, we also performed phylogenetic analysis of HCV quasi species in these patients to document the viral transmission. RESULTS: We obtained a total of 33 clones at different time points by using polymerase chain reaction amplification and cloning and sequencing of HVR-1. A predominant HVR-1 variant (in 4 of 10 isolates) in the donor was not present in the recipient 6 and 14 weeks after the accident. In contrast, a minor variant (in 1 of 10 isolates) in the donor became the predominant strain in the recipient 6 weeks (in 10 of 12 isolates) and 14 weeks (in 6 of 11 isolates) after the accident. Additional phylogenetic analysis showed high homology of nucleotide sequences between isolates obtained from the donor and isolates obtained from the recipient. In addition, the variants in the recipient's virus showed substantial genetic preservation in the course of acute resolving hepatitis. CONCLUSIONS: These data suggested that a minor HCV variant from a donor was transmitted to the recipient through a needlestick injury and that it prevailed as the dominant species. The preserved genetic homogeneity of the transmitted viral variants in patients with acute HCV infection may account for their clinical outcomes of resolving hepatitis.

Adult↗
PubMedDate not supplied

Lack of transmission of hepatitis C virus following needlestick accidents.

Healthcare workers (HCWs) have an occupational risk of infection with hepatitis C virus (HCV). However, data regarding the magnitude of this risk are limited. We conducted a prospective study on a cohort of 24 HCWs who were exposed to HCV by needlestick injuries involving 25 patients. All source patients were viremic with a mean HCV-RNA level of 1.65 megagenomic equivalents per milliliter. At least 64% of patients were infected with HCV serotype 4 (Simmond's classification). After a follow up period of at least 6 months, none of the exposed HCWs acquired HCV. Thus, HCV does not seem to be easily transmitted by needlestick injuries. However, further large-scale studies are needed for a more accurate estimation of the risk of transmission.

Accidents, Occupational↗
PubMed2006

Occupational blood and infectious body fluid exposures in a teaching hospital: a three-year review.

BACKGROUND AND PURPOSE: Blood and infectious body fluid (BBF) exposures are common safety problems for health care workers (HCWs). We analyzed reported BBF exposures during a 3-year period at a teaching hospital. METHODS: We collected reports of BBF exposures among HCWs occurring from January 2001 to December 2003 at a 2000-bed tertiary care medical center in northern Taiwan. HCWs were requested to report BBF exposures immediately after each exposure, which required completing a report sheet of questions concerning the exposure. The HCW was also required to visit an infectious diseases specialist who would decide on the appropriate management in each case. RESULTS: Needlestick injuries were the most commonly reported BBF exposure, accounting for 80% of reported cases. The total incidence density of BBF exposures was 1.96 per 100 person-years. BBF exposures were most common in December and least common in September. Nurses had the highest percentage (60.6%) of BBF exposures and other job categories including physicians, technicians, cleaning staff, and interns accounted for around 10% each. Injuries occurred most commonly during the daytime (57.0%). Three-quarters (74.9%) of the injured HCWs had appropriate immediate care. Interns had the highest incidence density (4.48 per 100 person-years) of BBF exposures and technicians the lowest (0.50 per 100 person-years). Among the exposed HCWs, 1 received hepatitis B vaccine, 1 received both hepatitis B vaccine and hepatitis B immune globulin, 1 received zidovudine/lamivudine due to a needlestick injury when treating an HIV-positive patient, and 4 received penicillin due to exposure to syphilis. No HCW developed infections after BBF exposure during the study period. CONCLUSIONS: Measures which may be effective in reducing BBF exposures include education of HCW, increased use of standard precautions, improved administrative support, and enhanced reporting of BBF exposures.

Blood-Borne Pathogens↗
PubMed1997

Dentists and cross-infection.

