Age and years in practice as factors associated with needlestick and sharps injuries among health care workers in a Portuguese hospital

Needlestick and Sharps Injuries Among Healthcare Workers at a Tertiary Care Hospital: A Retrospective Single-Center Study

Background

Healthcare workers are still at risk from needlesticks and sharps injuries, which can expose them to blood-borne diseases like hepatitis B, hepatitis C, and HIV. We aimed to investigate the proportion of needlesticks and sharps injuries among healthcare workers in a tertiary care hospital in Somalia and also evaluate associated risk factors.

Materials and Methods

This retrospective study was conducted at the Mogadishu Somalia Turkey Recep Tayyip Erdogan Training and Research Hospital. The data was retrieved from the hospital record of the infection prevention and control department over a six-year period between 2017 and 2022.

Results

There were a total of 233 needlestick and sharps injury incidents. The highest number of needlestick and sharps injury cases were reported among nurses (52.4%), followed by cleaners (22.3%), physicians (18.5%), and technicians (6.9%) during the six-year period. Operation theaters were the most frequent place (21.9%) where injuries happened, followed by inpatient care (17.6%) and emergency rooms (16.7%). The most commonly reported instrument that resulted in injuries was a hypodermic needle (81.1%). About 24.9% of the needles or sharps devices that caused needlestick and sharps injury cases were contaminated with hepatitis B. There was a significant difference between gender and place of injury for needlestick and sharps injuries (P=0.001).

Conclusion

Healthcare professionals around the world continue to face major health risks from needle stick and sharps injuries. The present study found that 8.6%of healthcare workers sustained a needle stick and sharps injuries incident in the past year. According to our findings, healthcare institutions need to regularly teach healthcare professionals, especially nurses and cleaners about the significance of needle stick and sharps injuries.

The need for sharps boxes to be offered in the hospital setting for people who use substances: Removing sharps boxes puts all of us at risk

Introduction

Substance use can occur in the hospital setting among people with substance use disorder, including intravenous use. However, the provision of sharps boxes is not typically offered in Canadian hospitals. This study set out to explore the current issues due to the lack of harm reduction in the hospital setting.

Method

Thirty-one health care professionals participated in virtual one-to-one interviews and focus groups regarding harm reduction in hospital. The issue of sharps box removal was highlighted as a concern. A secondary ethnographic thematic analysis explored this theme in more detail. A scoping review of the literature observed additional considerations.

Findings

Sharps box removal was commonplace for people who were known to be, or suspected of, using substances. Sharps boxes only to be used for medical purposes and fears of box tampering were cited as reasons for removal. Health care professionals noted that patients would have to use sharps boxes situated elsewhere. The scoping review revealed that needlestick injuries for hospital staff decreased with greater access to sharps boxes in hospital. Injuries can be addressed through safer disposal practices. Modern designs of sharps boxes and educational initiatives have been found to be successful in sharps disposal compliance and reductions in related injuries.

Discussion

Ensuring equitable access to sharps boxes would help to reduce unsafe needle discarding which can lead to needlestick injuries for hospital staff and potentially other patients. Education would be a key step in furthering understandings of the importance of sharps boxes and harm reduction as a whole.

Biohazard Accidents, Harmful Elements to the Wellness of Healthcare Workers, and Their Risk Factors

BACKGROUND

For healthcare personnel, biohazard accidents pose a significant risk to their health. These exposures can enable the transmission of pathogens such as Hepatitis B, Hepatitis C, and human immunodeficiency virus (HIV).

OBJECTIVE

To indicate and quantify the risk associated with higher threatening situations, such as biohazard accidents on repeated occasions or incorrect notifications to injured healthcare professionals.

METHODS

A cross-sectional study was conducted at the Poniente Hospital in Almeria (Spain). In total, 592 participants reported 1062 accidents and their characteristics and notifications were analyzed.

RESULTS

It was found that women (OR = 1.29) working in the surgical area (OR = 2.92), those on indefinite contracts (OR = 1.67), and those with high work experience (OR = 1.14) were the main risk factors for multiple biohazard accidents. Concerning the incorrect notification of these accidents, the main risk factors were work performance during the afternoon shift (OR = 1.72) and the fact that the accident was caused by the injured worker himself (OR = 1.53).

CONCLUSIONS

This study outlined the main factors that can contribute to healthcare professionals suffering these accidents. As a result, corrective measures must be taken against these risk factors to improve safety for healthcare workers in the future.

Prevention from Sharp Injuries in the Hospital Sector: An Italian National Observatory on the Implementation of the Council Directive 2010/32/EU before and during the COVID-19 Pandemic

Sharp injuries, determining the risk of bloodborne infections and psychological distress in healthcare workers, may be prevented by a set of strategies, legally enforced in Europe through the Directive 2010/32/EU. To assess its level of implementation in Italy, a national survey was conducted in 2017 and again in 2021, evaluating the progress and possible drawbacks of the COVID-19 pandemic. Altogether, 285 safety managers and 330 nurses from a representative sample of 97 and 117 public hospitals were interviewed using a standardized questionnaire. Knowledge of the Directive requirements decreased significantly, with <60% of participants answering correctly in 2021, and nurses' attendance in specific courses dropped to 25% in 2021 compared to 54% in 2017. Over 75% of hospitals introduced multiple safety-engineered devices (SED), though total replacement occurred in <50% of cases; routine SED availability increased for blood collection (89%) and venous access devices (83%). Incorrect behaviors in handling sharps decreased significantly over time. Nurses' HBV vaccination coverage was high (89% in both surveys); in the last year, 97% were vaccinated against COVID, and 47% against influenza. Average annual injuries per hospital did not increase significantly (32 in 2021 vs. 26 in 2017). In 2017, nurses' perceived safety barriers were working in emergency situations (49%) and lack of resources (40%); in 2021, understaffing (73%), physical fatigue (62%), and handling difficulties while wearing full protective equipment (59%). Safety measures were implemented in Italian hospitals, and although the average injuries per hospital did not show a decrease, these measures could have helped protect healthcare workers during the pandemic, mitigating its potential impact on the increase in situations at risk of injury.

