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PubMed2005

Effectiveness of education and problem solving work group on nursing practices to prevent needlestick and sharp injury.

OBJECTIVES: To examine the effect of an education program and problem solving work group on nursing practices for prevention of needlestick and sharp injury. MATERIAL AND METHOD: A quasi-experimental study design with a control group was conducted at the emergency and labor rooms in Sermngam Hospital, Lampang. All healthcare workers (HCWs) in the emergency and labor room were randomly assigned to the experimental and control group from April 17, 2002 to September 3, 2002. Data collection included demographics, a participatory problem solving plan, and safety nursing practice observation recording form. The present study was divided into a two months observation period, followed by a one month intervention period and a two month post-intervention observation period. Interventions included education and posters to promote safe nursing practices, peer reminders to avoid unsafe nursing practices, providing devices for recapping needles and small-sized trays to facilitate one-handed recapping, and making a hole in the lid of a sharp container Nursing practices on prevention of needlestick and sharp injury were prospectively monitored. RESULTS: Twelve HCWs (12/24; 50%) were randomly assigned to the experimental group and 12 (12/24; 50%) were assigned to the control group. There was no difference with respects to demographic and safety nursing practices on prevention of needlestick and sharp injury during the pre-interventional period among these groups. Compared to the pre-interventional period, significant improvement on safety nursing practices for all nursing practice categories were observed in the experimental group after the intervention (P=0.001). Compared to the control group, all safety nursing practice categories were performed more often in the experimental group (p=0.001). CONCLUSION: The educational and problem solving work group on nursing practices to prevent needlestick and sharp injury were effective and should be considered as an intervention to reduce needlestick and sharp injury in emergency and labor rooms at Sermngarm Hospital.

Adult↗
PubMed2006

Needlestick and sharps injuries among a cross-section of physicians in Mainland China.

BACKGROUND: Although needlestick and sharps injuries (NSI) represent a significant occupational hazard for physicians worldwide, their epidemiology has not been previously examined in Mainland China. This study describes the prevalence, distribution, and risk factors for NSI among a cross-section of Chinese physicians. METHODS: Data was obtained by an anonymous, self-reporting survey administered to all 361 physicians at a university teaching hospital, during 2004. RESULTS: Seventy-nine percent of the physicians responded. Among them, 64% had experienced an NSI in the previous 12 months, 50.3% of which involved contaminated devices. By device, 22.8% were caused by hollow-bore syringe needles, 19.1% by suture needles, and 12.1% by scalpel blades. Surgical procedures accounted for 27.9% of all injuries. Only 15.3% of physicians had officially reported their NSI to management, of which 10% went unreported because the individual felt they were not unlucky enough to get a disease. A statistically significant correlation was demonstrated between NSI and working in the intensive care unit (adjusted odds ratio: 5.3, 95% CI: 1.7-23.4). CONCLUSIONS: Although this study suggests that NSI are an important workplace hazard for Chinese physicians, future measures should consider the unique cultural beliefs of Chinese people and its effect on preventive behaviors. The concept of "luck," and its relationship with NSI reporting in particular, may also need to be addressed.

Accidents, Occupational↗
PubMed1997

Epidemiology of needlestick and sharp injuries at a university hospital in a developing country: a 3-year prospective study at the Jordan University Hospital, 1993 through 1995.

OBJECTIVE: To study the epidemiology of needlestick and sharp injuries in a university hospital in a developing country, Jordan. METHODS: A prospective study was undertaken of all needlestick and sharp injuries among workers at the Jordan University Hospital between 1993 and 1995. Health care workers were asked to report in person to the infection-control team to verify the incident and to respond to a questionnaire. Blood was obtained from patients and health care workers immediately and from the health care workers 6 months later for hepatitis B virus, hepatitis C virus, and HIV testing. RESULTS: During the 3-year period, 248 health care workers had needlestick and sharp injuries. Of these, 34.6% were staff nurses, 19%, environmental workers, 15.7%, interns, 11.7%, residents, 8.5%, practical nurses, and 6% were technicians. The incidence density was highest for the interns followed by staff nurses and environmental workers. Of incidents, 22.6% occurred during blood drawing, 11.3% during placing intravenous lines, 8.5% during administration of medication, 11% during recapping the needle, 10.5% during needle disposal, 12.5% during garbage collection, and 5% were caused by a neglected needle. Only 117 patients were identified; 36 of 62 of these had positive results for hepatitis B surface antigen, and 8 of 13 for hepatitis C virus. CONCLUSION: Needlestick and sharp injuries occur frequently in developing countries. Safer disposal facilities and routine hepatitis B vaccine should be adopted.