A structured questionnaire was administered to a random sample of general dental practitioners in Natal, South Africa in 1994, to ascertain the precautions they use against cross-infection and to gauge the attitudes and behaviour towards the treatment of HIV-infected individuals. An interview was conducted covering 5 broad topics: demographic details, personal barrier protection, instrument sterilization and disinfection, sharps disposal and incidence of needlestick injuries and the extent of the knowledge, attitude and behaviour of the practitioners toward the treatment of HIV-infected individuals. The key findings were: routine glove wearing, for all patients, was practised by 87 per cent. The most common heat sterilization method was by autoclave (68 per cent), although a dry heat sterilizer and water boiler were used by 22 per cent of the respondents. Of the 18 respondents reporting a needlestick injury in the past 6 months only one sought after-care. 42 per cent of the respondents would continue to treat carriers of HIV in their practices. This survey shows that a significant number of dentists are using unacceptable cross-infection control procedures. Educational efforts should be made to improve their knowledge and to alleviate anxiety of health workers to treat HIV-infected patients.

Adult↗
PubMed2000

Prevalence of hepatitis C antibodies in a large sample of Belgian healthcare workers.

OBJECTIVE: To assess the risk of hepatitis C virus (HCV) infection among Belgian (Flemish) healthcare workers. DESIGN: A seroprevalence survey of HCV IgG antibodies. SETTING AND PARTICIPANTS: A systematic sample of 5,064 employees from 22 general hospitals in Flanders and Brussels, Belgium, was tested at the annual occupational medical examination. Together with demographic and occupational data, information was collected on the frequency of blood contact, needlestick injuries, and medical and surgical history. The blood samples were tested using the third-generation Abbott Screen Kit test, with confirmation by Matrix, LIA, and an in-house polymerase chain reaction and the Quantiplex-HCV b-DNA test. RESULTS: 21 persons were found to be positive for HCV markers. The overall prevalence was 0.41% (95% confidence interval [CI95], 0.24-0.59). A statistically significant association was found with a history of blood transfusion (odds ratio [OR], 4.14; CI95, 1.67-10.31) and with history of a clinically apparent hepatitis (OR, 3.98; CI95, 1.60-9.90). Although the ORs for the frequency of blood contact were slightly elevated (between 1.17 and 2.73), this association was not significant. Moreover, a history of needlestick injuries showed a nonsignificant OR of 1.28 (CI95, 0.53-3.09), and no statistically significant difference was found with a variety of duties and tasks. The ORs for potential occupational risk factors were adjusted according to age, gender, antecedents, and other confounders using a logistic regression analysis. Based on this procedure, the ORs decreased slightly. CONCLUSIONS: Flemish healthcare workers showed a lower HCV seropositivity than is seen in the general population; a history of blood transfusion and of clinically apparent hepatitis was most strongly associated with the presence of HCV markers. We concluded that employees in Flemish regional general hospitals are not at an overall increased risk for HCV infection, although occasional transmission through percutaneous injuries is possible, and prevention therefore remains imperative.

Adult↗
PubMed1997

Evaluation of the acceptability of a needleless vascular-access system by nurses.

BACKGROUND: Needleless intravenous-access devices have been introduced in an effort to reduce needlestick injuries and possible transmission of blood-borne pathogens to health care workers. However, there are no data on the acceptance of these devices by nursing personnel. METHODS: A survey of nursing personnel was taken at Indiana University Medical Center after introduction of a needleless intravenous device to determine their opinion after use of the needleless device. RESULTS: The majority of the nurses (72 of 94, 70%) had a favorable overall opinion of the device. Among those with a favorable opinion, 76% (55/72) responded that reduced risk of needlestick injury was the most important reason. Among those who had a negative opinion about the needleless-device system, 32% (7/22) reported that contamination risk was their major concern. Those who were trained before device use were more likely to properly use and maintain the needleless intravenous-access system. Of 89 respondents, 75.3% (67/89) believed that the initial training was adequate; however, 43% (29/67) thought that additional training after using the device for some time would have been beneficial. CONCLUSIONS: Comprehensive education programs that include training before and after device use are necessary if new needleless intravenous-access systems are to be successfully introduced and accepted by nursing personnel.

Attitude of Health Personnel↗
PubMed1992

Blood culture: comparison of outcomes between switch-needle and no-switch techniques.