Reported Injuries from Sharp Objects among Healthcare Workers in Central Greece

Sharp injuries (SIs) are incidents or accidents caused by a needle, blades (such as scalpels) or other medical instruments which penetrate the skin. They are among the major work-related injuries in healthcare professionals. The purpose of this study is to estimate SIs in healthcare workers (HCWs) in Central Greece. Method: A cross-sectional descriptive study through an online survey in healthcare facilities in Central Greece was conducted. Snowball sampling contributed to further dissemination of the survey among the target population. The modified version of the EPINet questionnaire was used with self-reported answers of the participants via electronic Google form. Results: Analysis of collected data indicated that 74.1% of the participants had at least one injury, with the highest number of injuries occurring in nursing staff at 65.1% and 62.3% of injuries recorded in the morning shift. With respect to the site of the injury, participants reported 33.1% of the injuries in the patient’s room, 11.8% in the nurse’s station, 9.6% in the Emergency Department (ED), 9.2% in the Intensive Care Unit (ICU), 8.4% in blood sampling, 8.4% in surgery, and only 7.8% in laboratories or other places. Additionally, hands were the most frequently affected body part (96%), while 69.6% of the workers did not report the injury and 53% of them did not apply the procedures and guidelines defined by the healthcare organization (employer). Relative factors to the injury are age, level of education, shifts, and possibly sex. Conclusions: SIs are the “Achilles heel” of health workers. The high incidence and low reporting rate of SIs highlights the need for specialized training and education. Age, work experience, and shift appear to significantly affect the incidence of injury.

Needle-Stick and Sharp Injuries among Hospital Healthcare Workers in Saudi Arabia: A Cross-Sectional Survey

Needle-stick or sharp injuries (NSIs) are critical occupational hazards for healthcare workers. Exposure to blood and body fluids through NSIs increases the risk of transmission of blood-borne pathogens among them. The objectives of this study were to estimate the annual incidence of NSIs and investigate the associated factors of NSIs among the healthcare workers in Saudi Arabia. A cross-sectional online survey was conducted between October and November 2021. A total of 361 healthcare workers participated in the survey from all over Saudi Arabia. The one-year incidence of at least one event of NSIs among the healthcare workers is estimated at 22.2% (95% CI: 18.0, 26.8). More than half of the injury events (53.8%) were not reported to the authority by the healthcare workers. Incidence of NSIs was highest among the physicians (36%) and was followed by nurses (34.8%), dentists (29.2%), and medical technologists (21.1%). The odds of NSIs was higher among the healthcare workers aged 26–30 years compared to the 20–25 years age group (OR: 2.51; 95% CI: 1.04, 6.03), as well as among the workers who directly dealt with needles or other sharp objects while working compared to those who did not (OR: 5.9; 95% CI: 2.69, 12.97). The high incidence and low rate of reporting of NSIs highlights the need of education and awareness raising programs targeting healthcare providers with higher risk of injury.

An Assessment of the Knowledge, Attitude, and Practice Toward Standard Precautions Among Health Workers From a Hospital in Northern Cyprus

BACKGROUND

The objective was to assess the knowledge level, attitude, and practice of health care workers towards standard precautions, and to identify the related factors. Furthermore, it was attempted to identify the proportion of having the experience of needle stick injuries (NSIs) and associated factors among participants.

METHODS

A cross-sectional study was conducted in a teaching hospital among 233 health workers using a self-administrated questionnaire. The questionnaire included eight knowledge items, seven practice items, and five attitude items. Based on the mean score of each category, responses were grouped into "satisfactory" and "unsatisfactory". Univariate, bivariate, and multivariable logistic regression analyses were done.

RESULTS

The mean age of the participants 32.95 (SD ± 9.70) and 62.2% of them were women. 57.5% of the staff had a satisfactory level of correct knowledge (>5 correct answers), 37.3% had a satisfactory positive attitude (>3 correct answers), and 30.9% had a satisfactory practice (>3 correct answers) towards standard precautions. The occupation was one of the predictors as doctors were less likely to have satisfactory knowledge and practice compared to nurses (OR = 0.269, 95% CI: 0.10-0.70 and OR = 0.248, 95% CI: 0.08-0.77, respectively). Out of 174 participants, 31.6% of them reported experiencing NSIs and support staff were 71% less likely to experience NSIs compared to nurses & paramedics.

CONCLUSION

The findings revealed a substandard adherence of standard precautions among participants, which highlighted the necessity of the provision of a periodic, tailored training program based on the occupation and risk exposure.

Needlestick and sharps injuries in an Indonesian tertiary teaching hospital from 2014 to 2017: a cohort study

OBJECTIVE

Needlestick and sharps injuries among healthcare workers (HCWs) pose significant occupational health problems. We aim to provide incidence and other epidemiological aspects of needlestick and sharp injuries (NSSIs) among HCWs in a tertiary teaching hospital in Indonesia, to inform the evaluation of NSSIs prevention programme.

METHODS

A cohort study was conducted at Cipto Mangunkusumo Hospital in Jakarta. We analysed data of the sharps injury programme at the hospital between January 2014 and December 2017. Incidence of NSSIs was calculated per 1000 person-years (1000-PY).

RESULTS

Over the 4-year period, a total of 286 NSSIs were reported. The mean NSSIs incidence rate for 4 years was 13.3/1000-PY, peaking in 2015 (15.5/1000-PY) then decreasing afterward. Most NSSIs were experienced by nurses (42.7%), but the highest incidence was among midwives (18.9/1000-PY), followed by nurses, medical students and medical doctors (15.2/1000-PY, 12.6/1000-PY and 11.8/1000-PY, respectively). The devices causing the highest proportion of NSSIs were hollow-bore needles (66.8%), followed by suture needles (14.3%) and solid needles (10.8%). 9.4% of NSSIs were related to insulin pen injection. Of all the incidents, 31.3% occurred during surgical procedures, 25.9% during blood collections, 14.3% during administering injection of drugs and 13.3% during waste cleaning.

