Predicting needlestick and sharps injuries in nursing students: Development of the SNNIP scale

Immunity to Varicella Zoster Virus in Healthcare Workers: A Systematic Review and Meta-Analysis (2024)

Healthcare workers (HCWs) are occupationally exposed to varicella zoster virus (VZV), and their inappropriate vaccination status could contribute to an outbreak involving both professionals and the patients they care for, with a potential impact on the general population. Therefore, since 2007, the Advisory Committee on Immunization Practices (ACIP) recommends that all HCWs have evidence of immunity against varicella. The present meta-analysis was therefore designed to collect the available evidence on the seronegative status of VZV among HCWs. PubMed, Scopus, and Embase databases were searched without backward limit for articles reporting on the seroprevalence of VZV among HCWs, and all articles meeting the inclusion criteria were included in a random-effect meta-analysis model. From 1744 initial entries, a total of 58 articles were included in the quantitative analysis (publication range: 1988 to 2024), for a pooled sample of 71,720 HCWs. Moreover, the included studies reported on seroprevalence data on measles (N = 36,043 HCWs) and rubella (N = 22,086 HCWs). Eventually, the pooled seronegative status for VZV was estimated to be 5.72% (95% confidence interval [95% CI] 4.59 to 7.10) compared to 6.91% (95% CI 4.79 to 9.87) for measles and 7.21% (5.36 to 9.64) for rubella, with a greater risk among subjects younger than 30 years at the time of the survey (risk ratio [RR] 1.434, 95% CI 1.172 to 1.756). Interestingly, medical history of either VZV infection/vaccination had low diagnostic performances (sensitivity 76.00%; specificity 60.12%; PPV of 96.12% but PNV of 18.64%). In summary, the available data suggest that newly hired HCWs are increasingly affected by low immunization rates for VZV but also for measles and rubella, stressing the importance of systematically testing test newly hired workers for all components of the measles-pertussis-rubella-varicella vaccine.

Vaccine-preventable diseases: Immune response in a large population of healthcare students

BACKGROUND

Students in medicine and other health professions are exposed to numerous occupational hazards, primarily biological hazards, during their academic careers at university. The aim of the present study was to investigate the seroprevalence characteristics of anti-HBsAg, anti-Measles, anti-Mumps, anti-Rubella and anti-Varicella IgG antibodies in healthcare students of a large teaching hospital in Rome.

METHODS

To accomplish the study's aims, antibody serology data were gathered from students of Medicine and Surgery, Dentistry, and Health Professions at the Catholic University of the Sacred Heart (Rome Campus) during their first Health Surveillance visit, that took place from 2013 to 2023.

RESULTS

Our study sample included 2523 students, 44.4 % were protected against Hepatitis B, 87.3 % against measles, 85.5 % against mumps, 94.6 % rubella and 95.2 % against varicella. Differences in antibody coverage between age groups were statistically significant (p < 0.001), except for mumps. It found a lower probability of having seronegative anti-HBVs with an older date since the presumed primary vaccination.

CONCLUSION

In our sample, seropositivity rate against vaccine-preventable diseases, especially for Hepatitis B, was often inadequate to prevent possible biological risks connected with the activities carried out on the ward.

Comparing the hair apposition technique with traditional closure in scalp lacerations: a literature review

This literature review aimed to explore the clinical outcomes for adult and child patients with scalp lacerations using the hair apposition technique (HAT) compared with the traditional options of sutures and staples for wound closure in the emergency department (ED). Although the research is scant, in the studies examined HAT was received positively by patients, had limited complications, was cost-effective and was suitable for use in the age ranges that met the criteria for its application. Further research is required to support the existing evidence, but the use of HAT for low-risk scalp lacerations in the ED should be considered and is within the scope of all healthcare professionals who undertake appropriate practice of this clinical skill.

Incidence, knowledge, attitude and practice toward needle stick injury among nursing students in Saudi Arabia

Background

Needle stick injuries constitute the greatest threat to nursing students during clinical practice because of accidental exposure to body fluids and infected blood. The purpose of this study was to (1) determine the prevalence of needle stick injuries and (2) measure the level of knowledge, attitude and practice among nursing students about needle stick injuries.

Methods

Three hundred participants undergraduate nursing students at a private college in Saudi Arabia were included, of whom 281 participated, for an effective response rate of 82%.

