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Keicher F, Zirkel J, Leutritz T, König S. Combatting the occurrence of needle-stick injuries in a medical school: why is it still an issue? BMC MEDICAL EDUCATION 2024; 24:312. [PMID: 38509544 PMCID: PMC10953246 DOI: 10.1186/s12909-024-05309-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/13/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Needle-stick injuries (NSIs) pose a safety risk for healthcare workers with great potential for serious infections. The aim was to determine numbers and causes of NSIs as well as the frequency with which medical students report NSIs in the final stages of study. METHODS An online questionnaire was developed and made available in January and February 2023 to all undergraduate medical students (n = 423) in the last 1.5 years of their degree course at Würzburg University, Germany. RESULTS The response rate was 19.6% (n = 84). Among respondents, 27.4% (n = 23) reported at least one NSI. Occurrence was particularly frequent in surgery, obstetrics and gynaecology, and internal medicine. Assisting with procedures, suturing, and blood sampling were considered high-risk activities. Lack of concentration, distraction, and time pressure played a role in incidents. Respondents did not report 18.8% of NSIs with the main reasons being fear of the consequences, self-assessment of the injury as minor, or the opinion of supervisors that reporting was unnecessary. Students with previous practice on simulators or patients were significantly more likely to suffer NSIs. Instructions from occupational health specialists beforehand correlated with fewer NSIs. CONCLUSION We assume that trained students are more experienced in handling invasive procedures, leading to a greater adoption of corresponding activities and thus an increased risk of injuries in absolute numbers. This does not counter the need for didactic interventions prior to workplace-based training to raise awareness of NSI risks. Simultaneously, concepts must be developed and implemented to support reporting and alleviate fears regarding consequences.
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Affiliation(s)
- Franca Keicher
- Department of Paediatrics, University Hospital Würzburg, Würzburg, Bavaria, Germany.
| | - Janina Zirkel
- Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Bavaria, Germany
| | - Tobias Leutritz
- University Hospital Würzburg, Institute of Medical Teaching and Medical Education Research, Würzburg, Bavaria, Germany
| | - Sarah König
- University Hospital Würzburg, Institute of Medical Teaching and Medical Education Research, Würzburg, Bavaria, Germany
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Tulloch JSP, Fleming KM, Pinchbeck G, Forster J, Lowe W, Westgarth C. Audit of animal-related injuries at UK veterinary schools between 2009 and 2018. Vet Rec 2023; 193:e3171. [PMID: 37310022 DOI: 10.1002/vetr.3171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/02/2023] [Accepted: 05/31/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Animal-related injuries pose a significant risk to the veterinary profession. This study aimed to describe the incidence, demographics, context and consequences of animal-related injuries at UK veterinary schools. METHODS A multicentre audit of accident records (2009-2018) across five UK veterinary schools was performed. Injury rates were stratified by school, demographics and species. The context and cause of the injury were described. Multivariable logistic models explored factors associated with medical treatment, hospital visits and time off work. RESULTS An annual rate of 2.60 (95% confidence interval 2.48-2.72) injuries per 100 graduating students was calculated, varying between veterinary schools. Injuries were more frequently recorded in staff than students, and there were significant differences between staff and students in the activities performed preceding injury. Cats and dogs were associated with the highest number of reported injuries. However, injuries associated with cattle and horses were the most severe, with significantly higher hospital attendances and more time off work taken. LIMITATIONS Data were based on reported injuries and likely underestimate the true injury rate. The population at risk was hard to quantify as population size and exposure were variable. CONCLUSION Further research is recommended to explore the clinical and workplace management, including recording culture, of animal-related injuries among veterinary professionals.
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Affiliation(s)
- John S P Tulloch
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Kate M Fleming
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Gina Pinchbeck
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | | | - Walter Lowe
- The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, UK
| | - Carri Westgarth
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
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Wang Z, Song D, Wang J, Xiong L, Shi T, Zhang C, Di L, Zhang C, Zhang Y, Li H, Liu X, Liu J, Zhang Y. Simulation and experimental study on the influence of needle-free jet injection nozzle structure on injection performance. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2021.103043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Smith JL, Banerjee R, Linkin DR, Schwab EP, Saberi P, Lanzi M. 'Stat' workflow modifications to expedite care after needlestick injuries. Occup Med (Lond) 2021; 71:20-24. [PMID: 33399827 DOI: 10.1093/occmed/kqaa209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Post-exposure prophylaxis (PEP) for human immunodeficiency virus (HIV) is recommended to start within hours of needlestick injuries (NSIs) among healthcare workers (HCWs). Delays associated with awaiting the results of testing from the source patient (whose blood was involved in the NSI) can lead to psychological consequences for the exposed HCW as well as symptomatic toxicities from empiric PEP. AIMS After developing a 'stat' (immediate) workflow that prioritized phlebotomy and resulting of source patient bloodwork for immediate handling and processing, we retrospectively investigated whether our new workflow had (i) decreased HIV order-result interval times for source patient HIV bloodwork and (ii) decreased the frequency of HIV PEP prescriptions being dispensed to exposed HCWs. METHODS We retrospectively analysed NSI records to identify source patient HIV order-result intervals and PEP dispensing frequencies across a 6-year period (encompassing a 54-month pre-intervention period and 16-month post-intervention period). RESULTS We identified 251 NSIs, which occurred at similar frequencies before versus after our intervention (means 3.54 NSIs and 3.75 NSIs per month, respectively). Median HIV order-result intervals decreased significantly (P < 0.05) from 195 to 156 min after our intervention, while the proportion of HCWs who received one or more doses of PEP decreased significantly (P < 0.001) from 50% (96/191) to 23% (14/60). CONCLUSION Using a 'stat' workflow to prioritize source patient testing after NSIs, we achieved a modest decrease in order-result intervals and a dramatic decrease in HIV PEP dispensing rates. This simple intervention may improve HCWs' physical and psychological health during a traumatic time.