CONCLUSION

In conclusion, this study showed varied incidences of NSSI among different occupations, with the highest among midwives and nurses. Many unsafe work practices still continue, which is of utmost concern. We suggest opportunities for prevention including training and cultivating safer workplace practices.

The Effects of a Novel Mindfulness-based Intervention on Nurses' State Mindfulness and Patient Satisfaction in the Emergency Department

INTRODUCTION

The objective of this study was to examine the effect of a novel mindfulness-based time-out intervention on state of mindfulness among emergency nurses and, accordingly, on patient satisfaction.

METHODS

A pre-post intervention design among nurses in the emergency department was used with a between-subjects factor of patients who were nested within each nurse. The study was conducted between January 2017 and June 2018 among 48 nurses in the emergency department of a public tertiary academic hospital. For each nurse, a consecutive sample of 20 patients who attended the emergency department was recruited (n = 1920 patients; 960 in each phase). The mindfulness-based time-out intervention was based on theoretical mindfulness principles and carried out every 4 hours with direct communication to the patient at their bedside. Nurses' sociodemographic and professional characteristics and trait mindfulness were collected preintervention. Pre- and postintervention, data was collected on patients' sociodemographic and satisfaction, nurses' state mindfulness, and ED workload.

RESULTS

An increase in nurses' state mindfulness and patients' satisfaction was found after the mindfulness-based time-out intervention compared with before the intervention (4.35 [SD = 0.64] vs 4.03 [0.82], P < .001 and 4.03 [0.41] vs 3.16 [0.44], P < .001, respectively). A positive correlation was found between patients' satisfaction and nurses' state mindfulness (r = 0.29, P < .001). The findings also demonstrated that state mindfulness was higher among nurses, characterized by high trait mindfulness, after the mindfulness-based time-out intervention implementation.

DISCUSSION

By adapting mindfulness principles to the dynamic environment of the emergency department, we showed that the mindfulness-based time-out intervention was associated with a significant improvement in state mindfulness and patient satisfaction. The findings elucidate the interrelation among several conceptualizations of mindfulness that are increasingly reported in the literature, namely trait and state mindfulness, and interventions to promote mindfulness.

Work-life prevalence of self-reported occupational injuries in mothers of a birth cohort

Purpose. This study investigated self-reported occupational injuries among mothers in a large birth cohort study and the relation of their characteristics to different injury outcomes: occurrence, severity, temporal proximity and recurrence. Methods. We asked 4338 women whether they had been in 'an accident at work, even if it did not require medical treatment', and the number of accidents throughout their working life, type of injury and whether it occurred within the last 12 months. Results. Over one-fifth (21.8%) of working-age mothers reported having at least one occupational injury throughout their working life. Wounds and superficial injuries were the most frequently reported types of occupational injuries (11.0%), followed by dislocated bones and joints, sprains and strains (10.7%). Women who reported a history of occupational injuries also had a higher likelihood of reporting a work-related health problem (adjusted odds ratio [OR] = 2.64; 95% confidence interval [CI] [2.27, 3.07]) and of having a partner who also reported an occupational injury throughout their working life (adjusted OR = 1.86; 95% CI [1.33, 2.62]). Associations remained fairly stable across all outcomes. Conclusions. Our findings point towards a broadened understanding of occupational injury consequences and research focusing on family-level factors that account for the embeddedness of workers in households.

Factors contributing to needle stick injuries among new registered nurses at a hospital in Trinidad

BACKGROUND

Newly educated RNs are vulnerable to needle stick injuries (NSIs). Most needle stick injuries occur during practice and associated with nurses' practice and available resources.

METHODS

This was a quantitative, descriptive study. Registered nurses (N = 120) with less than three years' experience. Data collected using a 26-item questionnaire among newly registered nurses. Data were analyzed descriptively and inferentially using (SPSS) version 20.

RESULTS

Most of the nurses between the ages 20-30 years (49.7%), were female (73.4%), had 2 to <3 years' experience (44.2%) and experienced a needle stick injury (43.3%). Respondents knew about the policies on standard precautions but their practice was not compliant with safe practices. Adherence was associated with knowledge of policies on standard precautions (r. = 534, p < .01), having updated policies (r = .404, p < .01) and the appropriate use of resources (r. = 805, p < .01).

CONCLUSION

There are a number of factors that contribute to NSIs among newly registered nurses which are personal as well as structural. Avoidable practices such as non-adherence to standard precautions while using hypodermic needles contributed to NSIs. Mandatory training and evaluation of nurses' knowledge and attitude regarding safety practices should be examined.

Workplace accidents among hospital cleaning professionals at a hospital in the city of Maranhão, Brazil

The goal of this study was to investigate the prevalence and factors associated with workplace accidents among hospital cleaning professionals. This is a cross-sectional, analytical study of a sample of 199 cleaning workers at six hospitals in São Luís, Maranhão, Brazil. We first ran a univariate analysis, and later the Poisson regression analyzes with robust variance were used, with hierarchized modeling of the data in order to estimate the prevalence ratios (PR) between the independent variables and the outcome (workplace accidents). The prevalence of workplace accidents is 13.57%, 81.48% of them with sharps. At the end of the multivariate analysis the following were found to be associated with workplace accidents: age between 18 and 30, not having a high-school degree, on the job for 2 to 5 years, inadequate segregation of health service waste (HSW), training only on admission, failure to consider the health hazards of hospital waste and failure to use personal protective equipment (PPE). Our findings reinforce the importance of continued health education, stressing periodic training and the use of PPE.

Sharps and needle-stick injuries among medical residents and healthcare professional students: pattern and reporting in Italy-a cross-sectional analytical study

OBJECTIVES

Healthcare workers, in the course of their professional activity, are potentially exposed to chemical, physical and above all biological risks. The aims of our study were to investigate the extent and distribution of needle-stick and sharp injuries (NSIs) in healthcare students, the behaviours and circumstances most frequently associated with NSIs, the frequency of NSI reporting and the adherence to the post-exposure protocols.