Results

The participants showed good knowledge scores with a mean score of 6.4 (SD = 1.4), and results showed that students had positive attitudes (Mean = 27.1, SD = 4.12). Students reported a low level of needle stick practice (Mean = 14.1, SD = 2.0). The total prevalence of needle stick injuries in the sample was 14.1%. The majority, 65.1%, reported one incidence in the last year, while (24.4%) 15 students reported two incident of needle stick injuries. Recapping was the most prevalent (74.1%), followed by during injection (22.3%). Most students did not write a report (77.4%), and being worried and afraid were the main reasons for non-reports (91.2%). The results showed that female students and seniors scored higher level in all needle stick injuries domains (knowledge, attitude and practice) than male students and juniors. Students who had needle stick injuries more than three times last year reported a lower level of all needle stick injury domains than other groups (Mean = 1.5, SD =1.1; Mean = 19.5, SD =1.1; Mean = 9.5, SD =1.1, respectively).

Conclusion

Although the student's showed good knowledge and positive attitudes in NSI, the students reported a low level of needle stick practice. Raising awareness among nursing students and conducting continuing education related to sharp devices and safety and how to write an incident reporting is highly recommended.

Long-Term Effectiveness of Hepatitis B Vaccination in the Protection of Healthcare Students in Highly Developed Countries: A Systematic Review and Meta-Analysis

Hepatitis B virus represents an important global health problem. In highly developed countries, mass vaccination campaigns of newborns in recent decades have drastically reduced the proportion of carriers. However, workers exposed to blood and body fluids, including healthcare students, can be at risk of exposure. In order to assess the proportion of susceptible individuals in the specific population of healthcare students in highly developed countries, a systematic review and meta-analysis was performed to summarize the evidence on the persistence of humoral immune protection induced by the primary cycle of hepatitis B vaccination, as well as the proportion of true non-responders. Forty-six studies were included in the final analysis (52,749 participants). Overall, the seroprotection prevalence at the pre-exposure assessment was equal to 73.8% (95% CI 69.1-78.0); the prevalence of anamnestic response following the administration of a challenge dose was 90.9% (95% CI 87.7-93.3), demonstrating a high proportion of persistence of vaccination-induced immunity. Among those without evidence of anamnestic response, 5.0% (95% CI 2.1-11.5) were non-responders following the completion of a secondary immunization cycle. These findings demonstrate that the majority of healthcare students vaccinated with the complete HBV primary cycle maintain an effective humoral immunity against this pathogen for over two decades.

Prevalence of needle-stick injury among nursing students: A systematic review and meta-analysis

Introduction

Needle-stick injuries (NSI) are a serious threat to the health of healthcare workers, nurses, and nursing students, as they can expose them to infectious diseases. Different prevalence rates have been reported for this type of injury in different studies worldwide. Therefore, this study aimedto estimate the pooled prevalence of NSI among nursing students.

Methods

This study was conducted by searching for articles in Web of Science, PubMed, Scopus, Embase, and Google Scholar without time limitation using the following keywords: needle-stick, needle stick, sharp injury, and nursing student. The data were analyzed using the meta-analysis method and random-effects model. The quality of the articles was evaluated with Newcastle-Ottawa Quality Assessment Scale (NOS). The heterogeneity of the studies was examined using the I 2 index, and the collected data were analyzed using the STATA Software Version 16.

Results

Initially, 1,134 articles were retrieved, of which 32 qualified articles were included in the analysis. Nursing students reported 35% of NSI (95% CI: 28-43%) and 63% (95% CI: 51-74%) did not report their needle-stick injuries. The highest prevalence was related to studies conducted in Asia (39.7%; 95% CI: 31.7-47.7%). There was no significant correlation among NSI prevalence and age of samples, and article year of publication.

Conclusion

A third of nursing students reported experiencing NSI. Consequently, occupational hazard prevention training and student support measures need to be considered.

Prevalence, emotional and follow-up burden of insulin injection-related needle-stick injuries among clinical nurses in Shaanxi Province, west of China: A cross-sectional study

Aims and objectives

The aim of this study was to investigate the prevalence, emotional and follow‐up burden of insulin injection‐related needle‐stick injuries among clinical nurses.

Background

needle‐stick injures introduce statistically significant occupational hazards to healthcare workers. Although the large proportion of the needles injuries attributed to insulin injection, research evidence about the prevalence, emotional and follow‐up burden of such injures is lacking.

Design

Cross‐sectional study.

Methods

5389 nurses were recruited from 45 hospitals in Shaanxi, China, from November 2018 to July 2019. Participants were administrated with a questionnaire specifically developed for this study. Descriptive statistics were used to present the findings.

