Needlestick injuries during medical training

Occupational Injuries and Their Determinants Among Healthcare Workers in Western Countries: A Scoping Review

BACKGROUND

Healthcare workers (HCWs) in developed countries can be exposed to a wide range of hazards. The systematic identification of working conditions associated with the risk of occupational injury can significantly reduce this risk.

METHODS

From January 2000 to December 2021, a scoping review was performed using PCC (Population, Concept, and Context) criteria and searching major scientific databases. Studies conducted in Western Countries, defined as member countries of the Organisation for Economic Co-operation and Development (OECD), were selected.

RESULTS

We identified 282 studies for the present review. Studies focused more frequently on biological injuries (59%). Musculoskeletal injuries and injuries due to aggression and violence followed, based on the frequency of the investigated topic.

CONCLUSIONS

Most studies focused on the risk of bloodborne infections, while a knowledge gap emerged on the epidemiology of accidental exposure to other transmission pathways. Although the proportion of injured workers is not negligible in most studies, the most common determinants and risk factors of injury are entirely preventable.

Knowledge, attitude, and practice towards Hepatitis B and vaccination status of pre-clinical medical students at Sylhet Women's Medical College, Bangladesh

BACKGROUND

Hepatitis B is a global health problem with high morbidity and mortality. The risk of transmission is more common among health care personnels and medical students during their professional health trainings. Vaccination is the most effective means of prevention. The main objective of this study was to determine the level of knowledge, attitude, and practice regarding Hepatitis B and vaccination among pre-clinical students in a medical college.

MATERIALS AND METHODS

A web-based, single-center, descriptive cross-sectional study was conducted among pre-clinical medical students in Bangladesh from April 28, 2024, to May 4, 2024. The whole sampling technique method was used taking the entire population for our study. Data were collected using a self-administered questionnaire and analyzed using JMP Pro V17 Statistical Software.

RESULTS

Sixty-one (34%) students were vaccinated against Hepatitis B, of whom 18% received all three doses with a booster dose. The most common reason for non-vaccination was lack of awareness of one's vaccination status (43%). The median knowledge, attitude, and practice (KAP) scores were 54 (50-60), 19 (17-21) and 20 (19-23) respectively, and they were moderately positively correlated. Forty-six (25.98%) students had a good overall KAP score (≥ 102).

CONCLUSION

Only one-third of the students had been vaccinated, and the commonest reason for non-vaccination was lack of awareness of one's vaccination status. Nearly one-fourth of the participants had good knowledge, attitude, and practice related to Hepatitis B. Therefore, education regarding Hepatitis B infection, risk factors, and importance of vaccination is a must among pre-clinical medical students in Bangladesh.

Combatting the occurrence of needle-stick injuries in a medical school: why is it still an issue?

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.

Global prevalence of needle stick injuries among nurses: A comprehensive systematic review and meta-analysis

BACKGROUND

Nurses usually provide direct patient care. However, they account for the majority of healthcare workers (HCWs) injured by needles or other sharp objects.

OBJECTIVES

To assess the prevalence of needle stick injuries (NSI) among nurses worldwide; according to WHO regions, the socioeconomic development index (SDI) of countries, and the developmental status of individual countries, and in the Middle East.

DESIGN

Systematic review and meta-analysis.

METHODS

We searched PubMed, Scopus, and Web of Science databases. We calculated the pooled NSI prevalence estimates using a random-effect meta-analysis with the Comprehensive Meta-Analysis software. The report of the study was in accordance with the PRISMA 2020 statement.

RESULTS

The overall worldwide NSI prevalence pooled from our analysis was 40.97% (95% confidence interval [CI]: 31.29-50.63%, p = .00001). A subgroup analysis of NSI prevalence according to WHO regions revealed the highest prevalence in Southeast Asia (49.9%, 95% CI: [23.4-76.3%]) and the lowest in the United States of America (25.1%, 95% CI: [18.1-32.1%]), respectively. The pooled prevalence in developed and developing countries was 30.5% (95% CI: 27.3-33.8%) and 46.6% (95% CI: 33.7-59.5%), respectively. According to the SDI, NSI prevalence was highest in low-middle SDI countries (48.9% [95% CI: 30.7-67.2%]).

CONCLUSION

Our results showed a high NSI prevalence among nurses worldwide. Developing countries had a significantly higher NSI prevalence than developed countries, especially low-middle SDI countries.

RELEVANCE TO CLINICAL PRACTICE

This study highlighted the prevalence of NSI risk among nurses practising in clinical settings worldwide. The study findings suggest that continuous training programs should be implemented for nurses to enhance their knowledge, performance and attitude toward NSI prevention in clinical settings.

NO PATIENT OR PUBLIC CONTRIBUTION

Contributions from patients or the public are irrelevant because the purpose of this study was to examine the global prevalence of NSIs in nurses.