METHODS

This study involved, through an interviewer-administered structured questionnaire, undergraduate and postgraduate students attending postgraduate medical schools and healthcare professional schools who underwent occupational health visits between January 2015 and July 2018.

RESULTS

Of the 642 students that participated in the study, 95 (14.8%) sustained an NSI during the traineeship and, of these, 59 (62.1%) reported the NSI to the occupational health service. NSIs were significantly more frequent in older subjects (χ²=9.853, p=0.020) and, among medical residents, in surgical residents (χ²=31.260, p<0.0001); moreover, occurrence of NSIs increased with increasing duration of traineeship (t=-2.051, p=0.041). Reporting of NSIs significantly increased with increasing age (χ²=12.543, p=0.006), with medical residents significantly under-reporting NSIs compared with undergraduate healthcare professional students (χ²=10.718, p=0.001) and among medical residents, those attending critical care units had the highest under-reporting (χ²=7.323, p=0.026).

CONCLUSIONS

The study showed remarkable under-reporting, as well as a lack of preparedness of students for NSI preventive and post-exposure effective measures. Our findings underline that healthcare student education should be reinforced to ensure that safe practices are carried out when needles and sharps are involved, as well as stressing the importance of NSI reporting and adherence to post-exposure prophylaxis protocols.

Relationship between psychosocial working conditions, stress perception, and needle-stick injury among healthcare workers in Shanghai

Background

The present study aims to identify the association between psychosocial working conditions, global stress perception, and needle-stick injury among Chinese healthcare workers. It also endeavors to detect the mediating effects of global stress perception.

Methods

A total of 1956 valid samples were collected from eight teaching hospitals in Shanghai, China. A self-reported questionnaire was administered to participants after obtaining their written consent. Structural equation model was used to analyze the relationship between study variables.

Results

Most of the correlation coefficients between psychosocial conditions at work, stress perception, and needle-stick injury are of statistical significance ranging from 0.004 to 0.869. Results of the internal consistency test shows that Cronbach’s α is between 0.770 and 0.925. All three models for effect analysis demonstrated satisfactory global goodness and acceptable path loadings. Psychosocial working conditions and stress perception were directly associated with events of needle-stick injury, as 0.39 (95%CI: 0.32 to 0.48) and 0.32 (95%CI: 0.22 to 0.39), respectively. Furthermore, stress perception had been proved to have a mediating effect (0.25, 95%CI: 0.19 to 0.31) between psychosocial working condition and needle-stick injury, which occupied over one-third of the total effect.

Conclusions

Both stressful psychosocial working conditions and negative stress perception could increase the risk of needle-stick injury that occurs among healthcare workers. Management of stress perception could reduce health risk brought by stressful psychosocial working conditions.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-7181-7) contains supplementary material, which is available to authorized users.

Epidemiology of needlestick and sharp injuries among health care workers based on records from 252 hospitals for the period 2010-2014, Poland

BACKGROUND

Needlestick and sharp injuries (NSIs) are an important element of public health and should be closely monitored. On the other hand there are no precise Polish data on a number of the occupational NSIs. The aim of the study was to assess the failure to report injuries and then to estimate the actual number of NSIs among healthcare workers (HCWs) in Poland based on the collected data.

METHODS

Analysis of injury registers on the basis of 252 hospitals in Poland. Conducting 487 surveys among doctors, nurses and paramedics. Calculation of rates of injuries per 1000 workers per year (with 95% confidence intervals (CI)). The level of statistical significance was set at p ≤ 0.05.

RESULTS

In the study period, 9775 NSIs were registered in the hospitals. Majority of the NSIs were recorded among nurses (72.6%,p < 0.01). The needle was the tool responsible for the greatest number of the NSIs in all professional groups (79.5%, p < 0.01). The average annual NSIs rates based on hospital registers were: 16.0/1000 doctors, 20.5/1000 nurses, 16.8/1000 paramedics. Every second NSIs was not reported (45.2%). We estimated that there are probably 13,567 NSIs every year among hospital care workers in Poland.

CONCLUSIONS

NSIs are a significant health problem for HCWs and should be subject to epidemiological surveillance. The purpose of the training of medical personnel should be to increase the number of injuries reported. The implementation of the epidemiological surveillance system will allow for the unification of the obtained data, which would be more comparable on the national scale as well as between different countries.

[Prevalence of hepatitis B markers and vaccination status of healthcare personnel: Experience of the Tunis Military Hospital]

BACKGROUND

Hepatitis B is the main cause of liver disease in the world. Chronic hepatitis B may lead to cirrhosis, liver insufficiency or liver cancer. Tunisia is considered as a country with intermediate endemicity, where hepatitis B presents a real public health problem. The aims of this study were to evaluate the prevalence of viral biomarkers of hepatitis B in healthcare personnel; to look for potential risk factors associated with HbS antigen carriage and to evaluate the prevalence of vaccination in this particular population.

METHODS

Sero-epidemiological, prospective and descriptive study, among 2411 healthcare personnel in the Military Hospital of Tunis, during a 5-month period from September 2013 to January 2014.

RESULTS

Blood samples were collected from 1497 volunteers among the hospital staff. Two hundred and seventy-one individuals had a positive HbC antibody titer (prevalence 18.1%), including 229 who were positive for HbC and HbS antibodies (prevalence 15.3%), 12 positive for only HbC antibody (prevalence 0.8%), and 30 positive for HBsAg (prevalence 2%). Among HbS Ag carriers, 56.6% reported needle stick and sharp object injuries during their professional careers. Among HbS Ag carriers, there were three patients with a history of acute viral hepatitis with jaundice, and 27 patients (90%) who were asymptomatic and were diagnosed during our study. Among healthcare workers in the hospital, 56.1% were immunized through vaccination (positive HbS antibodies without HbC antibodies), of whom 66% had durable protective immunity (HbS antibodies>100mU/mL). Lastly, 25.8% of the hospital workers remained without any protection against hepatitis B (serology entirely negative) and were then offered a complete vaccination.