Developing Countries↗
PubMed2004

Needlestick and sharps injuries among nurses in the healthcare sector in a city of western Turkey.

The aims of this study were to determine the rate of bloodborne infections after needlestick and sharps injuries in nurses at work, to estimate the number of vaccinations administered, and to assess whether universal precautions were being followed. The study involved 289 nurses working in five hospitals and six primary healthcare centres. Between 1 April 2002 and 31 June 2002, a total of 139 practising nurses were included in the study following a needlestick or sharps injury. The results of completed questionnaires were collated, and Chi-squared test was used for analysis. The rate of hollow-bored needle-related injuries was 76.2% (106/139). Most nurses (69.1%) did not report any details of their injuries and 32.4% (45/139) of nurses had not been vaccinated against hepatitis B virus (HBV). Only 5.3% of the nurses who responded to the compliance question indicated that they always complied with universal precautions. Of 139 nurses, 1.4% and 7.9% showed evidence of HBV infection and hepatitis C virus (HCV) infection, respectively. All those who had hepatitis B were aged 30 years or under, whereas most of those who were anti-HCV positive (81.8%) were over 30 years old (P < 0.05). Nurses working in the Turkish healthcare sector are frequently exposed to bloodborne infections. Precautions and protection from needlestick and sharps injuries are important in preventing infection of nurses. Education about the transmission of bloodborne infections, vaccination and post-exposure prophylaxis must be implemented. Further investigations are warranted to elucidate the risk to nurses of contracting these potentially serious infections.

Adolescent↗
PubMed2002

Epidemiology of needlestick and sharps injuries in a tertiary care center in Saudi Arabia.

BACKGROUND: Health care workers (HCWs) are frequently exposed to the danger of infectious agents through needlestick and sharps injury (NSSI). In Saudi Arabia, the hepatitis B and C viruses pose a great threat to the HCW because of their high prevalence rate (8%-10% and 2%-6%, respectively). METHOD: A prospective study on the management of NSSI at King Fahad National Guard Hospital from 1996 to 2000. Data relating to the epidemiology of NSSI were collected with the Exposure Prevention Information Network (EPIN(et)) data collection tool, 1997. RESULTS: The results were compared with data as reported by EPIN(et) 1998. Consistency was demonstrated between King Fahad National Guard Hospital and EPIN(et) 1998 for the occupational categories, locations, and the devices involved. Three anomalies were noted: (1) housekeeping staff injuries ranked third at our facility and eighth as reported by EPIN(et) 1998; (2) injuries caused by devices discarded inappropriately commonly occurred at this facility but were not reported by EPIN(et); and (3) injuries due to unsafe practices ranked third at our hospital but ranked seventh in EPIN(et). To date, only 1 employee in our hospital had a seroconversion to hepatitis C. CONCLUSION: This surveillance highlighted risky practices and demonstrated employees and locations frequently involved in NSSIs. An education program was designed for all staff at risk of exposure, targeting higher-risk employees.

Accidents, Occupational↗
PubMedDate not supplied

Changing knowledge, behavior, and practice related to universal precautions among hospital nurses in China.

PURPOSE: To evaluate the effect of an educational training program for hospital nurses on universal precautions in Changsha, Hunan Province, People's Republic of China. METHOD: Using a quasi-experimental design, 50 of 100 randomly selected hospital nurses were randomly assigned to receive an educational intervention. Questionnaires were administered to the 100 nurses prior to and 4 months after the training. FINDINGS: Knowledge, practice, and behaviors related to universal precautions and the prevalence of hepatitis B immunization improved among nurses in the group who received training. No significant change in the frequency of glove use was found. Underreporting of sharps injuries to hospital authorities continued in both groups. CONCLUSION: Although educational training significantly improved Chinese nurses' knowledge, practice, and behavior related to universal precautions, there remains room for improvement in glove use and needlestick injury reporting.

Adult↗
PubMed1991

Patterns of occupational hand injury in pathology. The interaction of blades, needles, and the dissector's digits.

