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 973 records · Page 54Linked to original sources
PubMed2003

Percutaneous injury, blood exposure, and adherence to standard precautions: are hospital-based health care providers still at risk?

To examine factors associated with blood exposure and percutaneous injury among health care workers, we assessed occupational risk factors, compliance with standard precautions, frequency of exposure, and reporting in a stratified random sample of 5123 physicians, nurses, and medical technologists working in Iowa community hospitals. Of these, 3223 (63%) participated. Mean rates of hand washing (32%-54%), avoiding needle recapping (29%-70%), and underreporting sharps injuries (22%-62%; overall, 32%) varied by occupation (P<.01). Logistic regression was used to estimate the adjusted odds of percutaneous injury (aOR(injury)), which increased 2%-3% for each sharp handled in a typical week. The overall aOR(injury) for never recapping needles was 0.74 (95% CI, 0.60-0.91). Any recent blood contact, a measure of consistent use of barrier precautions, had an overall aOR(injury) of 1.57 (95% CI, 1.32-1.86); among physicians, the aOR(injury) was 2.18 (95% CI, 1.34-3.54). Adherence to standard precautions was found to be suboptimal. Underreporting was found to be common. Percutaneous injury and mucocutaneous blood exposure are related to frequency of sharps handling and inversely related to routine standard-precaution compliance. New strategies for preventing exposures, training, and monitoring adherence are needed.

Blood-Borne Pathogens↗
PubMed2006

Perioperative use of the hands-free technique: a semistructured interview study.

OCCUPATIONALLY CONTRACTED bloodborne infections are preventable, but the use of many protective measures remains limited. THERE IS GROWING EVIDENCE that the use of the hands-free technique (HFT) to pass sharp items during surgical procedures is effective in protecting against sharps injury and bloody contamination. RESEARCHERS CONDUCTED in-depth telephone interviews to explore 20 health care providers' knowledge and use of the HFT. MOST OF THE INTERVIEWEES did not regularly use the HFT, and some were resistant to its use.

Attitude of Health Personnel↗
PubMedDate not supplied

Registered and enrolled nurses' knowledge of hepatitis C and attitudes towards patients with hepatitis C.

A questionnaire was used to determine registered and enrolled nurses' knowledge of, and attitudes towards patients with hepatitis C. The research aim was to discover if nurses held discriminatory attitudes towards patients with hepatitis C, and to determine how their knowledge of hepatitis C and their demographic characteristics impacted on their attitudes and practices. One thousand questionnaires vere distributed to nurses (20 were returned unopened). One hundred and sixty of the remaining 980 were returned (16.3%). The majority of nurses reported non-discriminatory attitudes towards patients with hepatitis C. A number of variables impacted on nurses' level of hepatitis C knowledge and their willingness to care for patients with hepatitis C. These variables included nurses' level of experience, perceptions of personal risk of contracting hepatitis C in the workplace, and recent incidents of sharps injuries. Strategies to reduce the level of staff anxiety related to hepatitis C infection and risks of transmission may further increase the willingness of nurses to care for hepatitis C positive persons.

Adult↗
PubMed2000

Management of occupational exposure to hepatitis C: survey of United Kingdom practice.

We conducted a survey to assess the action taken when health care workers suffered inoculation injuries from patients who might have hepatitis C virus (HCV) infection. A substantial proportion of health care workers may be receiving inadequate follow up and existing guidelines should now be implemented in full and extended to include guidance on treatment.

Data Collection↗
PubMed1999

A comparison of certain practice characteristics of dental anesthesiologists in Canada and the United States.

An existing database was used to compare aspects of dental anesthesiology practice of dental anesthesiologists in Canada (n = 32) and the United States (n = 123). Data focusing on percutaneous injuries were obtained through a mailed questionnaire that was returned anonymously. Respondents provided information on the treatment of patients under deep sedation or general anesthesia only. Eighty-one percent of Canadians and 61% of Americans returned the questionnaire. The vast majority (84%) of injuries reported were due to sharps associated with general dentistry compared with those associated with anesthesiology. Canadians were more likely to be operator-anesthetists (P < .01) and to experience a percutaneous injury (P < .01) than US practitioners. American practitioners were more likely to have a greater proportion of the caseload under the age of 20 (P < .02). No other significant differences were observed. These results illustrate a number of unique attributes of the practice of dental anesthesiology in these 2 countries.