CONCLUSION

Hepatitis B vaccine is the mainstay of hepatitis B prevention. Safe injection practices, blood safety and promoting wider access to monitoring and screening, care and treatment services for hepatitis B are the best guarantees to prevent and control this disease.

Behaviors and Attitudes of Polish Health Care Workers with Respect to the Hazards from Blood-Borne Pathogens: A Questionnaire-Based Study

Blood-borne infections represent an important occupational health issue in health care settings. The aim of this study was to analyze behaviors of health care workers (HCWs) in the field of needlestick injuries (NSIs) as well as to learn about their attitudes to patients infected with blood-borne viruses. A total of 487 HCWs based at 26 hospitals in Poland completed an anonymous self-administered questionnaire in the period of October⁻December 2015. Data was analyzed using descriptive statistics and multiple logistic regression. Of the HCWs, 44.8% suffered superficial wounds, and 17.9% HCWs were cut deeply at least once. The most frequent causes of injuries were: rush (31.4%), unpredictable patient behavior (29%), and lack of attention (27%). The rate of underreporting NSIs was 45.2%. Males showed more than three times higher chance of not reporting injuries (odds ratio (OR) 3.495, 95% Confidence Interval (CI): 1.65⁻7.49). The nurses more often took off their protective gloves to make the procedure easier (p = 0.036). Taking off protective clothes was positively associated with long work experience (OR 1.16, 95% CI: 0.995⁻1.36). Recapping concerned 15.5% of doctors, 8.2% of nurses, and 11.2% of paramedics. 25.9% HCWs feared infection in the workplace, and every tenth HCW refused to help the infected patient. The longer the work experience, the greater the concern about the possibility of infection (OR 1.33, 95% CI: 0.99⁻1.78). Most HCWs were more cautious when dealing with an infected patient and in their opinion infected patients should be required to inform HCWs of their serological status and such information should be compulsorily transferred between different health institutions. The emphasis in the training of HCWs in the future should be on classes perfecting practical skills like paying more attention to reporting NSIs, improving occupational behaviors like avoiding needle recapping, and on the development of appropriate attitudes towards patients infected with HIV, HBV, or HCV.

Overcoming public health risks to staff during the management of waste from healthcare facilities

Purpose The management of public health risks is a key focus for the European Union. One of the key factors that has been shown to pose a public health risk is that of the management of needles from healthcare facilities. The paper aims to discuss this issue. Design/methodology/approach Using audits of two case study hospitals based in northern Italy, this study sought to examine the key factors that resulted in needle stick injuries amongst staff and suggest measures to minimise these risks. Findings The number of needle stick injuries was influenced by various key factors including the time period during the year, the length of time employed, the location within the site, staff category and working hours. Practical implications Suggestions for overcoming the risk factors, including redesigning working patterns, staff training and awareness building, and the use of safety-engineered devices are outlined. Originality/value This study examined the incidence of needle stick injuries amongst healthcare staff in two Italian hospitals, which was lower than in other countries due to various factors, including recapping of needles not being allowed, the introduction of self-retractable needles and awareness campaigns about the correct disposal procedures of potentially infectious waste.

Prevalence of needlestick and sharps injuries in the healthcare workers of Iranian hospitals: an updated meta-analysis

BACKGROUND

Needlestick and sharps injuries (NSIs) are critical occupational risk among health care workers (HCWs), which is extremely worrying due to the potential risk of transmitting bloodborn pathogens (BBPs). This study was carried out to evaluate the prevalence of NSIs among Iranian HCWs.

METHODS

In this systematic review and meta-analysis, the key terms percu* injur*, needle* stick injur*, needlestick* injur*, or sharp* injur* were searched in the Scientific Information Database (SID), MagIran, IranMedex, Google Scholar, Science Direct, PubMed, and Scopus. A prefabricated checklist, including variables: first author, publication year, study population, sample size, gender, total prevalence of needlestick in each gender, type of questionnaire, region, and type of hospitals, was used to extract data from the selected articles included which were published between 2003 and 2016.

RESULTS

The analysis showed that the prevalence of NSIs in the Iranian HCWs was 42.5% (95% CI 37-48). Moreover, the prevalence of NSIs was more in women (47%; 95% CI 36-58) compared to men (42%; 95% CI 26-58).

CONCLUSION

Given the high prevalence of NSIs, it is necessary to supply safe needles and instruments, hold training programs focused on new methods of using sharp objects safely, observe safety principles and standards, reinforce the practical skills of personnel, and pay more attention to reporting and improving occupational behaviors like avoiding needle recapping in order to reduce the prevalence of NSIs and consequently reduce potential risk of transmission of BBPs.

Trend analysis and factors associated with biological injuries among health care workers in Southern Italy

Background:

Biological injuries are the most common and serious among health care workers.

Objectives:

This study aims to estimate the injuries’ incidence, job distribution and temporal trend in a hospital in Southern Italy.

Methods:

Data on accidents, collected from January 2010 to December 2016, were analyzed. Poisson distribution was used to calculate incidence rates and respective 95% confidence intervals. Trends were analyzed using the Joinpoint regression model. A multiple logistic regression model was used to identify factors associated with injuries.

Results:

Three hundred and thirty-five injuries were reported from 2010 to 2016, occurring mainly in the morning (54%) and frequently caused by needlestick (70%). We observed a significant decline in the incidence rates of the total amount of injuries (ACP=-11.3; 95% CI: -16.3 - -5.9), for nurses (ACP=-15.7; 95% CI: -24.3 - -6.2) and for health and social care assistants (ACP=-13.2; 95% CI: -23.1 - -2.0). Among male physicians the risk of biological accident was higher than female physicians (OR=3.67; 95% CI:1.9-7.1), while among male nurses the risk was lower than among female nurses (OR=0.31; 95% CI: 0.17-0.59). For the nursing category, “afternoon” and “night” represented risk factors with OR=2.19 (95% CI: 1.2-3.7) and OR=8.8 (95% CI: 3.4-22.8) respectively. For physicians, surgical intervention was a risk factor (OR=7.71; 95% CI: 3.2-18.4).