Details of injuries and exposures to body fluids while handling tissue that were sustained by 36 pathologists (nine residents and 27 staff pathologists) were ascertained by retrospective questionnaire. In the preceding year 56% (20/36) had sustained a cut or needlestick injury. A total of 72 individual injuries occurred and corresponded to one injury for every 2629 surgical specimens handled and for every 37 autopsies performed. Residents reported a five-fold excess in injuries compared with staff pathologists. The lesions described predominantly (67%) involved the oppositional area consisting of the distal thumb, index, and middle fingers of the nondominant hand; during dissection, when opposed to hold or retract tissue, these digits form a surface that is directly exposed to the cutting edge, and injury to this area may be termed dissector's digital injury. Injuries to other areas of the nondominant hand were much less numerous and the dominant hand was rarely injured. Splashes to the face and eyes and glove punctures were frequent. These injury and exposure rates are probably broadly representative of practice in areas of low acquired immunodeficiency syndrome prevalence and may be improved on with increasing concern about human immunodeficiency virus infection. It is likely, however, that development of comfortable protective devices, based on knowledge of the pattern and circumstances of injury, will be necessary to eliminate these occupational hazards.

Fingers↗
PubMed1996

[Risk of contamination with blood during obstetric-gynecologic surgery].

To determine the risk of exposure to blood and body fluids potentially contaminated with infectious organisms, we instituted a prospective study of 100 gynecologic procedures performed at Hospital General Regional of Puebla, México. Accidental exposure to blood occurred during 8 procedures (8%). There were 8 glove tears (8%). Needlestick injuries occurred in 6% of the operations. The frequency of blood contamination, glove tears and percutaneous injuries is high; surgical personnel are at risk of contracting a blood-borne disease such as HIV infection or viral hepatitis. Implantation of universal blood and body fluids precautions is useful in preventing HIV exposures of which needlestick precautions are most important.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Effect of changing needle disposal systems on needle puncture injuries.

Accidental needle puncture injuries continue to pose a hazard to hospital workers. In order to reduce the number of such injuries in our hospital, needle disposal procedures were revised to discourage recapping and prevent bending or clipping of needles before discard. Collapsible cardboard boxes were replaced with impervious containers. An educational program accompanied these changes. We compared reports of needlestick injuries before and after the change of procedure, for three parallel 9-month periods. During the 27-month study, injuries occurred during administration of medication (22%), or recapping of used needles (16%), from needles protruding through (10%) or out of the "mouth" (9%) of the container, from needles left in the patient's environment (10%), or those left on procedure trays (7%). Seven percent were the result of being stuck by someone else, usually in the operating room. The mechanism of injury for 19% was not described. Altering the disposal procedures did not change the number or anatomic site of injuries, nor the risk of injury among the various job categories. A reduction in the rate of sticks from needles protruding through the container (1.3 vs 0.3/mo, p less than or equal to 0.005) was the only difference observed. Changing the needle receptacle changed the type but not the overall number of injuries. The education program had little effect on the number and types of injuries. These data point to the need for developing innovative approaches for eliciting changes in behavior of health care personnel.

Accidents, Occupational↗
PubMed1990

The pharmacist's role in controlling bloodborne infections with emphasis on procuring safe injection systems.

The hospital's department of pharmacy plays an important role in lessening the risk of bloodborne disease transmission through its influences in the coordination and control of the hospital's drug distribution system, intravenous (IV) admixture service and purchasing decisions with regard to injectable drug products. A review of drug distribution systems has shown that the unit-dose system is the most advantageous in terms of accuracy, safety, time savings and overall costs to the institution. Needlestick injuries are an occupational hazard for healthcare workers. Today, the need for safety in medication administration is a priority in injectable medication systems. Pre-filled cartridges offer a number of advantages, one of which is their safety in preventing needlesticks, through facilitating administration of medication quickly and easily and disposal of the needle immediately thereafter.

Drug Packaging↗
PubMed1995

Salmon farming: occupational health in a new rural industry.

The medical hazards of salmon farming can be grouped into those related to marine safety, fish husbandry, fish-farm diving and disease treatments. The hostile water environment requires thermal protection and personal buoyancy aids as workers frequently fall in the water from boats or cages. Feedstuffs may generate respirable dust and attract rats, creating a risk of leptospirosis. Musculo-skeletal injuries are common from lifting nets. Fish-farm diving has particular risks which can be minimized. Organophosphorous pesticides are used to treat sea lice and employees require health surveillance. Fish immunization is required to reduce the incidence of Aeromonas salmonitica. Needlestick injuries when using oil-based vaccines are a serious hazard to employees. The occupational health problems of salmon farming are predictable and preventable with primary safety measures. This new industry is safer than land-based agriculture on current evidence.

Animals↗
PubMed2001

Students sitting medical finals--ready to be house officers?