Non-Invasive Vaccines: Challenges in Formulation and Vaccine Adjuvants

Given the limitations of conventional invasive vaccines, such as the requirement for a cold chain system and trained personnel, needle-based injuries, and limited immunogenicity, non-invasive vaccines have gained significant attention. Although numerous approaches for formulating and administrating non-invasive vaccines have emerged, each of them faces its own challenges associated with vaccine bioavailability, toxicity, and other issues. To overcome such limitations, researchers have created novel supplementary materials and delivery systems. The goal of this review article is to provide vaccine formulation researchers with the most up-to-date information on vaccine formulation and the immunological mechanisms available, to identify the technical challenges associated with the commercialization of non-invasive vaccines, and to guide future research and development efforts.

Prevalence and causes of unreported needle stick injuries among health care workers: a systematic review and meta-analysis

OBJECTIVES

Health care workers (HCWs) are exposed to needle needles daily. Despite individual studies, there is no statistics on the prevalence of unreported needle stick injuries (NSIs) have been reported. This study was performed to determine the prevalence and causes of unreported NSIs among HCWs.

CONTENT

In present systematic review and meta-analysis study, three international databases (Web of Science, Scopus, PubMed) were searched from January 1, 2000 to December 31, 2018. The random model was used to determine the prevalence of unreported needle stick among HCWs.

SUMMARY AND OUTLOOK

Forty-one studies performed on 19,635 health care workers entered the final stage. Based-on random effect model, pooled prevalence of unreported needle stick injuries was 59.9% (95% CI: 52.0, 67.7; I2=98.9%). The most common cause of unreported NSIs was: They were not worried about NSIs (n=12). The high prevalence of unreported needle sticks injuries indicates the urgency and necessity of paying attention to strategies to improve reporting among health workers.

The Influence of PDCA Process Management on the Incidence of Stab Wound and Psychological Anxiety of Nursing Interns

Objective

To research the influence of PDCA (Plan-Do-Check-Act) process management on the incidence of needle injury and psychological anxiety of nursing interns.

Methods

This study belonged to the experimental study. A total of 180 nursing interns who practiced in the hospital from March 2020 to April 2022 were studied. A total of 135 interns from March 2020 to March 2021 were selected as the control group and 175 interns from April 2021 to April 2022 as the research group. PDCA process management was carried on in the research group. The control group did not make any intervention only following the routine teaching plan. The incidence of needle injury, theoretical knowledge, behavior score, self-rating anxiety scale (SAS), professional self-efficacy questionnaire score, and nursing practice satisfaction score were evaluated before and after 12 months of management.

Results

After management, the incidence of needle injury in the research group was lower compared to that in the control group, and there are statistically significant differences between groups (P < 0.05). The scores of theoretical knowledge, attitude, and behavior in the research group were higher compared to those in the control group, and there are statistically significant differences between groups (P < 0.05) after management. After 12 months of management, the SAS score of the research group was lower compared to that of the control group, and there are statistically significant differences between groups (P < 0.05). The score of occupational self-efficacy questionnaire in the research group was higher compared to that in the control group, and there are statistically significant differences between groups (P < 0.05) after PDCA process management. After 12 months of management, the satisfaction score of nursing practice in the research group was higher compared to that in the control group, and there are statistically significant differences between groups (P < 0.05).

Conclusion

Through PDCA process management, we can keep abreast of the situation of needlestick injuries among nursing students in practice and analyze in more detail the root cause of each nursing student's occupational exposure and the outcome of treatment. The nursing students not only learn more practical knowledge in clinical practice but also feel that the hospital values and cares for them, which greatly increases their satisfaction.

The psychological impact of sharps injuries sustained by medical students

Much is known and reported about sharps injuries among healthcare workers, but there has been a lack of published evidence regarding the psychological impact of sharps injuries among medical students. The purpose of this narrative review was to discover the psychological impact of sharps injuries within the medical student population. Medical, health and psychology databases were searched for studies written in the English language and published between 1980 and 2021. The review identified six studies conducted in six countries which described the psychological impacts of sharps injuries among medical students as being fear, anxiety, depression and post-traumatic stress disorder. The findings highlight the potential psychological issues created by sharps injuries, and highlights that further research is needed into this topic to aid the education and prevention of this harmful problem.

Needlestick and sharps injuries among secondary and tertiary healthcare workers, Saudi Arabia

Aim

The study aimed to assess the incidence of needlestick and sharps injuries among healthcare workers (HCWs) in the Jazan region of Saudi Arabia, as well as to determine whether there exists an association between hospital level and needlestick and sharps injuries rate.

Design

A cross‐sectional survey was conducted among 609 randomly selected HCWs from nine general hospitals.

Methods

A self‐administered questionnaire, which covered the structure and process of injection safety, was used for data collection.

Results

The overall needlestick and sharps injuries incidence rate was 24%. The needlestick and sharps injuries rates were 30% and 14% in secondary and tertiary hospitals, respectively. HCWs working in tertiary hospitals were 61% less likely to have needlestick and sharps injuries than those employed in secondary hospitals. This was mainly the impact of better and continuous training. High safety level maintenance and health education provision are vital in such settings.