Conclusions:

Our findings confirm the need for continuous monitoring and improved control of work-related exposures, both for health and the associated costs.

Circumstances and Structure of Occupational Sharp Injuries among Healthcare Workers of a Selected Hospital in Central Poland

(1) Background: An analysis of work-related sharp injuries in Healthcare Workers (HCWs) based at a selected hospital in Central Poland by presenting the frequency of accidents, injury rates, and identifying circumstances of Needle Sticks and Sharp Injuries (NSSI) and giving Post-Exposure Procedures (PEP). (2) Methods: A retrospective analysis of medical documentation regarding work-related NSSI at a district hospital located in central Poland; over the period 2010⁻2017. The study group included HCWs who had an accident while on duty. (3) Results: Most injuries were reported by nurses and staff over 40, on the morning shift. The most common injuries were using a needle. The most exposed part of the body were fingers. The average annual injury rates were: 1.22/100 Nurses; 2.02/100 doctors; 1.34/100 hospital beds; and 8.59/100,000 inpatient days. The rates for 3-year periods, after the implementation of legal regulations were higher than before.

CONCLUSION

Injuries rates are more reliable for comparison than frequency. Legislation on the need to register injuries seems to be necessary. In the supervision of work safety of personnel, reliable reporting of all injuries by the respective HCWs plays a key role.

Prevalence of needle stick injury and its associated factors among nurses working in public hospitals of Dessie town, Northeast Ethiopia, 2016

OBJECTIVE

Nurses are exposed to dangerous and deadly blood borne pathogens through contaminated needle stick injuries. This study was designed to assess prevalence of needle stick injury and its associated factors among nurses working in hospitals. Institution-based cross-sectional study design was used among 258 randomly selected nurses. Collected data was entered into Epi-Data version 3.1 and transferred to SPSS Version 20.0 for analysis. The degree of variables were assessed using adjusted odds ratio and its 95% confidence interval with P value (< 0.05).

RESULTS

Eighty-nine (34.5%) nurses self-reported receiving a needle stick injury in the previous 12 months. Work experience, working hour, personal protective, infection prevention guide line utilization and infection prevention training were significantly associated to needle stick injury.

CONCLUSIONS

The needle stick injury in this study area was prevalent. The contributing factors to the injury were duration of working hours, experience, use of personal protective equipment and training.

Determinants of Workplace Injuries and Violence Among Newly Licensed RNs

Workplace injuries, such as musculoskeletal injuries, needlestick injuries, and emotional and physical violence, remain an issue in U.S. hospitals. To develop meaningful safety programs, it is important to identify workplace factors that contribute to injuries. This study explored factors that affect injuries in a sample of newly licensed registered nurses (NLRNs) in Florida. Regressions were run on models in which the dependent variable was the degree to which the respondent had experienced needlesticks, work-related musculoskeletal injuries, cuts or lacerations, contusions, verbal violence, physical violence, and other occupational injuries. A higher probability of these injuries was associated with greater length of employment, working evening or night shifts, working overtime, and reporting job difficulties and pressures. A lower probability was associated with working in a teaching hospital and working more hours. Study findings suggest that work environment issues must be addressed for safety programs to be effective.

Evaluating the Effectiveness of a Continuing Education Program for Prevention of Occupational Exposure to Needle Stick Injuries in Nursing Staff Based on Kirkpatrick's Model

BACKGROUND

Nurses are the most vulnerable group that are faced with occupational injuries caused by exposure to needle stick injuries. This study evaluated the effectiveness of a continuing education program about the prevention of occupational exposure to needle stick injuries in the nursing staff, based on the Kirkpatrick model.

METHODS

In this study, 120 nurses were selected in the experimental and control groups. A continuing education program for experimental group was performed. After the education program, its effectiveness has been evaluated across four levels (Reaction, Learning, Behavior, Results) of the Kirkpatrick model. Data analysis was conducted using Pearson's correlation coefficient, chi-square test, paired t-test, independent samples t-test, and descriptive statistics. The data were analyzed using the SPSS statistical software (V. 22).

RESULTS

The mean score for knowledge in the experimental group improved significantly from 8.32 ± 2.17 to 13.98 ± 1.2 (p < 0.05). The experimental group of 24 nurses (40%) were exposed to needle stick injury before education, but this number was reduced to 9 (15%) after intervention. The chi-square test showed a significant difference (P = 0.013). However in the experimental group, 15 nurses (25%) were exposed to blood and body fluids before intervention, but again it was reduced to 6 (10%) after education. The chi-square test showed a significant difference (P = 0.002).

CONCLUSION

The results from the execution of continuing education program showed that through designing training programs and raising awareness in nursing personnel, we can reduce occupation exposure to needle stick injuries.

Occupational exposure to sharps injury among healthcare providers in Ethiopia regional hospitals

BACKGROUND

Sharps injury is a penetrating stab wound from a needle, scalpel, or another sharp object that may result in exposure to blood or other body fluids. According to World Health Organization pooled estimate, the annual incidence of sharps injury in Africa was ranged from 2.10 to 4.68 per person per year, but research data in Ethiopia is limited. The aim of the study was to investigate sharps injury prevalence and associated risk factors.

METHODS

Institution based cross-sectional study was conducted with 200 healthcare providers (HCP) in Northeast Ethiopia. Proportionate stratified sampling was used to select HCP. Sharps injury during the last 12 months was an outcome variable whereas demographic characteristics, behavioral attributes, and job environment characteristics were independent variables. Data was collected from April to May 2016 using self-administered questionnaire; which was adapted from World Health Organization best practices for injections and related procedures toolkit. Bivariate and multivariate logistic regression analysis was carried out to identify sharps injury associated risk factors. Epi Info version 3.5.1 software package was used for data coding and entry whereas Statistical Package for Social Sciences (SPSS) version 20 software package was used for analysis.