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Affiliation(s)
- J L Smith
- The University of Texas Health Science Center at Houston, McGovern Medical School, UT Health, Houston, TX, USA
| | - R Banerjee
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - D R Linkin
- Division of Infectious Diseases, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Medicine, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - E P Schwab
- Department of Medicine, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA.,Division of Geriatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - P Saberi
- Division of Employee Occupational Health, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - M Lanzi
- Division of Employee Occupational Health, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
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Labafchi A, Rahpeyma A, Khajehahmadi S. A study on PEI among private dentists in Mashhad, Iran. J Family Med Prim Care 2020; 9:1403-1406. [PMID: 32509623 PMCID: PMC7266217 DOI: 10.4103/jfmpc.jfmpc_900_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 02/07/2020] [Accepted: 03/02/2020] [Indexed: 11/16/2022] Open
Abstract
Aim: We aimed to identify the percutaneous exposure incident (PEI) by private dentists in Mashhad, Iran. Methods: Subjects included 199 dentists enrolled in this study. A questionnaire consisting of 11 questions was sent to the dentists for data collection. Information was collected on knowledge about dangers of PEI, a history of needlestick or sharps injuries over the past 12 months, types of devices causing the needlestick or sharps injuries, HBV vaccination, knowledge about PEI protective and therapeutic protocol, and reporting PEI to the specialist. The first ten questions were corrected and each sheet received a score ranging from 0 to 10. Result: 95 women (47.7%) and 104 men (52.3%) participated in this study aged between 27–72 years old. The findings showed that a total of 132 dentists (66.3%) had experiences with PEI. 45 (22.6%) of them had experiences with PEI in the past year. Files and needles were found to be the most frequent tools causing PEI, each with 29.7% of frequency. 16.6%, 8.6, 5.7, and 9.7% were obtained for dental burs, band, and surgical baled, respectively as other tools responsible for injuries. Results of the question about causes of needlestick injuries showed that personal carelessness is the most frequent reason (53.8%) followed by inappropriate disposal of the needles (7.6%). Conclusion: The personal carelessness and inappropriate disposal of needles were reported as the most common reasons for PEI injuries. It is suggested to educational programs for dentists should focus on preventing the PEI.
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Affiliation(s)
- Ali Labafchi
- Student Research Committee, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amin Rahpeyma
- Oral and Maxillofacial Diseases Research Center, Mashhad, Iran.,Department of Oral and Maxillofacial Surgery, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeedeh Khajehahmadi
- Dental Research Center, Mashhad, Iran.,Department of Oral and Maxillofacial Pathology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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Ogg MJ. Clinical Issues—January 2020. AORN J 2019; 111:123-130. [DOI: 10.1002/aorn.12915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
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Needlestick and sharps injuries in orthopedic surgery residents and fellows. Infect Control Hosp Epidemiol 2019; 40:1253-1257. [DOI: 10.1017/ice.2019.262] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AbstractObjective:Needlestick and sharps injury (NSSI) is a common occupational hazard of orthopedic surgery training. The purpose of this study was to examine the incidence and surrounding circumstances of intraoperative NSSI in orthopedic surgery residents and fellows and to examine postexposure reporting.Design:A 35-question cross-sectional survey.Setting:The study was conducted by orthopedic surgery residents and faculty at a nonprofit regional hospital.Participants:The questionnaire was distributed to US allopathic orthopedic surgery residency and fellowship programs; 300 orthopedic surgery trainees participated in the survey.Results:Of 223 trainees who had completed at least 1 year of residency, 172 (77.1%) sustained an NSSI during residency, and 57 of 63 trainees (90.5%) who had completed at least 4 years sustained an NSSI during residency. The most common causes of NSSI were solid needles, followed by solid pins or wires. The surgical activity most associated with NSSI was wound closure, followed by fracture fixation. The type of surgery most frequently associated with NSSI was orthopedic trauma, followed by hip and knee arthroplasty. Of 177 trainees who had sustained a prior NSSI, 99 (55.9%) failed to report all events to their institution’s occupational health department.Conclusions:The incidence of NSSI during residency training is high, with >90% of trainees in their fifth year or later of training having received an injury during their training, with a mean of >4 separate events. Most trainees with an NSSI did not report all of their events, which implies that changes are needed in the incident reporting process universally.
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Yang AD, Quinn CM, Hewitt DB, Chung JW, Zembower TR, Jones A, Buyske J, Hoyt DB, Nasca TJ, Bilimoria KY. National Evaluation of Needlestick Events and Reporting Among Surgical Residents. J Am Coll Surg 2019; 229:609-620. [PMID: 31541698 DOI: 10.1016/j.jamcollsurg.2019.09.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 09/03/2019] [Accepted: 09/03/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND Needlestick injuries pose significant health hazards; however, the nationwide frequency of needlesticks and reporting practices among surgical residents are unknown. The objectives of this study were to examine the rate and circumstances of self-reported needlestick events in US surgery residents, assess factors associated with needlestick injuries, evaluate reporting practices, and identify reporting barriers. STUDY DESIGN A survey administered after the American Board of Surgery In-Training Examination (January 2017) asked surgical residents how many times they experienced a needlestick during the last 6 months, circumstances of the most recent event, and reporting practices and barriers. Factors associated with needlestick events were examined using multivariable hierarchical regression models. RESULTS Among 7,395 resident survey respondents from all 260 US general surgery residency programs (99.3% response rate), 27.7% (n = 2,051) noted experiencing a needlestick event in the last 6 months. Most events occurred in the operating room (77.5%) and involved residents sticking themselves (76.2%), mostly with solid needles (84.7%). Self-reported factors underlying needlestick events included residents' own carelessness (48.8%) and feeling rushed (31.3%). Resident-level factors associated with self-reported needlestick events included senior residents (PGY5 29.9% vs PGY1 22.4%; odds ratio 1.66; 95% CI 1.41 to 1.96), female sex (31.9% vs male 25.2%; odds ratio 1.31; 95% CI 1.18 to 1.46), or frequently working more than 80 hours per week (odds ratio 1.42; 95% CI 1.20 to 1.68). More than one-fourth (28.7%) of residents did not report the needlestick event to employee health. CONCLUSIONS In this comprehensive national survey of surgical residents, needlesticks occurred frequently. Many needlestick events were not reported and numerous reporting barriers exist. These findings offer guidance in identifying opportunities to reduce needlesticks and encourage reporting of these potentially preventable injuries among trainees.