An initial survey of students approaching qualification and the preregistration house officer year revealed anxiety about competence in several important clinical skills. A questionnaire study was then undertaken to assess, first, the extent to which students had attained the skills required for the preregistration year and, second, the amount of training in these skills provided during the preregistration year. 122 medical students taking their final examinations were asked about training and practice in eight core clinical skills, and 84 graduates from the same school, approaching the end of their preregistration year, were asked about postgraduate training in these skills. The response rate of each group was 100%. Of the eight skills studied, most had been performed few times by the students at qualification. Less than half the current preregistration house officers could recall training being given in any of the skills studied. There were no significant differences in house-officer training between teaching hospitals and district general hospitals. Regarding needlestick injuries, nearly two-thirds of preregistration house officers were unable to recall any training at either undergraduate or postgraduate level. These results suggest that training in clinical skills can be improved. Training is already changing with use of clinical skills laboratories and logbooks. We also recommend mandatory needlestick training both in undergraduate programmes and in induction courses for preregistration house officers.

Blood Gas Analysis↗
PubMed2002

Blood-borne pathogens and nosocomial infections.

Guidelines to prevent the transmission of blood-borne infections have evolved rapidly since the recognition that "serum hepatitis" could be transmitted to health care personnel via percutaneous exposure to blood. The HIV epidemic focused renewed attention on the problem of protecting health care personnel, culminating in "standard precautions" for patient care, which emphasized the use of gloves for all contact with blood and body fluids. This focus on protection of the health care worker sometimes obscures the other important functions of gloves: protection of patients from microorganisms on the hands of providers and prevention of patient-to-patient transmission of nosocomial pathogens. The risk of infection after percutaneous exposure to the 3 major blood-borne viruses-hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV-varies greatly. The risk for a nonimmune individual exposed to HBV may be >30% if the source is Hb(e)Ag-positive. The average infection rate for HCV is 1.8%. For HIV, the average risk is 0.3%, but is higher with deep injury, when there is visible blood on the device, when a needle has been in an artery or vein, or when the source patient is in the terminal phase of HIV. Prompt administration of anti-HIV therapy reduces risk by about 80%. Mucous membrane and cutaneous exposures carry less risk. Recent efforts to reduce needlestick injuries in hospitals have reduced the risk to health care providers. Surgeons and other health care professionals who are infected with HIV or HCV pose a very small risk to their patients, although a number of outbreaks have been traced to surgeons who are HBV carriers; most have been Hb(e)Ag-positive.

Blood-Borne Pathogens↗
PubMed2004

Analysis of job-related risks faced by hospital nurses.

The aim of this study was to analyze the job-related risks nurses face during training such as needle-stick injuries, contaminated blood and infectious fluids. From May to July 2003 we conducted a survey of a sample of 242 nurses who were working in the the Pediatric Hospital, Government Hospital, the Training Hospital of Celal Bayar University, the Gynecology Hospital and the Psychiatric Hospital in Manisa City in Turkey. Two hundred sixteen nurses (89.3%) had needlestick injuries and 107 (44.2%) had injuries by contaminated cutting utensils. A total of 104 nurses (43.0%) used gloves, while 65 (26.9%) used gloves and mask. In medical and surgical staff nurses, injuries due to contaminated cutting utensils were statistically significant (p < 0.05). Awareness of accidents was significant between the two groups (p < 0.05).

Accidents, Occupational↗
PubMed1991

Determinants of blood and body fluid exposure in a large teaching hospital: hazards of the intermittent intravenous procedure.

Determinants of staff exposure to blood and body fluids in a 1100-bed hospital were examined over a 2-year period. Eighty-two percent of the 799 reported accidental exposures were needlestick injuries, and 18% were cutaneous or mucous membrane splashes. Nurses and nursing students incurred 78.8% of the exposures; respiratory technologists and laboratory personnel, 9.2%; medical personnel, 7.5%; and support staff, 4.2%. Rate of exposure per 100,000 hours worked showed nursing students to be at particularly high risk, highlighting the need for specific instruction. Analysis of events leading to needlestick-related exposures revealed that the heparin lock intermittent intravenous procedure was involved in 26%; recapping accounted for 17%; improper disposal, 15%; manipulating equipment, 14%; phlebotomy, 12%; and other needlestick events, 16%. Ocular splashes and spills onto nonintact skin each accounted for 50% of the total number of non-needlestick-related exposures. This study revealed the hazardous nature of the intermittent intravenous procedure, prompting specific revisions in this procedure as well as promoting point-of-use sharps disposal and other preventive measures.

Accident Prevention↗