BACKGROUND: Because blood culture is a common test at our institution, we hoped to save money and reduce the risk of needlestick injury by modifying our current technique for the preparation of culture specimens without increasing the risk of contamination. METHODS OBJECTIVE: To compare the contamination rates of blood culture specimens obtained by the conventional method of switching to another sterile needle before inoculation with those of specimens obtained by a method without switching. DESIGN: Cross-over study. SETTING: Department of Medicine of university hospital. PARTICIPANTS: Nursing personnel working in seven acute care medical wards in Siriraj Hospital, Bangkok, Thailand. INTERVENTIONS: From March to June 1991, participating nurses prepared blood culture specimens by means of both switch-needle and no-switch techniques in a cross-over study. All blood culture specimens were submitted to microbiology laboratory to determine the growth of microorganisms. MEASUREMENT: Growth in a culture was considered to be "true positive" or "contamination" by predetermined criteria. RESULTS: Total number of blood culture specimens was 1619; of these, 813 were prepared by switch-needle technique and 806 were prepared by no-switch technique. The contamination rates were 7.6% and 8.3% for switch-needle and no-switch techniques, respectively (p = 0.61). CONCLUSIONS: The switch-needle technique may not be necessary for obtaining blood culture specimens unless the needle is obviously contaminated. The no-switch technique for the preparation of blood culture specimens is more convenient and less expensive; it also poses less risk of needlestick injury.

Bacteriological Techniques↗
PubMedDate not supplied

Awareness of post-exposure prophylaxis guidelines against occupational exposure to HIV in a Mumbai hospital.

BACKGROUND: Exposure to the human immunodeficiency virus (HIV) is a matter of concern for healthcare workers. We conducted a survey to determine the level of awareness amongst operating room personnel regarding post-exposure prophylaxis in case of needlestick injuries from confirmed or suspected cases of HIV. METHODS: A structured questionnaire was presented to 39 anaesthetists and 31 surgical residents. Questions were related to identification of high risk fluids, risk of transmission, drugs, costs and procedure to be adopted for post-exposure prophylaxis. RESULTS: Fourteen respondents (20%) were aware of the true risk of transmission. About one-third identified all high risk fluids correctly. Fifty-five respondents (78%) correctly stated that washing the site with soap and water was the initial measure, but less than a third knew whom to contact immediately after a needlestick injury. Though 45 respondents (64%) correctly stated that prophylaxis should be initiated within 1 hour of injury, none knew exactly which drugs were to be used. Thirty respondents (42%) were aware of the use of zidovudine but none were aware of the second or third drugs used for post-exposure prophylaxis. Only 4 respondents (6%) knew the correct duration of post-exposure prophylaxis. Five respondents (7%) knew that the drugs were available in medical stores and 7 knew the approximate cost of therapy. CONCLUSION: There is surprisingly poor knowledge of post-exposure prophylaxis against HIV. Ongoing awareness and training programmes are necessary to improve the same.

Anti-HIV Agents↗
PubMed2003

Use of safety dental syringes in British and Irish dental schools.

AIM: The aim of the present study was to determine what types of dental syringes were being used in British dental schools and whether recent studies on the use of safety syringes had had any impact. INTRODUCTION: In 2001 a controlled trial showed that avoidable needlestick injuries could be reduced with the introduction of safety syringes which did not require the re-sheathing or removal of a needle from its syringe. METHOD: A self complete questionnaire asking about safety syringe use was distributed through the deans of all 16 dental schools in the UK and Ireland. RESULTS: Fifteen schools formally replied and data are available for the missing one. Two schools have totally converted to the use of safety syringes and in seven schools some departments are using them. Six schools are not considering a change, four others are hoping to change and four are undecided as to whether they are going to change. Five schools had tried them previously. All acknowledge that extensive training is essential, there is also considerable staff resistance and the safety syringes currently available are still not ideal. CONCLUSION: All dental schools should determine their avoidable needlestick injuries rates, reconsider their views on the use of safety syringes and contribute to the development of the ideal model.

Dental Instruments↗
PubMed1994

Hepatitis C virus infection in healthcare workers: risk of exposure and infection.