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Affiliation(s)
- Anthony D Yang
- Surgical Outcomes and Quality Improvement Center, Department of Surgery and Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL; Northwestern Medicine, Chicago, IL.
| | - Christopher M Quinn
- Surgical Outcomes and Quality Improvement Center, Department of Surgery and Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL; Northwestern Medicine, Chicago, IL
| | - D Brock Hewitt
- Surgical Outcomes and Quality Improvement Center, Department of Surgery and Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL; Northwestern Medicine, Chicago, IL; Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA
| | - Jeanette W Chung
- Surgical Outcomes and Quality Improvement Center, Department of Surgery and Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL; Northwestern Medicine, Chicago, IL
| | - Teresa R Zembower
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | - Jo Buyske
- American Board of Surgery, Philadelphia, PA
| | | | - Thomas J Nasca
- Accreditation Council for Graduate Medical Education, Chicago, IL
| | - Karl Y Bilimoria
- Surgical Outcomes and Quality Improvement Center, Department of Surgery and Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL; Northwestern Medicine, Chicago, IL
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Madhavan A, Asokan A, Vasudevan A, Maniyappan J, Veena K. Comparison of knowledge, attitude, and practices regarding needle-stick injury among health care providers. J Family Med Prim Care 2019; 8:840-845. [PMID: 31041211 PMCID: PMC6482777 DOI: 10.4103/jfmpc.jfmpc_103_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: Needle-stick injury (NSI) is one of the most potential hazards for health care workers. They pose a significant risk of occupational transmission of blood-borne pathogens. The present study was done to determine the incidence of NSI among interns and nurses; their knowledge, attitude, and preventive strategies undertaken by the respondents after NSI. Materials and Methods: The cross-sectional study was done among interns and nurses in various departments of a tertiary care center in Kerala, India using a self-administered questionnaire. Results: The incidences of NSI among interns and nurses were 75.6% and 24.4%, respectively. The most common clinical activity leading to NSI among interns was blood withdrawal (42%) followed by recapping (29%). It was found that nurses had enough knowledge and followed better NSI practices and attitude than the interns. Conclusion: All the parameters analyzed were inadequate among the interns, indicating the need for continual awareness programs particularly during the preclinical years.
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Affiliation(s)
- Anitha Madhavan
- Department of Microbiology, Govt TD Medical College, Alappuzha, Kerala, India
| | - Anjana Asokan
- Department of Microbiology, Govt TD Medical College, Alappuzha, Kerala, India
| | - Anu Vasudevan
- Department of Biostatistics, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Janeesh Maniyappan
- Department of Microbiology, Govt TD Medical College, Alappuzha, Kerala, India
| | - K Veena
- Department of Microbiology, Govt TD Medical College, Alappuzha, Kerala, India
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Bekker CL, Kalicharan RW, Melis EJ, Gardarsdottir H, van den Bemt BJ, Bouvy ML, van Maarseveen EM, Egberts AC. Redispensing of unused HIV post-exposure prophylaxis for medical students. Travel Med Infect Dis 2019; 29:82-83. [DOI: 10.1016/j.tmaid.2019.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 02/18/2019] [Accepted: 02/20/2019] [Indexed: 10/27/2022]
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Garus-Pakowska A, Górajski M. Behaviors and Attitudes of Polish Health Care Workers with Respect to the Hazards from Blood-Borne Pathogens: A Questionnaire-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E891. [PMID: 30870976 PMCID: PMC6427109 DOI: 10.3390/ijerph16050891] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/06/2019] [Accepted: 03/08/2019] [Indexed: 12/20/2022]
Abstract
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.
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Affiliation(s)
- Anna Garus-Pakowska
- Department of Hygiene and Health Promotion; Medical University of Lodz, 90-752 Lodz, Poland.
| | - Mariusz Górajski
- Department of Econometrics, University of Lodz, 90-214 Lodz, Poland.
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Retrospective investigation of 9 years of data on needlestick and sharps injuries: Effect of a hospital infection control committee. Am J Infect Control 2019; 47:186-190. [PMID: 30220615 DOI: 10.1016/j.ajic.2018.07.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/17/2018] [Accepted: 07/17/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND The risk of occupational transmission of bloodborne pathogens to health care workers is primarily associated with needlestick and sharps injuries (NSIs). However, most NSIs are not reported, and most health care workers are not aware of postexposure procedures. METHODS Data for NSIs reported in our hospital between 2008 and 2016 were reviewed retrospectively. RESULTS A total of 546 staff members reported NSIs. Of these, 376 (68.9%) were women. NSIs were more commonly reported by trainee nurses (243 [44.5%]), followed by nurses (121 [22.2%]), cleaning staff (108 [19.8%]), and doctors (49 [9%]). The rate of postexposure interventions was 13% in 2008 and 92.6% in 2016 (P < .0001; χ2 = 82.866). NSI rates also show that the number of applications with NSIs increased over the years. When occupational blood exposure was examined, the number of bloodborne pathogens was 50 (9.3%) cases of hepatitis B virus, 30 (5.6%) cases of hepatitis C virus, 3 cases of Crimean-Congo hemorrhagic fever, 1 case of HIV, and 2 cases of hepatitis B virus and hepatitis C virus coinfection. DISCUSSION Over the years, the increase in both the appropriate intervention rate and the number of reports to the hospital infection control committee after NSIs shows that regular training regarding NSIs is effective. CONCLUSIONS Hospital infection control committees may play a more active role in raising awareness in this regard and thus reducing the rate of unreported NSIs.
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Marusic V, Markovic-Denic L, Djuric O, Protic D, Dubljanin-Raspopovic E. Knowledge about Blood-borne Pathogens and the Prevalence of Needle Stick Injuries among Medical Students in Serbia. Zdr Varst 2017; 56:179-184. [PMID: 28713447 PMCID: PMC5504544 DOI: 10.1515/sjph-2017-0024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 04/10/2017] [Indexed: 11/15/2022] Open
Abstract
Introduction Medical students are mainly exposed to needle stick and sharp object injuries in the course of their clinical activities during studying. They are at high risk due to their undeveloped skills, restricted clinical experience, lack of knowledge and risk perception. The objectives of this study were to determine the prevalence of needle stick injuries of the fourth and final year medical students, and to estimate their knowledge about blood-borne pathogens disease transmission and standard precautions. Methods This cross-sectional study was conducted at the Faculty of Medicine, in February 2014. The students were invited to self-administer a questionnaire of 26 closed questions prepared for this study. Results The questionnaire was filled in and returned by 637 students. The prevalence of needle sticks and sharp object injuries was 29.5%. Needle stick injuries were the most common type of accidents, more frequent among the fourth compared to the sixth year students (p=0.002). The majority of accidents occurred in patient rooms (53%) and the emergency department (15%). 54% of participants reported an accident to the responsible person. Students without accidents had a significantly better perception of risk (3.79 vs. 3.35; p<0.05). Out of the total participating students, only 16.6% (106/637) received all three doses of Hepatitis B vaccination, while 16.2% were partially vaccinated. Conclusions There is a need for additional theoretical and practical education of our students on blood exposure via accidents, raising the awareness of the necessity of hepatitis B vaccination, and introducing the unique/comprehensive procedure for accident reporting for students and healthcare workers in the entire country.