Anesthesia, Dental↗
PubMed1992

[Cervical spinal cord injury caused by a broken acupuncture needle: a case report].

Spinal cord injury is a rare but considerable complication of acupuncture. A case with cervical spinal cord injury caused by a broken acupuncture needle was reported and sixteen previously reported cases including our case were reviewed. A 49-year-old woman was treated by herself with acupuncture on the nuchal region for occipitalgia, and the needle was accidentally broken during the treatment. Six hours later she noticed pain and numbness in the right upper and lower extremities. Neurological examination revealed slight impairment of temperature, pain and touch sensation on the right extremities. Plain X-ray film and CT scan showed a broken needle in the interspinous ligament between C1/C2 vertebrae, the tip of the needle appearing to be in the spinal canal. The needle was removed surgically nineteen days after the accident. Intraoperative fluoroscopic monitoring with injection of dye enabled the needle to be found without difficulty. Postoperative course was uneventful, and her pain and sensory impairment gradually disappeared. Once the diagnosis for cervical spinal cord injury by an acupuncture needle is made, the needle should be removed surgically as soon as possible, especially prior to the development of motor symptoms. This is because movement of the needle in the spinal cord is considered to be a main possible cause of the development and progression of symptoms.

Acupuncture Analgesia↗
PubMed2003

Molecular investigation of two possible cases of accidental HIV-1 transmission in South Africa.

HIV-1 sequences from two possible transmission cases in South Africa were examined for evidence of genetic linkage. HIV-1-seropositive blood samples were obtained from a donor and recipient within 8 months following a blood transfusion and from a healthcare worker and her patient within 10 months following a needle-stick injury. A 700-bp region in env and 550-bp region in gag were analyzed. All sequences were phylogenetically associated with HIV-1 subtype C, the predominant HIV-1 subtype in South Africa. The nucleotide sequences from the blood transfusion case grouped together significantly with a bootstrap value of 100%. These samples were 98% and 100% identical in the predicted amino acid sequences of env and gag, respectively. In contrast, sequences from the needle-stick case showed only 67% and 80% amino acid identity in env and gag, respectively, and were separated on a phylogenetic tree. Molecular analysis suggested that HIV transmission occurred in the blood transfusion case but not in the case of the needle-stick injury. These data emphasize the need for molecular investigation of epidemiologically linked cases of HIV transmission.

Adult↗
PubMed2004

[Occupational exposure and prevention of viral hepatitis B in health care personnel in the Canton of Sarajevo].

Health workers are exposed to the accidental injuries with blood, so that increasing of HBsAg among inhabitants in Bosnia and Herzegovina and professional risk for VHB is increased in this risk group. Among 6.712 health workers in Canton Sarajevo, it's expected that 1.217 health workers will be exposed to the professional accidental injury with the blood, but it's expected annually 44 professionally infected health workers with HBV. With introduction of vaccine against HBV it would come to very important decreasing of the diseases among health workers (p < 0.001), but the risk for the disease HBV would decrease 45 times.

Accidents, Occupational↗
PubMed2005

Occupational exposure to blood and body fluids among health care workers in Ankara, Turkey.