Results

All 5,389 nurses responded to the survey, of which 396 (7.4%) participants experienced 620 insulin injection‐related needle‐stick injuries in the past year, representing an annual prevalence of 115.0 per 1000 nurses. The annual prevalence of infection caused by the injuries was 18.7 per 1000 nurses. The injuries occurred most frequently when nurses were recapping the needle (42.4%). In the majority (98.4%) of the injuries, the hurt nurses took proper immediate actions. However, only 30.3% of nurses reported the injuries to the administrative staff, and in 43.2% of the injuries, the nurses refused or discontinued the suggested follow‐up. A large proportion (58.6%) of the hurt nurses experienced emotional changes. Multivariate logistic regression showed that department, removing and/or setting back needle caps with bare hands, frequency of insulin pen and syringes are associated with the incidence of insulin injection‐related needle‐stick injuries. This paper is reported following the STROBE recommendations.

Conclusions

This survey demonstrated a considerably high prevalence of insulin injection‐related needle‐stick injuries among clinical nurses. Even though the majority of the hurt nurses took proper immediate actions, a large quantity of them failed to report the accidents to the administrative staff and complete the suggested follow‐up. Nurses who suffered from insulin injection‐related needle‐stick injuries were subject to various negative emotional changes. It portends a statistically significant risk to occupational health management for nurses.

Relevance to clinical practice

Scientific preventive and management strategies are desirable in order to minimize the consequences of insulin injection‐related needle‐stick injuries.

Factors influencing self-reported adherence to standard precautions among Thai nursing students: A cross sectional study

AIM

This study explored nursing students' compliance with standard precautions (SPs) and attitudes to SPs in Thailand, to identify factors that may increase adherence to SPs and infection prevention and control best practice.

BACKGROUND

In the context of high rates of healthcare associated infections as in Thailand, effective strategies to promote high levels of clinician adherence to SPs is a priority. Nursing students are one group of healthcare workers who play a vital role in caring for patients and constitute the future nursing workforce.

DESIGN

A cross-sectional survey design was used.

METHODS

A self-reported survey comprising the Compliance with Standard Precautions Scale and the Factors Influencing Adherence to Standard Precautions Scale were distributed to nursing students as a Thai paper-based survey.

RESULTS

A total of '533 second' to fourth year nursing students from a tertiary nursing school in Bangkok, Thailand completed the survey. The average nursing student compliance to SPs was 68.5%. Most (91.2%) reported only using water for handwashing and 57.2% reported reuse of surgical masks. The fourth-year students had higher compliance (M=3.90, SD=1.12) on the 'prevention of cross infection from person-to-person' dimension while second-year students reported higher compliance on the 'disposal of sharps' (M=2.67, SD=0.57) dimension. 'Contextual Cues' was identified as the factor (M=3.41, SD=0.40) that had the greatest influence on adherence and 'Practice Culture' (M=1.84, SD=0.66) and 'Justification' (M = 1.35, SD.68 had the lowest influence. Fourth year students identified 'Leadership' (M=2.90, SD=0.49) as an important influence on adherence to SPs.

CONCLUSIONS

To increase nursing students' adherence there needs to be greater emphasis on the importance of SPs in theoretical sessions and regular monitoring and feedback on hand hygiene performance and personal protective equipment use while students are on placements. More visible organizational leadership and promotion of high levels of adherence to SPs may assist students to translate their theoretical knowledge into practice.

Prevalence, student nurses' knowledge and practices of needle stick injuries during clinical training: a cross-sectional survey

BACKGROUND

The incidence of needle stick injuries is higher among nurses with a low level of knowledge on the prevention of needle stick injury, and who have not received the relevant training during their undergraduate study. The aim of this study was to determine the level of knowledge of the prevention guidelines and the prevalence of needle stick injury among students in Oman.

METHODS

An online cross-sectional survey using a questionnaire and involving 167 students from a governmental university was conducted. The questionnaire consists of 30 questions; eight general questions, knowledge related questions, and questions about risk factors, prevention measures, and actions in a case of needle stick injury. Ethical approval was obtained and the link to the survey was shared with students using their university email portal.

RESULTS

Of the participants, 81.2% were females; mean age was 23.3 (SD = 4.5) years. The mean total knowledge score was 6.6 out of 10 (SD = 2.1). In addition, 18.2% (n = 32) of the students experienced needle stick injury. Most of the injuries 71.9% (n = 24) occurred during medication preparation and administration. The main cause of NSI as reported by students was recapping the needles (59%, n = 19).

CONCLUSIONS

This study demonstrates that student nurses have a moderate level of knowledge about needle stick injury prevention measures and lack many facets of safe infection control practice. These findings require the collaborative effort of nursing administrators from both academic and clinical areas, to develop effective strategies to reduce or eliminate the occurrence of needle stick injury.