RESULTS

In total, 195 HCP participated with a response rate of 97.5%. The prevalence of sharps injury was 32.8%. Following adjustment for covariates, lack of in-service job training and previous exposure to sharps injury were statistically significant risk factors for sharps injury. HCP who had no in-service job training were 4.7 times more likely sustained sharps injury compared with those who had in-service job training (p < 0.001, OR = 4.7, 95% CI = 2.05-10.56). HCP who had previous exposure to sharps injury were 3.7 times more likely sustained sharps injury compared with those who were not exposed (p-value = 0.002, OR = 3.7, 95% CI = 1.62-8.27).

CONCLUSIONS

This study revealed 32.8% or at least three out of ten HCP exposed to sharps injury. This was found statistically significant among HCP who had no in-service job training and who had previous exposure to sharps injury. Thus, training HCP perhaps increase their skill and curiosity to reduce exposure to sharps injury.

Long work hours and chronic insomnia are associated with needlestick and sharps injuries among hospital nurses in Taiwan: A national survey

BACKGROUND

Needlestick and sharps injuries are prevalent work-related injuries among nurses. Safety devices prevent only one-quarter of related injuries. More studies of modifiable risk factors are needed.

OBJECTIVES

To examine whether long work hours and chronic insomnia are associated with needlestick and sharps injuries among hospital nurses in Taiwan.

DESIGN

Cross-sectional survey.

SETTINGS/PARTICIPANTS

This analysis included 19,386 full-time bedside nurses working in 104 hospitals across Taiwan.

METHODS

Participants filled out an anonymous questionnaire from July to September 2014. Chronic insomnia, needlestick injuries, and sharps injuries during the past year were each measured by a yes/no question. Multivariate logistic regression models were applied to examine the effects of long work hours and chronic insomnia on needlestick and sharps injuries, given with control for sex, marital status, educational level, age, years of practice, work unit, and hospital level in the model.

RESULTS

More than 70% of study nurses worked long hours during the previous week (>50h: 27.5%; 41-50h: 43.2%), and 15.5% of nurses reported chronic insomnia. The percentage of sharps injuries (38.8%) was higher than that for needlestick injuries (22.4%) during the previous year among nurses. After adjusting for potential confounders, logistic regression yielded significant results showing that those who worked 41 to 50h per week, >50h per week, and had chronic insomnia were 1.17 times (95% C.I.=1.04-1.32), 1.51 times (95% C.I.=1.32-1.72), and 1.45 times (95% C.I.=1.25-1.68) more likely to experience needlestick injuries, and 1.29 times (95% C.I.=1.17-1.42), 1.37 times (95% C.I.=1.23-1.53), and 1.56 times (95% C.I.=1.37-1.77) more likely to experience sharps injuries, respectively, than those who worked fewer hours and did not have insomnia.

CONCLUSIONS

This nationwide nurse survey showed that high rates of needlestick and sharps injuries persist in hospital nurses in Taiwan. The common problems of long work hours and chronic insomnia increase the risk of these injuries. We suggest that hospital managers follow regulations on work hours and optimize shift schedules for nurses to decrease related injuries.

Factors Associated with Needlestick Injuries in Health Care Occupations: A Systematic Review

INTRODUCTION

Needlestick and sharps injuries (NSIs), are among the main job-related injuries that health care workers experience. In fact, contraction of hepatitis B or hepatitis C from work-related NSIs is one of the most common occupational hazards among health care workers.

AIM

The aim of this study was to determine the factors associated with NSIs in health care occupation.

MATERIALS AND METHODS

In this study, a systematic and purposive review with emphasis on the research question was run to retrieve, evaluate and consolidate the required information. The following four key words were used to search for the relevant articles published from January 1998 to May 2015: NSI health care workers, risk factor and factors associated, in Science direct, EBSCO Host, PubMed, ProQuest, SID and Cochrane Library. Several steps of evaluation were taken to select and analyse the full texts of relevant articles. According to the inclusion criteria, we finally selected 11 articles from the 18642 retrieved articles.

RESULTS

The data of the analysed articles indicated that the highest incidence of NSIs was seen in nurses and that the associated factors were age, level of education, number of shifts per month and history of related training. The highest rate of NSIs was related to instrument preparation followed by injection and recapping of used needles. Findings show that health care workers suffer a high rate of needlestick injuries.

CONCLUSION

It was seen that device, location, or action cannot be separately considered as responsible for all types of the NSIs. Rather, each of them has a contribution to the NSIs. Nevertheless, factors with higher frequency should be given a higher priority.

Predictive factors for percutaneous and mucocutaneous exposure among healthcare workers in a developing country

The aim of this study is to determine the risk factors for percutaneous and mucocutaneous exposures in healthcare workers (HCW) in one of the largest centers of a middle income country, Turkey. This study has a retrospective design. HCWs who presented between August 2011 and June 2013, with Occupational Exposures (OEs) (cases) and those without (controls) were included. Demographic information was collected from infection control committee documents. A questionnaire was used to ask the HCWs about their awareness of preventive measures. HCWs who work with intensive work loads such as those found in emergency departments or intensive care units have a higher risk of OEs. Having heavy workloads and hours increases the risk of percutaneous and mucocutaneous exposures. For that reason the most common occupation groups are nurses and cleaning staff who are at risk of OEs. Increasing work experience has reduced the frequency of OEs.

Effect of Education on Stress of Exposure to Sharps Among Nurses in Emergency and Trauma Care Wards

Background:

Health care services can cause injuries to medical staff. One of these injuries is exposure to needle-sticks. This can result in the transmission of blood-borne diseases, such as HIV and hepatitis B; the staff undergo continuous stress. Thus, it is necessary to use some method to reduce this stress.

Objectives:

The purpose of this study was to examine the effect of education based on the stabilization model on stress induced exposure to needle sticks among nurses working in emergency and trauma wards.