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Affiliation(s)
- Vuk Marusic
- University of Belgrade, Faculty of Medicine, Institute of Epidemiology, Visegradska 6, Belgrade102, 11129, Serbia
| | - Ljiljana Markovic-Denic
- University of Belgrade, Faculty of Medicine, Institute of Epidemiology, Visegradska 6, Belgrade102, 11129, Serbia
| | - Olivera Djuric
- University of Belgrade, Faculty of Medicine, Institute of Epidemiology, Visegradska 6, Belgrade102, 11129, Serbia
| | - Dragana Protic
- University of Belgrade, Faculty of Medicine, Institute of Pharmacology, Belgrade102, 11129, Serbia
| | - Emilija Dubljanin-Raspopovic
- University of Belgrade, Faculty of Medicine, Clinical Center Serbia, Clinic for Physical Medicine and Rehabilitation, Belgrade102, 11129, Serbia
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Garcia VH, Radon K. Preventive Training among Medical Interns in Mexico City and Its Association with Needlestick and Sharp Injuries - A Cross Sectional Study. J Clin Diagn Res 2017; 11:IC05-IC07. [PMID: 28511410 DOI: 10.7860/jcdr/2017/24606.9594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 12/11/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Medical students are a vulnerable group for the acquisition of blood borne pathogens due to their lack of experience. In Europe and Asia preventive training programs have reduced accidental exposures. AIM The aim of the study was to compare the lifetime prevalence of Needlestick and Sharp Objects Injuries (NSIs) among medical interns who received preventive training versus those without such training in Mexico City. MATERIALS AND METHODS In 2013, a cross-sectional study was performed applying an anonymous self-administrated questionnaire. The study population included 467 medical students, male and female, at the end of their internship. The lifetime prevalence of NSI was estimated and compared between students who had received preventive training and those who did not. RESULTS The overall lifetime prevalence of NSI was 58%. Lifetime prevalence was higher in students without preventive training compared to those who had such a training (68% vs 51%; p value= 0.002). NSI Lifetime prevalence was not associated with sex, age or place of birth. The task most commonly associated with the latest NSI in trained and untrained students was withdrawing blood. CONCLUSION NSI are frequent accidents among medical students in Mexico City, especially during blood taking. Training units on how to prevent NSI should be encouraged in Mexican medical colleges.
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Affiliation(s)
- Victor Hugo Garcia
- Alumnus, Master of International Occupational Safety and Health Program, Ludwig-Maximilians-Universität, Munich, Germany
| | - Katja Radon
- Professor, Center for International Health, Institute for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU)
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15
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Awareness, Knowledge, and Practices Regarding Occupational Hazards Among Medical Students. J Occup Environ Med 2017; 59:e41-e45. [DOI: 10.1097/jom.0000000000000972] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Okoh M, Saheeb BD. Assessment of knowledge, attitude and practice of post-exposure prophylaxis against blood-borne viral infection among dental surgeons in a teaching hospital. S Afr J Infect Dis 2017. [DOI: 10.1080/23120053.2016.1198079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Ouyang B, Li LD, Mount J, Jamal AJ, Berry L, Simone C, Law M, Tai RM. Incidence and characteristics of needlestick injuries among medical trainees at a community teaching hospital: A cross-sectional study. J Occup Health 2016; 59:63-73. [PMID: 27885240 PMCID: PMC5388614 DOI: 10.1539/joh.15-0253-fs] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objectives: This field study aimed to determine the incidence and distribution of needlestick injuries among medical trainees at a community teaching hospital in Toronto, Canada. Methods: The study was performed during the 2013-2015 academic years at Toronto East General Hospital (TEGH), a University of Toronto-affiliated community-teaching hospital during the 2013-2015 academic years. Eight-hundred and forty trainees, including medical students, residents, and post-graduate fellows, were identified and invited via email to participate in an anonymous online fluidsurveys.com survey of 16 qualitative and quantitative questions. Results: Three-hundred and fifty trainees responded (42% response rate). Eighty-eight (25%) respondents reported experiencing at least one injury at TEGH. In total, our survey identified 195 total injuries. Surgical trainees were significantly more likely to incur injuries than non-surgical trainees (IRR = 3.03, 95% CI 1.80-5.10). Orthopaedic surgery trainees had the highest risk of a needlestick injury, being over 12 times more likely to be injured than emergency medicine trainees (IRR = 12.4, 95% CI 2.11-72.32). Only 28 of the 88 most recent needlestick injuries were reported to occupational health. Trainees reported a perception of insignificant risk, lack of resources and support for reporting, and injury stigmatization as reasons for not reporting needlestick injuries. Conclusions: Needlestick injuries were a common underreported risk to medical trainees at TEGH. Future research should investigate strategies to reduce injury and improve reporting among the high-risk and reporting-averse trainees.
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Affiliation(s)
- Ben Ouyang
- Faculty of Medicine, University of Toronto
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Frickmann H, Schmeja W, Reisinger E, Mittlmeier T, Mitzner K, Schwarz NG, Warnke P, Podbielski A. Risk Reduction of Needle Stick Injuries Due to Continuous Shift from Unsafe to Safe Instruments at a German University Hospital. Eur J Microbiol Immunol (Bp) 2016; 6:227-237. [PMID: 27766172 PMCID: PMC5063016 DOI: 10.1556/1886.2016.00025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 08/01/2016] [Indexed: 12/02/2022] Open
Abstract
This study assessed protective effects of a continuous introduction of safe instruments in terms of reduction of needle stick injuries. The retrospective study analyzed correlations between the increasing proportion of safe instruments and a reduction of the incidence of needle stick injuries linked to such instruments in a German university hospital over 5 years. Incidents declined about 17.6% from 80.3 incidents per 1000 employees to 66.2, associated with an increase in the proportions of injuries due to instruments without protective mechanisms such as scalpels or hypodermic needles by 12.2%. For injuries due to venipuncture cannulae in various surgical and internal medicine departments, there was a negative association between the proportion of safe instruments and the incidence of injuries. For injection needles, portacath needles, and lancets in selected internal medicine departments, the number of injuries also dropped during this study interval. However, there was no clear-cut association with the percentage of safe instruments. This observational study suggests a correlation between the implementation of use of safe instruments and the reduction of needle stick injuries in a case of a graduated implementation. However, the effects are much less pronounced than in previous interventional studies.