BACKGROUND: The risk of occupational acquisition of bloodborne pathogens via exposure to blood and body fluids is a serious problem for health care workers in Turkey. Because there are no systematic recording programs in Turkey, national data concerning frequency of exposures are not readily available. OBJECTIVE: To determine the risk factors of exposure to blood and body fluids among health care workers (HCWs). METHODS: This study was conducted in the hospitals of Ankara University School of Medicine. A structured survey form was administered by person-to-person interview. RESULTS: The study included 988 HCWs: 500 nurses (51%), 212 residents (21%), 152 nurse assistants (15%), and others (13%). Six hundred thirty-four (64%) of the HCWs had been exposed to blood and body fluids at least once in their professional life (0.85 exposure per person-year). The most frequent cause of the sharps injuries was recapping the needle (45%). Of the injured HCWs, 60 (28%) were not using any personal protective equipment, and 144 (67%) did not seek any medical advice for injury. CONCLUSIONS: Systematic control measures, including an effective and goal-oriented education program targeting HCWs, prospective record keeping, and instillation of a special unit for the health of HCWs should be implemented in the hospital setting.

Adult↗
PubMed1997

Occupational blood exposures in dentistry: a decade in review.

This review summarizes data from self-reported and observational studies describing the nature, frequency, and circumstances of occupational blood exposures among US dental workers between 1986 and 1995. These studies suggest that, among US dentists, percutaneous injuries have declined steadily over the 10-year period. Data also suggest that, in 1995, most dental workers (dentists, hygienists assistants, and oral surgeons) experienced approximately three injuries per year. Work practices (eg, using an instrument instead of fingers to retract tissue), safer instrumentation or design (eg, self-sheathing needles, changes in dental-unit design), and continued worker education may reduce occupational blood exposures in dentistry further.

Blood-Borne Pathogens↗
PubMed2007

Induction of hepatitis C virus (HCV)-specific T cells by needle stick injury in the absence of HCV-viraemia.

BACKGROUND: The risk of hepatitis C virus (HCV) infection after occupational exposure is low with seroconversion rates between 0 and 5%. However, factors associated with natural resistance against HCV after needle stick injury are poorly defined. HCV-specific T-cell responses have been described in cross-sectional studies of exposed HCV-seronegative individuals. MATERIALS AND METHODS: In this study, we prospectively followed 10 healthcare professionals who experienced an injury with an HCV-contaminated needle. Blood samples were taken on the day or the day after the event and at different time points during follow-up for up to 32 months. HCV-specific T-cell responses were investigated directly ex vivo and in T-cell lines. RESULTS: None of the individuals became positive for HCV-RNA in serum tested with the highly sensitive transcription-mediated amplification (TMA)-assay or in peripheral blood mononuclear cells (PBMC). All of them remained anti-HCV negative throughout follow-up. At the time of injury, HCV-specific CD4+ T-cell responses were already detectable in two individuals and became detectable thereafter in three additional persons. Transient HCV-specific CD8+ T-cell responses developed in two HLA-A2 positive patients, which became negative until the most recent follow-up after 5 and 17 months, respectively. CONCLUSION: We demonstrate the development of HCV-specific T cells in HCV-exposed individuals after needle stick injury indicating subinfectious exposure to HCV. T-cell immunity against HCV may contribute to the low prevalence of HCV in medical healthcare professionals in Western countries.

Adult↗
PubMed2003

A comprehensive approach to percutaneous injury prevention during phlebotomy: results of a multicenter study, 1993-1995.

OBJECTIVE: To examine a comprehensive approach for preventing percutaneous injuries associated with phlebotomy procedures. DESIGN AND SETTING: From 1993 through 1995, personnel at 10 university-affiliated hospitals enhanced surveillance and assessed underreporting of percutaneous injuries; selected, implemented, and evaluated the efficacy of phlebotomy devices with safety features (ie, engineered sharps injury prevention devices [ESIPDs]); and assessed healthcare worker satisfaction with ESIPDs. Investigators also evaluated the preventability of a subset of percutaneous injuries and conducted an audit of sharps disposal containers to quantify activation rates for devices with safety features. RESULTS: The three selected phlebotomy devices with safety features reduced percutaneous injury rates compared with conventional devices. Activation rates varied according to ease of use, healthcare worker preference for ESIPDs, perceived "patient adverse events," and device-specific training. CONCLUSIONS: Device-specific features and healthcare worker training and involvement in the selection of ESIPDs affect the activation rates for ESIPDs and therefore their efficacy. The implementation of ESIPDs is a useful measure in a comprehensive program to reduce percutaneous injuries associated with phlebotomy procedures.