Patients and Methods:

This Quast- Experiental Study was performed on 35 nurses working in emergency and trauma wards of our hospital in October-December 2013. Data were collected using a two-part questionnaire; Reliability and validity of the questionnaire were confirmed (α = 0. 92 and ICC = 0.94).Data were analyzed using SPSS version 20. The one-sample Kolmogorov-Smirnov test, independent t-test and paired sample t-test were also used.

Results:

The mean and standard deviation of stress experienced by nurses before and after the intervention were 64.94 ± 15.67 and 43.91 ± 10.73, respectively. Findings indicated that education decrease needle stick stress in nurses significantly (P < 0.001).

Conclusions:

According to the results of this study, the stress level induced due to needle-stick exposure and its complications is high and interventions for reduction are essential.

Prevalence of hepatitis B virus infection among barbers and their knowledge, attitude and practices in the district of Sukkur, Sindh

OBJECTIVES

Several occupations in developing countries lag behind in ensuring the safety of their workers in occupational settings. Lack of implementation of safety guidelines at workplaces can expose workers to health risks. In Pakistan, barbers are one of the un-regulated occupational groups. Low literacy, increased frequency of direct skin contact and blade/razors use can expose barbers to body fluids including blood of the customers. We conducted this study in order to determine hepatitis B virus (HBV) prevalence among barbers and their knowledge, attitude and practices in a peri-urban district of Sindh.

MATERIAL AND METHODS

Three hundred eighty-five barbers from the Sukkur district were interviewed using a structured questionnaire. Blood samples were collected and tested for HBsAg. A scale was built to determine the proportions of responses to knowledge, attitude and practice items.

RESULTS

The prevalence of HBV among barbers was 2.1%. The barbers' knowledge on HBV and its transmission routes was poor. The response to attitude items was good, except that only 35.1% of the participants agreed to have vaccination against HBV. The overall performance on the knowledge and practice scales was poor compared to the attitude scale on which 80% of the barbers performed well.

CONCLUSION

The prevalence of HBV among barbers was lower compared to the available national figures for the prevalence among the general population.

Risk factors for bloodborne viral hepatitis in healthcare workers of Pakistan: a population based case-control study

OBJECTIVES

A high prevalence of viral hepatitis B and C was found among healthcare workers during a province-wide screening in Sindh Province, Pakistan. A follow-up study was undertaken to identify risk factors for this high prevalence in healthcare workers.

DESIGN

Population based case-control design.

SETTING

Public sector healthcare facilities in a rural district of Pakistan.

PARTICIPANTS

Healthcare workers who were screened for hepatitis B surface antigen (HBsAg) and hepatitis C virus (HCV) antibodies. 178 healthcare workers employed at the public sector clinics and hospitals of the district were approached, of which 14 refused to participate. Cases had detectable serum antibodies against HCV and the presence of HBsAg. Healthcare workers non-reactive to HCV antibodies and with no HBsAg were controls. These were matched in a ratio of 1:1.

OUTCOME MEASURE

Detectable serum HBsAg and HCV antibody titer were taken as outcome. OR for various exposures was calculated; those with p<0.25 were entered in a multivariate logistic regression model to find out significant predictors.

RESULTS

Needle stick injury (OR=6; CI95 1.4 to 23), recapping the needle (OR=5.7; CI95 1.1 to 28), wound care at accident and emergency of a hospital (OR=5.5; CI95 1 to 28), female gender (OR=3.4; CI95 1 to 12) and more than 10 years of formal education (OR=0.25; CI95 0.07 to 0.8) were associated with hepatitis C. Hepatitis B was found to be associated with trying to bend or break a needle after use (OR=4.9; CI95 1 to 24).

CONCLUSIONS

Healthcare workers in Pakistan are at additional risk of exposure to bloodborne pathogens. Bi-dimensional risk factors present at individual and broader health systems levels are responsible. Occupational safety, health trainings and redesigning of the curriculum for allied health professionals are required.

The importance of implementing safe sharps practices in the laboratory setting in Europe

Healthcare workers are at risk of sharps injuries and subsequent infection from more than 40 bloodborne pathogens or species. Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Human Immunodeficiency Virus (HIV) together account for the vast majority of cases. The Directive 2010/32/EU “Prevention from sharp injuries in the hospital and healthcare sector”, issued to protect workers from these risks, requires an integrated approach to prevention including awareness-raising, education, training, elimination of unnecessary needles, safe procedures for sharps use and disposal, banning of recapping, vaccination, use of personal protective equipment, provision of safety-engineered devices, and appropriate surveillance, monitoring, response and follow-up.

As laboratories represent a high-risk setting both in the preanalytical and analytical phase, we reviewed accidents and prevention in this setting in the light of the new legislation.

Phlebotomy is the procedure carrying the highest risk of exposure and infection, involved in 30–50% of HIV and HCV cases detected in nationwide systems following accidental blood exposures implemented since the 1990s in Italy and France. In laboratories, problems in the management of sharps containers, recapping, needle disassembly by hand and blood transfer from syringes into tubes were observed and accounted for two-thirds of injuries. These accidents could be reduced through education and monitoring of behaviours, and introduction of medical devices incorporating safety-engineered protection mechanisms with appropriate training. Laboratory staff should be immunized against HBV, and know policies and procedures for the post-exposure management and prophylaxis. The management commitment to safety is crucial to ensure the necessary support to these changes.

Needlestick injuries and safety syringes: a review of the literature

Needlestick injuries are a serious concern for nurses and other healthcare workers. One of the main clinical risks from needlestick injury is the possible infection by blood-borne diseases, such as hepatitis and HIV. A number of different measures have been introduced to minimise the risk and impact of needlestick injuries, including the use of fixed-needle safety syringes. However, some healthcare workers refuse to use such devices, for reasons that include the perceived need to change syringe needles between drawing up a medicine and its administration to a patient. This paper will explore the literature relating to needlestick injuries and the reasons commonly given for not using fixed-needle safety syringes.