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Affiliation(s)
- Hagen Frickmann
- Department of Tropical Medicine at the Bernhard Nocht Institute, German Armed Forces Hospital of Hamburg, Germany
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Germany
| | - Wibke Schmeja
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Germany
| | - Emil Reisinger
- Department of Tropical Medicine and Infectious Diseases, University Medicine Rostock, Germany
| | - Thomas Mittlmeier
- Department of Trauma, Hand and Reconstructive Surgery, University Medicine Rostock, Germany
| | - Karen Mitzner
- Central Pharmaceutical Facility, University Medicine Rostock, Germany
| | - Norbert Georg Schwarz
- Infectious Disease Epidemiology Group, Bernhard Nocht Institute of Tropical Medicine Hamburg, Germany
| | - Philipp Warnke
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Germany
| | - Andreas Podbielski
- Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, Germany
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Fritzsche C, Heine M, Loebermann M, Klammt S, Podbielski A, Mittlmeier T, Reisinger EC. Reducing the underreporting of percutaneous exposure incidents: A single-center experience. Am J Infect Control 2016; 44:941-3. [PMID: 27125915 DOI: 10.1016/j.ajic.2016.02.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 01/28/2016] [Accepted: 02/01/2016] [Indexed: 10/21/2022]
Abstract
Although risk reduction strategies have been implemented throughout the world, underreporting of percutaneous exposure incidents (PEIs) is common among exposed health care workers. The aim of this study was to determine the incidence rate of reported PEIs before and after implementation of an intensified reporting management policy. The introduction of an intensified reporting system led to significantly increased reporting after a PEI has occurred. However, continuous education needs to be provided to improve awareness.
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20
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Mannocci A, De Carli G, Di Bari V, Saulle R, Unim B, Nicolotti N, Carbonari L, Puro V, La Torre G. How Much do Needlestick Injuries Cost? A Systematic Review of the Economic Evaluations of Needlestick and Sharps Injuries Among Healthcare Personnel. Infect Control Hosp Epidemiol 2016; 37:635-46. [PMID: 27022671 PMCID: PMC4890345 DOI: 10.1017/ice.2016.48] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 02/10/2016] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To provide an overview of the economic aspects of needlestick and sharps injury (NSI) management among healthcare personnel (HCP) within a Health Technology Assessment project to evaluate the impact of safety-engineered devices on health care METHODS A systematic review of economic analyses related to NSIs was performed in accordance with the PRISMA statement and by searching PubMed and Scopus databases (January 1997-February 2015). Mean costs were stratified by study approach (modeling or data driven) and type of cost (direct or indirect). Costs were evaluated using the CDC operative definition and converted to 2015 International US dollars (Int$). RESULTS A total of 14 studies were retrieved: 8 data-driven studies and 6 modeling studies. Among them, 11 studies provided direct and indirect costs and 3 studies provided only direct costs. The median of the means for aggregate (direct + indirect) costs was Int$747 (range, Int$199-Int$1,691). The medians of the means for disaggregated costs were Int$425 (range, Int$48-Int$1,516) for direct costs (9 studies) and Int$322 (range, Int$152-Int$413) for indirect costs (6 studies). When compared with data-driven studies, modeling studies had higher disaggregated and aggregated costs, but data-driven studies showed greater variability. Indirect costs were consistent between studies, mostly referring to lost productivity, while direct costs varied widely within and between studies according to source infectivity, HCP susceptibility, and post-exposure diagnostic and prophylactic protocols. Costs of treating infections were not included, and intangible costs could equal those associated with NSI medical evaluations. CONCLUSIONS NSIs generate significant direct, indirect, potential, and intangible costs, possibly increasing over time. Economic efforts directed at preventing occupational exposures and infections, including provision of safety-engineered devices, may be offset by the savings from a lower incidence of NSIs. Infect Control Hosp Epidemiol 2016;37:635-646.
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Affiliation(s)
- Alice Mannocci
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Gabriella De Carli
- Department of Epidemiology, Pre-Clinical Research and Advanced Diagnostics, L. Spallanzani National Institute for Infectious Diseases, Rome, Italy
| | - Virginia Di Bari
- Department of Epidemiology, Pre-Clinical Research and Advanced Diagnostics, L. Spallanzani National Institute for Infectious Diseases, Rome, Italy
| | - Rosella Saulle
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Brigid Unim
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
| | - Nicola Nicolotti
- Department of Epidemiology, Pre-Clinical Research and Advanced Diagnostics, L. Spallanzani National Institute for Infectious Diseases, Rome, Italy
| | - Lorenzo Carbonari
- Department of Economics and Finance & CEIS, University of Rome “Tor Vergata”Italy
| | - Vincenzo Puro
- Department of Epidemiology, Pre-Clinical Research and Advanced Diagnostics, L. Spallanzani National Institute for Infectious Diseases, Rome, Italy
| | - Giuseppe La Torre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy
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Hoenigl M, Chaillon A, Kessler HH, Haas B, Stelzl E, Weninger K, Little SJ, Mehta SR. Characterization of HIV Transmission in South-East Austria. PLoS One 2016; 11:e0151478. [PMID: 26967154 PMCID: PMC4788428 DOI: 10.1371/journal.pone.0151478] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 02/29/2016] [Indexed: 11/18/2022] Open
Abstract
To gain deeper insight into the epidemiology of HIV-1 transmission in South-East Austria we performed a retrospective analysis of 259 HIV-1 partial pol sequences obtained from unique individuals newly diagnosed with HIV infection in South-East Austria from 2008 through 2014. After quality filtering, putative transmission linkages were inferred when two sequences were ≤1.5% genetically different. Multiple linkages were resolved into putative transmission clusters. Further phylogenetic analyses were performed using BEAST v1.8.1. Finally, we investigated putative links between the 259 sequences from South-East Austria and all publicly available HIV polymerase sequences in the Los Alamos National Laboratory HIV sequence database. We found that 45.6% (118/259) of the sampled sequences were genetically linked with at least one other sequence from South-East Austria forming putative transmission clusters. Clustering individuals were more likely to be men who have sex with men (MSM; p<0.001), infected with subtype B (p<0.001) or subtype F (p = 0.02). Among clustered males who reported only heterosexual (HSX) sex as an HIV risk, 47% clustered closely with MSM (either as pairs or within larger MSM clusters). One hundred and seven of the 259 sequences (41.3%) from South-East Austria had at least one putative inferred linkage with sequences from a total of 69 other countries. In conclusion, analysis of HIV-1 sequences from newly diagnosed individuals residing in South-East Austria revealed a high degree of national and international clustering mainly within MSM. Interestingly, we found that a high number of heterosexual males clustered within MSM networks, suggesting either linkage between risk groups or misrepresentation of sexual risk behaviors by subjects.