Attitude of Health Personnel↗
PubMed2002

OSHA bloodborne pathogens rule--revisions and clarifications.

Recent revisions to the Occupational Safety and Health Administration's Bloodborne Pathogens Rule have clarified requirements for record keeping and engineered sharps injury protection devices. It is important for dental workers, and especially dentists who are employers, to be aware of the changes in the regulatory language and be prepared to modify existing programs to meet these new demands. This article provides an overview of the 2001 Bloodborne Pathogens Rule with an emphasis on the impact on dental offices.

Blood-Borne Pathogens↗
PubMed1995

Percutaneous injury analysis: consistent categorization, effective reduction methods, and future strategies.

OBJECTIVE: To report the results of an 8-year analysis of percutaneous injuries (PI), to describe interventions to decrease these injuries, and to discuss future prevention strategies. DESIGN: Using consistent methods, 881 percutaneous injury reports were reviewed, categorized, and analyzed from 1986 through 1993. SETTING: A 620-bed acute-care county teaching hospital located in San Jose, California, that is affiliated with Stanford University Medical School, Palo Alto, California. PARTICIPANTS: Employees of Santa Clara Valley Medical Center who reported percutaneous injuries from 1986 through 1993. INTERVENTIONS: Placement of needle disposal containers in all patient care areas, 1987; education, 1987 to present; communication of percutaneous injury analyses to all departments, 1988 to present; and safety product evaluation and purchases, 1991 to present. RESULTS: The total number of PI decreased by 65% (P = .0007) from 1986 through 1993. Recapping injuries decreased from 1986 through 1993 by 88% (P < .0002); interventions that included convenient placement of needle disposal containers and consistent annual education may have contributed to this decrease. Injuries from manipulating intravenous lines or heparin locks decreased in 1992 (P < .03) after purchase of a needleless system for intravenous lines. Injuries from improper disposal or from abrupt patient movement did not decrease significantly over the 8-year period. CONCLUSIONS: This institution has conducted percutaneous injury analysis for 8 years, utilizing consistent reviewers and categorization methods. Successful interventions have reduced recapping injuries, injuries from manipulating intravenous lines/heparin locks, and the overall numbers of PI. The categories of "Improper Disposal" and "Patient Moved Abruptly" present challenges for future reductions, as well as the recently identified problem of staff not using available safety devices or using them improperly.

California↗
PubMedDate not supplied

Needle safety in an endoscopy unit.

Personnel in GI Endoscopy units are at higher risk than health care workers in general for exposure to Hepatitis B and Human Immunodeficiency Virus. Occupational Safety and Health Administration Standards require personal protective equipment including gloves, goggles, masks, water-impervious gowns, shoe covers, sharps containers, and biohazardous waste containers to be readily available. Special hazards in endoscopy make staff compliance both essential and challenging. Contaminated needle sticks are a common occupational injury in this setting, and one GI unit has developed several safeguards to increase staff's protection. These safeguards include inserting all intravenous lines in the safest, most accessible site: the right forearm; hanging IV fluids on all patients whose procedures are done in the radiology suite; and employing the needle recapping system that is cost-effective and easy to use in the endoscopy setting.

Endoscopy↗
PubMed1993

Human immunodeficiency virus transmission between surgeons and patients in orthopaedic surgery.

Surgeons are at risk for contracting human immunodeficiency virus (HIV) from patients. The risk of HIV transmission between patient and surgeon and the potential strategies to reduce the risk of HIV transmission are important. Continuous occupational exposure makes the risk of HIV transmission greater for surgeons than patients. Although the risk of seroconversion after a single exposure is relatively low, the risk for surgeons is more appropriately expressed as a cumulative lifetime risk. The estimated cumulative risk of HIV seroconversion for surgeons may be as high as 1 to 4%. Currently available strategies to prevent HIV transmission require knowledge of the mechanisms of exposure. Adequate barriers, such as double-gloving, waterproof outerwear, and face protection, should be worn for most, if not all, orthopaedic procedures. Additional specific strategies, however, are required to minimize sharp injuries. Surgeons should report any significant exposure to the occupational health department of their institution. Hospitals should have appropriate guidelines and procedures for counseling exposed surgeons, HIV testing of source patients, consideration of zidovudine prophylaxis, and disability insurance policies for surgeons who are occupationally infected with HIV.