OBJECTIVES: To determine the incidence of hepatitis C virus (HCV) infection among healthcare workers (HCWs) at a university hospital, the proportion of HCWs having non-A, non-B hepatitis (NANBH) who were anti-HCV positive, and the rate of HCV transmission following a HCV-positive needlestick injury. DESIGN: Longitudinal analysis of a dynamic (cohort) population. MEASUREMENTS: From 1980 through 1989, HCWs who had clinical NANBH were identified, and from 1987 through 1989, HCWs who reported a blood or body fluid exposure and the patients who were the source of the exposure were screened for antibodies to HCV. SETTING: A 732-bed, university hospital and outpatient clinics. RESULTS: Over the 10-year period, six cases of occupationally acquired NANBH were observed, for an incidence of 21 cases per 100,000 HCWs per year (standardized incidence ratio, 2.96; 95% confidence interval [CI95], 1.83 to 4.36). Four of the six cases were confirmed to be HCV infection. From 1987 through 1989, 176 (12.7%) of 1,387 patients who were the source of an exposure were anti-HCV positive. Exposures that occurred in the emergency department were more likely to be anti-HCV positive than were exposures from all other locations (relative risk [RR] = 1.7; P = 0.009). Of HCWs who had an HCV-positive needlestick injury and whose serum had been tested for anti-HCV at least 5 months after the exposure, 3 (6.0%) of 50 seroconverted. From 1987 through 1989, the incidence of HCV infection among HCWs was 54 cases per 100,000 HCWs per year. CONCLUSION: The incidence of clinical NANBH among HCWs in this study is approximately three times higher than that of non-HCWs. HCWs are at significant risk for exposure to and acquisition of HCV.

Adult↗
PubMed1997

An erbium:YAG laser to obtain capillary blood samples without a needle for point-of-care laboratory testing.

BACKGROUND: Needlestick injury poses an occupational hazard to health care workers that will increase with the increasing availability of point-of-care testing using capillary blood obtained with a lancet. OBJECTIVES: To demonstrate the safety and efficacy of a portable pulsed erbium:yttrium-aluminum-garnet (Er:YAG) laser in obtaining a blood sample from patients in a clinical setting and to determine whether the laser radiant energy alters the level of various components of blood, resulting in misleading laboratory results. DESIGN: Comparison of laboratory values of blood samples obtained with the laser and conventional lancet and comparison of patient and user preferences by questionnaire. PATIENTS AND METHODS: One hundred patients with diabetes mellitus attending a diabetes clinic were randomized to have capillary blood sampling from the fingertip performed either by the laser or a conventional lancet first, then with the other device. MAIN OUTCOME MEASURES: A comparison of pain, healing, hematocrit, and glycosylated hemoglobin (HbAlc), blood urea nitrogen, sodium, potassium, bicarbonate, and glucose levels. RESULTS: Adequate blood was obtained with both devices 97% of the time. Blood flow was greater with the laser perforation, resulting in higher operator preference. Although patients felt greater pain and experienced slower healing with the laser, these were not serious problems. Modification of the laser energy output led to a reduction in pain. Possibly owing to hemolysis, the potassium level in the blood obtained with the laser was significantly elevated and unsuitable for clinical decision making in many cases. None of the other measurements were similarly affected. CONCLUSIONS: We conclude that the laser device has the potential to obtain a blood sample for routine tests without a needle. This needle-free method will decrease the risk of bloodborne infections caused by needlestick injuries and thus lead to considerable cost savings and public health advantages. Further work is needed to alter the laser energy so that hemolysis can be decreased, thus enabling a more reliable potassium estimation.

Bicarbonates↗
PubMed1990

Current epidemiologic evidence and case reports of occupationally acquired HIV and other bloodborne diseases.

Studies in which noninfected persons shared households with human immunodeficiency virus (HIV)-infected family members and friends, and had substantial though non-sexual contact with them revealed no transmissions of the HIV virus. These results suggest a similar low risk for healthcare workers, particularly those who have little or no contact with blood. However, occupational transmission of HIV, when it does occur, is most commonly caused by needlestick injuries. Nurses make up the largest group--nearly 80%--of hospital workers who contract HIV infection on the job. Generally, the risk ratio following an HIV needlestick is 1 in 250. Improper needle disposal, recapping and other ingrained behavior patterns are typical causes of needlestick accidents. Though the focus today is on HIV/acquired immunodeficiency syndrome (AIDS), it is important to realize that hepatitis B accounts for 200 to 300 deaths a year among healthcare workers. Awareness of the risk of needlestick injuries, and the considerable financial and emotional costs they can impose, should justify preliminary expenditures on needlestick prevention programs.