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Affiliation(s)
- Martin Hoenigl
- Division of Infectious Diseases, University of California San Diego, San Diego, California, United States of America
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Antoine Chaillon
- Division of Infectious Diseases, University of California San Diego, San Diego, California, United States of America
| | - Harald H. Kessler
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Bernhard Haas
- Department of Infectious Diseases, Landeskrankenhaus Graz West, Graz, Austria
| | - Evelyn Stelzl
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Karin Weninger
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Graz, Austria
| | - Susan J. Little
- Division of Infectious Diseases, University of California San Diego, San Diego, California, United States of America
| | - Sanjay R. Mehta
- Division of Infectious Diseases, University of California San Diego, San Diego, California, United States of America
- Veterans Affairs Healthcare System, San Diego, California, United States of America
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22
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Awareness About Needle Stick Injures and Sharps Disposal: A Study Conducted at Army College of Dental Sciences. J Maxillofac Oral Surg 2015. [PMID: 26225005 DOI: 10.1007/s12663-013-0526-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND The present study aims to assess the knowledge and attitude about needle stick injuries and sharps disposal. METHODS A self designed questionnaire of 15 questions was handed out to 200 participants including undergraduate students (group 1), postgraduate students (group 2), faculty members (group 3) and auxiliary staff members (group 4). The data was collected and analyzed using Chi square test. RESULTS Sixty-one percent of total participants reported of experiencing needle stick injury and 25.5 % knew that there could be several causes for this. Only 22 % of total population studied got the source tested. Immunization status of group 4 was very low and they also lacked the knowledge of sharps disposal and hepatitis C being spread by needle stick injuries. 57 % participants confirmed that there was no reporting facility and 66 % were not familiar with the guidelines of reporting. CONCLUSIONS There is a definite scope of improvement in terms of reporting and prevention of needle stick injuries. There is a need to improve knowledge and awareness of dental health care workers about the post exposure protocol.
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23
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Rajkumari N, Mathur P, Gunjiyal J, Misra MC. Effectiveness of Intensive Interactive Classes and Hands on Practice to Increase Awareness about Sharps Injuries and Splashes among Health Care Workers. J Clin Diagn Res 2015; 9:DC17-21. [PMID: 26393129 DOI: 10.7860/jcdr/2015/12833.6219] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 06/18/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Occupational exposure to sharps and splashes pose a major hazard among health care workers (HCWs); so knowledge and awareness regarding sharps/splashes by blood and potentially infectious body fluids (BBF) is a must. Hence, the study was done to assess the extent of knowledge of the staff and using awareness classes and hands on practice as a model to increase awareness as well as prevention. MATERIALS AND METHODS This prospective interventional cohort study, using before - after trial, was conducted in a Level I trauma care centre. All cadres of HCWs were enrolled randomly into 5 different groups of 15 each. This study was conducted in 2 phases - interactive classes and hands on practice (Phase I) and questionnaire assessment and work area observation (phase II). This was repeated twice and the final outcome was analysed. A systematic level of grading was used to assess the improvement. RESULTS It was observed that Group 1 (doctors) and group 2 (nurses) had the maximum knowledge about such exposures and its prevention compared to the other groups (groups 3, 4 and 5) during the initial assessment (Phase I). The remaining groups showed a major improvement after the 2(nd) assessment, though their knowledge was poor in the beginning. Groups 1and 2 showed 32% and remaining groups showed a 25% improvement in voluntary reporting after the second assessment (Phase II). CONCLUSION Awareness classes and hands on practice are indeed useful in generating knowledge about sharps/ splashes. Certain incentives given at right time can improve it further.
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Affiliation(s)
- Nonika Rajkumari
- Assistant Professor, Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research , Puducherry, India
| | - Purva Mathur
- Additional Professor, Department of Laboratory Medicine (Microbiology Division), Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences , New Delhi, India
| | - Jacinta Gunjiyal
- Nursing-in-Charge, Hospital Infection Control, Hospital Infection Control Unit, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences , New Delhi, India
| | - Mahesh Chandra Misra
- Professor, Department of Surgical Disciplines, All India Institute of Medical Sciences , New Delhi, India
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24
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Hoenigl M, Weibel N, Mehta SR, Anderson CM, Jenks J, Green N, Gianella S, Smith DM, Little SJ. Development and validation of the San Diego Early Test Score to predict acute and early HIV infection risk in men who have sex with men. Clin Infect Dis 2015; 61:468-75. [PMID: 25904374 DOI: 10.1093/cid/civ335] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 04/12/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Although men who have sex with men (MSM) represent a dominant risk group for human immunodeficiency virus (HIV), the risk of HIV infection within this population is not uniform. The objective of this study was to develop and validate a score to estimate incident HIV infection risk. METHODS Adult MSM who were tested for acute and early HIV (AEH) between 2008 and 2014 were retrospectively randomized 2:1 to a derivation and validation dataset, respectively. Using the derivation dataset, each predictor associated with an AEH outcome in the multivariate prediction model was assigned a point value that corresponded to its odds ratio. The score was validated on the validation dataset using C-statistics. RESULTS Data collected at a single HIV testing encounter from 8326 unique MSM were analyzed, including 200 with AEH (2.4%). Four risk behavior variables were significantly associated with an AEH diagnosis (ie, incident infection) in multivariable analysis and were used to derive the San Diego Early Test (SDET) score: condomless receptive anal intercourse (CRAI) with an HIV-positive MSM (3 points), the combination of CRAI plus ≥5 male partners (3 points), ≥10 male partners (2 points), and diagnosis of bacterial sexually transmitted infection (2 points)-all as reported for the prior 12 months. The C-statistic for this risk score was >0.7 in both data sets. CONCLUSIONS The SDET risk score may help to prioritize resources and target interventions, such as preexposure prophylaxis, to MSM at greatest risk of acquiring HIV infection. The SDET risk score is deployed as a freely available tool at http://sdet.ucsd.edu.