Gloves, Surgical↗
PubMed2003

Study on incidence of needle stick injury and factors associated with this problem among medical students.

Medical students face the threat of needle stick injury with the consequent risk of acquiring blood-borne infection by pathogens such as HIV, Hepatitis B and Hepatitis C while performing their clinical activities in the hospitals. A cross-sectional study was conducted among 417 final year medical students from Universiti Kebangsaan Malaysia (UKM), University Malaya (UM) and Universiti Putra Malaysia (UPM). The aims of the study were to determine the incidence of cases and episodes of needle stick injury among them in the past year. This study was also done to find out the factors that might be associated with the occurrence of this problem. The factors were sociodemographic factors, duration of exposure, level of knowledge of blood-borne diseases and Universal Precaution, perception of risk of blood-borne diseases and level of practice of Universal Precaution. The incidence of needle stick injury among medical students was 14.1% (59 cases). The total number of episodes of needle stick injury was 87 and the incidence of episodes among respondents was high i.e. 20.9%. The highest incidence of episodes of needle stick injury occurred in Obstetric & Gynaecology postings, followed by Medicine and Surgery. For clinical procedures, venepuncture had the highest incidence followed by setting up drips and giving parenteral injections. The results showed the students who had needle stick injury (cases) had lower scores in the practice of Universal Precautions than non-cases (p<0.05). There was a significant association between the level of practice of Universal Precautions and the number of episodes of needle stick injury, i.e. the higher the score for the practice of Universal Precautions, the lower the number of episodes (beta=-2.03 x 10(-2), p<0.05). This study showed that medical students are at risk of needle stick injury and blood-borne infections during their clinical activities while performing procedures on patients especially for those who were poor at practising Universal Precautions. Therefore some preventive measures should be taken by the management of the universities and medical students to avoid the occurrence of these problems.

Adult↗
PubMed2003

A training programme for prevention of occupational exposure to bloodborne pathogens: impact on knowledge, behaviour and incidence of needle stick injuries among student nurses in Changsha, People's Republic of China.

BACKGROUND: Although the human immunodeficiency virus (HIV) epidemic in China is expanding rapidly, the principles of universal precautions (UP) are not widely disseminated in Chinese hospitals. Lack of training about occupational prevention of bloodborne pathogens (BBP) may place student nurses at risk when they are in clinical practice. AIM: To examine the impact of structured training on prevention of occupational exposure to BBP on knowledge, behaviour, and incidence of medical sharp injuries among student nurses in Changsha, China. METHODS: A quasi-experimental study evaluated changes in knowledge, self-reported UP behaviours, observed adherence to UP, and needle stick/sharp injuries during a 4-month follow-up period. The study population consisted of 106 student nurses in two classes. One class served as the experimental group, while the other served as a control group. Students in the experimental group participated in a structured training intervention consisting of lectures and demonstrations. RESULTS: At 4 months, the group that received the BBP training scored significantly higher than the standard education group on both knowledge (P < 0.001) and behaviour (P = 0.002). Although students in the experimental group were not observed to practise UP significantly more frequently than those in the control group, they were less likely to experience needle stick/sharp injuries (OR = 0.29; 95% CI 0.11, 0.74; P = 0.004). CONCLUSION: Structured training in prevention of occupational exposure to BBP improved knowledge and behaviour and reduced the number of needle stick/sharp injuries among Chinese student nurses, compared with students who did not receive the training. Training in the techniques of UP could play a role in reducing the risk for occupational exposure to BBP among Chinese future nurses. In view of the accelerating HIV epidemic, implementation and evaluation of such training programmes are urgently needed.

Blood-Borne Pathogens↗