HIV Infections↗
PubMed1990

[Investigation on the relation between hepatitis B virus knowledge and needle-stick injury of hospital personnel].

The purposes of this study are: (1) to understand the knowledge of Hepatitis B virus known by hospital personnel. (2) to investigate the injury caused by accidental needle stick and its frequency. (3) to identify those personnel and job activities at high risk of needlestick injuries, to assess current medical management of these injuries in our hospital, and also to develop rational guidelines for prevention, based on the findings. 510 effective questionnaires were collected and analyzed by SPSS analytical system. The result of the present study showed that 77.1% hospital personnel had been experienced by needlestick injury. Most injuries occurred during recapping the needle after use and disposal of used needle. 92.7% hospital personnel felt that hospital should provide all the expense needed for Hepatitis B virus immunoglobulin while needle-stick injuries happened within the hospital. 86.3% of them felt that hospital should establish a special committee to evaluate and manage all the needle-stick injuries events. This study also showed that hospital personnel who have been working less than five years and their age between 21-30 can pay more attention to this kind of event. Dietitian and doctor got higher score in this study. Hospital personnel who were infected by Hepatitis B virus scored higher than uninfected one. In conclusion, we recommend not recapping used needles and making widely available and promoting use of an efficient needle disposal system. And we hope that those who have never been infected by Hepatitis B virus should accept vaccination as soon as possible.

Accident Prevention↗
PubMed1994

Surgery, surgical pathology and HIV infection: lessons learned in Zambia.

HIV (human immunodeficiency virus) infection is prevalent in many areas of sub-Saharan Africa. Seropositivity rates reach 10-15% in urban adults, 21% in critically ill adults and 30% in surgical inpatients aged 21-40 years. AIDS (acquired immune deficiency syndrome) is a multisystem disease which presents to the surgeon with a wide range of pathologies including Kaposi's sarcoma, lymphadenopathy and sepsis. The more common sites for sepsis are the female genital tract, anorectum, pleural cavity, soft tissues (necrotizing fasciitis) and bone and joints. To prevent iatrogenic HIV infection more use should be made of autologous blood. Occupational exposure to HIV infection can be minimized by double-gloving, protecting the eyes when operating and ensuring that theatre gowns are waterproof. The risk of HIV infection from a needlestick injury is 0.4%. Although contact with blood during a surgical procedure is common, the risk is lower than for a hollow needlestick injury.

AIDS-Related Opportunistic Infections↗
PubMed1990

Adverse exposures and universal precautions practices among a group of highly exposed health professionals.

An anonymous national survey of a representative population of healthcare workers who were thought likely to have frequent and intensive exposures to blood and other body fluids (certified nurse-midwives [CNMs]), was conducted to assess the type and frequency of self-reported occupational exposures to blood and body fluids experienced, the extent to which barrier precautions and other infection control measures were used, whether or not reported use of barriers was associated with a lower perceived rate of exposures and factors that influenced the use of infection control procedures. Of those responding, 74% had soiled their hands with blood at least one time in the preceding six months, 51% had splashed blood or amniotic fluid in their faces and 24% reported one or more needlestick injuries during that same period. Our study also found evidence of an association between the practice of needle recapping and the occurrence of needlestick injury (p = .003). Despite a high level of training and knowledge, only 55% reported routinely practicing universal precautions (UPs). Several factors that potentially influenced the use of UPs were studied, including healthcare worker perceptions of risk of occupational bloodborne infection, knowledge of routes of transmission of bloodborne pathogens and rationale for not using appropriate barriers. Our data suggest that occupational exposures occur frequently and that healthcare workers' (HCWs') perceptions of risk for occupational infection play an important role in influencing use of UPs. This study emphasizes the importance of developing new strategies for UP training.

Acquired Immunodeficiency Syndrome↗