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Affiliation(s)
- Martin Hoenigl
- Division of Infectious Diseases, University of California, San Diego Section of Infectious Diseases and Tropical Medicine Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Austria
| | - Nadir Weibel
- Department of Computer Science and Engineering, University of California, San Diego
| | - Sanjay R Mehta
- Division of Infectious Diseases, University of California, San Diego Veterans Affairs Healthcare System, San Diego, California
| | | | - Jeffrey Jenks
- Division of Infectious Diseases, University of California, San Diego
| | - Nella Green
- Division of Infectious Diseases, University of California, San Diego
| | - Sara Gianella
- Division of Infectious Diseases, University of California, San Diego
| | - Davey M Smith
- Division of Infectious Diseases, University of California, San Diego Veterans Affairs Healthcare System, San Diego, California
| | - Susan J Little
- Division of Infectious Diseases, University of California, San Diego
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Lakbala P, Sobhani G, Lakbala M, Inaloo KD, Mahmoodi H. Sharps injuries in the operating room. Environ Health Prev Med 2014; 19:348-53. [PMID: 25082440 DOI: 10.1007/s12199-014-0401-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 07/17/2014] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES We aimed to identify who sustains needlestick and sharps injuries, under what circumstances and what actions are taken to minimize the risk and in response to intraoperative NSSIs. METHODS The cross-sectional study was conducted in 2013 on 215 operation room personnel in 14 hospitals of the Hormozgan province, Iran. RESULTS Two hundred and fifty appropriate responders completed the questionnaire (86 %). Anaesthesia 59 (27.4 %) and operation room technicians 55 (25.6 %) sustained the greatest numbers of NSSIs over the past year. Awareness of local protocols was significantly worse in the residents group. The commonest reasons for noncompliance with NSSIs local protocols were not sure of the local protocols 44 (20.4 %) and prolonged operation so unable to leave operation table 37 (17.3 %). CONCLUSIONS A revision of the local protocol to reduce the time it takes to complete may improve compliance. Education is of paramount importance in making health care workers aware of this issue. The application of safety devices led to a reduction in NSSIs and reduces the risk of blood borne infection as well.
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Affiliation(s)
- Parvin Lakbala
- Infectious and Tropical Diseases Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran,
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26
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Motavaf M, Mohaghegh Dolatabadi MR, Ghodraty MR, Siamdoust SAS, Safari S, Mohseni M. Anesthesia Personnel's Knowledge of, Attitudes Toward, and Practice to Prevent Needlestick Injuries. Workplace Health Saf 2014; 62:250-5. [PMID: 24971820 DOI: 10.1177/216507991406200605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 04/14/2014] [Indexed: 01/06/2023]
Abstract
Anesthesia personnel are at risk for needlestick injuries (NSIs). This study evaluated the knowledge of, attitudes toward, and practice of preventing NSIs among anesthesia personnel in four Iranian university hospitals. A self-administered anonymous questionnaire was distributed to 104 anesthesia personnel. In addition, hospital infection control center records were reviewed. The prevalence of NSI among anesthesia personnel was 56.8%. Only 32.2% reported their NSI. Men were more knowledgeable about the risks associated with NSI and the application of standard precautions than women, but were also more likely to experience NSI. Standard precautions were often not followed. In contrast with other hospital staff, most reported NSIs among anesthesia personnel produced high-risk exposures. The knowledge and prevention practices of anesthesia personnel related to needles and other sharps were not satisfactory. These health care providers need appropriate training on standard precautions and administrative oversight to improve their practices. Anesthesia personnel's gender and position should also be considered to improve compliance.
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Motavaf M, Mohaghegh Dolatabadi MR, Ghodraty MR, Siamdoust SAS, Safari S, Mohseni M. Anesthesia Personnel’s Knowledge of, Attitudes Toward, and Practice to Prevent Needlestick Injuries. Workplace Health Saf 2014. [DOI: 10.3928/21650799-20140514-05] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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28
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Souza-Borges FRFD, Ribeiro LA, Oliveira LCMD. Occupational exposures to body fluids and behaviors regarding their prevention and post-exposure among medical and nursing students at a Brazilian public university. Rev Inst Med Trop Sao Paulo 2014; 56:157-63. [PMID: 24626419 PMCID: PMC4085846 DOI: 10.1590/s0036-46652014000200012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 07/18/2013] [Indexed: 11/22/2022] Open
Abstract
A cross-sectional study was conducted to assess the frequencies and
characteristics of occupational exposures among medical and nursing students at a
Brazilian public university, in addition to their prevention and post-exposure
behavior. During the second semester of 2010, a self-administered semi-structured
questionnaire was completed by 253/320 (79.1%) medical students of the clinical
course and 149/200 (74.5%) nursing students who were already performing practical
activities. Among medical students, 53 (20.9%) suffered 73 injuries, which mainly
occurred while performing extra-curricular activities (32.9%), with cutting and
piercing objects (56.2%), in the emergency room (39.7%), and as a result of lack of
technical preparation or distraction (54.8%). Among nursing students, 27 (18.1%)
suffered 37 injuries, which mainly occurred with hollow needles (67.6%) in the
operating room or wards (72.2%), and as a result of lack of technical preparation or
distraction (62.1%). Among medical and nursing students, respectively, 96.4% and 48%
were dissatisfied with the instructions on previously received exposure prevention;
48% and 18% did not always use personal protective equipment; 67.6% and 16.8%
recapped used needles; 49.3% and 35.1% did not bother to find out the source
patient's serological results post-exposure; and 1.4% and 18.9% officially reported
injuries. In conclusion, this study found high frequencies of exposures among the
assessed students, inadequate practices in prevention and post-exposure, and,
consequently, the need for training in “standard precautions” to prevent such
exposures.
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Affiliation(s)
- Fernanda Ribeiro Fagundes de Souza-Borges
- Federal University of Uberlândia Medical School (FAMED/UFU), UberlândiaMG, Brazil, Postgraduate Program in Health Sciences of the Federal University of Uberlândia Medical School (FAMED/UFU). Uberlândia, MG, Brazil
| | - Larissa Araújo Ribeiro
- Undergraduate medical student of the FAMED/UFU, UberlândiaMG, Brazil, Undergraduate medical student of the FAMED/UFU. Uberlândia, MG, Brazil
| | - Luiz Carlos Marques de Oliveira
- Federal University of Uberlândia Medical School (FAMED/UFU), UberlândiaMG, Brazil, Postgraduate Program in Health Sciences of the Federal University of Uberlândia Medical School (FAMED/UFU). Uberlândia, MG, Brazil
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Needlestick and sharps injuries among medical undergraduate students. Am J Infect Control 2014; 42:235-9. [PMID: 24387948 DOI: 10.1016/j.ajic.2013.08.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 08/23/2013] [Accepted: 08/23/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Needlestick and sharps injuries (NSIs) can cause a transmission of bloodborne diseases. In this study, injury rate, accident mechanisms, and targets for preventive strategies were investigated at a major university hospital hosting different medical study programs. METHODS In 2009 and 2010, cross-sectional anonymous surveys were carried out among medical undergraduate students. Furthermore, all NSIs reported to the accident insurer from 2007 to 2010 were analyzed. This spans the comprehensive introduction of safety instruments in the university hospital in 2008. RESULTS The online survey was completed by 1,214 students in 2009 and 917 students in 2010. Results show an injury rate of 21.4% per year (mean value). Accidents are mostly related to vein puncture, surgical procedures, and instrument disposal. Comparing 2 parallel medical programs, the educational curriculum using objective structured clinical examinations, which are associated with significantly lower NSI incidences. The rate of under-reporting is 53% (mean value). Analysis of the injury reports made to the accident insurer showed a 50% decrease in NSIs surrounding the introduction of safe instruments. CONCLUSION Undergraduate medical students are at high risk of NSIs. Safe instruments and university instructions can prevent NSIs. Reporting procedures should be part of medical undergraduate training.
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Koehler N, Vujovic O, Dendle C, McMenamin C. Medical graduates' knowledge of bloodborne viruses and occupational exposures. Am J Infect Control 2014; 42:203-5. [PMID: 24360355 DOI: 10.1016/j.ajic.2013.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 07/30/2013] [Accepted: 08/19/2013] [Indexed: 11/27/2022]
Abstract
A survey of medical graduates commencing employment as junior doctors was performed to investigate knowledge of bloodborne viruses and occupational exposure management, coupled with their experience of occupational exposures. There was a mismatch between general knowledge (excellent) and knowledge of postexposure management (poor), and graduates had commonly experienced an occupational exposure and not reported it. The knowledge deficit regarding postexposure management and history of poor practice (ie, nonreporting) following an exposure implies that the transition period from student to junior doctor may be associated with increased occupational health and safety risk.
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Hoffmann C, Buchholz L, Schnitzler P. Reduction of needlestick injuries in healthcare personnel at a university hospital using safety devices. J Occup Med Toxicol 2013; 8:20. [PMID: 23895578 PMCID: PMC3728001 DOI: 10.1186/1745-6673-8-20] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Accepted: 07/24/2013] [Indexed: 11/17/2022] Open
Abstract
Background Healthcare personnel (HCP) is exposed to bloodborne pathogens through occupational risk factors. The objective of this study was to compare the incidence of needlestick injuries (NSIs) before and after the introduction of safety devices in all departments of our hospital. Methods Data was extracted from mandatory needlestick report forms of the hospital’s Occupational Health Service. Serological results of patients and healthcare personnel (HCP) were reviewed in the laboratory information system. Results In 2007, the year before the introduction of safety devices, 448 needlestick injuries were self-reported, corresponding to an annual rate of 69.0 NSIs per 1 000 full-time HCP. The highest incidence was observed among medical staff in the surgery department and internal medicine with 152 (33.9%) and 79 (17.6%) NSIs, respectively. Of all occupational groups, nurses (36.2%) had the highest risk to sustain NSIs. In 2008 safety devices were introduced across the hospital, e.g. peripheral venous catheter, hypodermic needle and stapling system for wound sealing providing active or passive protection. In 2009, the year after introduction of safety devices, only 350 NSIs were reported, the annual rate of NSIs decreased to 52.4 per 1 000 full-time HCP. Thus an overall reduction of 21.9% for NSIs was achieved when safer devices were applied. The number of NSIs was reduced by even 50% for blood withdrawal, for use of peripheral venous catheters and application of hypodermic needles. Conclusion The application of safety devices led to a reduction of NSIs and significantly reduces the risk of bloodborne infections.
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Affiliation(s)
- Cornelia Hoffmann
- Department of Infectious Diseases, Virology, University of Heidelberg, Heidelberg, 69120, Germany.
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Vaid N, Langan KM, Maude RJ. Post-exposure prophylaxis in resource-poor settings: review and recommendations for pre-departure risk assessment and planning for expatriate healthcare workers. Trop Med Int Health 2013; 18:588-95. [PMID: 23461554 DOI: 10.1111/tmi.12080] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
It is estimated that more than 3 million healthcare workers worldwide suffer needlestick and splash injuries whilst at work resulting in the potential transmission of blood-borne pathogens via exposure to bodily fluids. Under-reporting and the subsequent management of occupational injuries is a problem both in the United Kingdom and abroad. Many expatriate health care workers will work in low resource settings where the risk of transmission is greatest but in contrast to wealthier countries such as the United Kingdom, there is often a lack of effective systems for its safe management. This article provides important information about this risk and how to minimise it. The reasons for an increased risk in transmission, its subsequent management and pre-departure planning are discussed, together with the evidence for initiation of post-exposure prophylaxis; current National and International guidelines as well as the urgent need for International standardisation of these is also discussed.
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Affiliation(s)
- Nidhi Vaid
- Department of Acute Medicine, The Royal London Hospital, London, UK
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Green B, Griffiths EC. Psychiatric consequences of needlestick injury. Occup Med (Lond) 2013; 63:183-8. [DOI: 10.1093/occmed/kqt006] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Jones AB, Hughes A, Barton S. Guidance on Occupational-Related HIV Post-Exposure Prophylaxis (PEP) in the Intensive Care Setting. J Intensive Care Soc 2012. [DOI: 10.1177/175114371201300413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Ann-Britt Jones
- Specialist Registrar in Genito-urinary Medicine, Chelsea and Westminster Hospital NHS Foundation Trust
| | - Amelia Hughes
- Specialist Registrar in Genito-urinary Medicine, Chelsea and Westminster Hospital NHS Foundation Trust
| | - Simon Barton
- Clinical Director HIV, GUM and Dermatology, Chelsea and Westminster Hospital NHS Foundation Trust
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Berger A, Stürmer M, Doerr HW. Case report: risk of virus infection after accidental blood inoculation from a multi-infected AIDS patient. J Med Virol 2012; 84:897-900. [PMID: 22499012 DOI: 10.1002/jmv.23286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Infections caused by blood-borne viruses such as hepatitis B and C and the human immunodeficiency virus (HIV) are associated commonly with needlestick injuries, especially in a hospital setting. A prospective investigation was conducted on a medical doctor who suffered an accidental needlestick injury during blood collection from a patient with AIDS. The patient's blood contained 195,000 copies of HIV RNA, 1 × 10(6) IU hepatitis C virus (HCV) RNA, and >10(7) copies of parvovirus B19 DNA per 1 ml plasma. It was positive for cytomegalovirus virus and evidence of a resolved hepatitis B virus (HBV) infection was found. HCV viremia was detected in the physician 15 days later and was not resolved by seroconversion after 57 days. HIV infection was not transmitted, possibly because of the immediate use of anti-HIV prophylactic drugs after exposure. Parvovirus B19 infection was presumably prevented by pre-existing specific antibodies in the patient. Considering that many HIV carriers are coinfected with hepatitis B and C viruses, this case report support the knowledge that the risk of HCV transmission from a patient with AIDS is greater than that of HIV.
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Affiliation(s)
- Annemarie Berger
- Institute of Medical Virology, Hospital of Johann-Wolfgang-Goethe University, Frankfurt/M, Germany.
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