Molecular Detection of Borrelia Bacteria in Cerebrospinal Fluid-Optimisation of Pre-Analytical Sample Handling for Increased Analytical Sensitivity

The main tools for clinical diagnostics of Lyme neuroborreliosis (LNB) are based on serology, i.e., detection of antibodies in cerebrospinal fluid (CSF). In some cases, PCR may be used as a supplement, e.g., on CSF from patients with early LNB. Standardisation of the molecular methods and systematic evaluation of the pre-analytical handling is lacking. To increase the analytical sensitivity for detection of Borrelia bacteria in CSF by PCR targeting the 16S rRNA gene, parameters were systematically evaluated on CSF samples spiked with a known amount of cultured Borrelia bacteria. The results showed that the parameters such as centrifugation time and speed, the use of complementary DNA as a template (in combination with primers and a probe aiming at target gene 16S rRNA), and the absence of inhibitors (e.g., erythrocytes) had the highest impact on the analytical sensitivity. Based on these results, a protocol for optimised handling of CSF samples before molecular analysis was proposed. However, no clinical evaluation of the proposed protocol has been done so far, and further investigations of the diagnostic sensitivity need to be performed on well-characterised clinical samples from patients with LNB.

Hepatitis B: Knowledge and awareness among preclinical year medical students

Background and Objective

Hepatitis B is an occupational health hazard to health-care workers. The complete knowledge of hepatitis B virus (HBV) transmission and prevention is indispensable for medical students. This study was conducted to assess the knowledge and awareness of hepatitis B among preclinical year medical students.

Materials and Methods

This is a descriptive cross-sectional study. A predesigned self-administered questionnaire concerning hepatitis B knowledge and awareness was distributed to all the preclinical year medical students. The data were collected, tabulated, and analyzed by Microsoft Excel and Statistical Package for the Social Sciences (SPSS) software, version 22. The results were expressed in numbers and percentages.

Results

Of 251 students, only 132 students voluntarily participated in the study. Majority of the students (84.8%) were aware of HBV infection. Many students knew that blood transfusion (81.1%) and use of contaminated needles and syringes (74.2%) are major modes of transmission. However, less than 30% of the students had knowledge about other modes of transmission. More than 50% of the students lacked in their knowledge about clinical features and complications of hepatitis B infection. Majority of students (72.7%) were aware of HBV vaccination. However, many students did not know their vaccination status, whereas only 23.5% of the students were fully immunized.

Conclusion

This study revealed lack of complete knowledge regarding hepatitis B among preclinical year medical students. They are at high risk of acquiring HBV infection during their clinical practice, later in life. Hence, implementation of well-structured education program in the first year itself is needed to create complete awareness among medical students about hepatitis B.

Hepatitis B vaccination status and knowledge, attitude, and practice regarding Hepatitis B among preclinical medical students of a medical college in Nepal

BACKGROUND

Hepatitis B imposes a major public health problem with an increased risk of occupational exposure among unvaccinated health care workers. This study was conducted to determine the Hepatitis B vaccination status, along with the knowledge, attitude, and practice regarding Hepatitis B, among preclinical medical students of a medical college in Nepal.

MATERIALS AND METHODS

This descriptive study was conducted among preclinical students of a medical college in Kathmandu, Nepal from 6th July to 14th July 2020. The whole sampling technique was used. Data were collected using a pretested, self-administered questionnaire which was emailed to individuals and analyzed with the statistical package for social sciences version-22.

RESULTS

A total of 181 students participated in the study out of 198, giving a response rate of 91.4%. Among the study participants, only 67 (37%) were fully vaccinated against Hepatitis B while 71 (39.2%) were never vaccinated. For the majority (74.6%) of the non-vaccinated participants, the main reason for not getting vaccination was a lack of vaccination programs. Half the study participants (n = 92, 50.8%) had good knowledge, attitude and practice regarding hepatitis B. The median knowledge, attitude and practice scores towards Hepatitis B were 61.00 (57.00-66.00), 20(18.00-21.00) and 21(19.00-23.00) respectively.

CONCLUSIONS

The majority of preclinical medical students were not fully vaccinated against Hepatitis B and only half of them had acceptable knowledge, attitude and practice towards Hepatitis B, which makes them vulnerable to the infection. This might represent the situation of not only Nepal, but also all South Asian countries, and creates concern about whether students take the vaccination programs seriously. Since unavailability of vaccination program is the main cause of non-vaccination, we strongly recommend the provision of the Hepatitis B vaccination program to the preclinical medical students.

Interdisciplinary differences in needlestick injuries among healthcare professionals in training: Improving situational awareness to prevent high-risk injuries

BACKGROUND

Needlestick injuries among healthcare professionals continue to be an occupational hazard, frequently and incorrectly regarded as low-risk, and exacerbated by underreporting. We aimed to investigate rates of needlestick injury, reasons for underreporting, and how explicit announcements that patients are "high-risk" (i.e., human immunodeficiency virus, hepatitis, or intravenous drug abuse history) might affect the actions of those at risk of sustaining an injury.

METHODS

A cross-sectional survey was administered to medical students (MS), nursing students (NS), and residents.

RESULTS

30/224 (13%) of MS, 6/65 (9%) of NS, and 67/126 (53%) of residents experienced needlestick injuries. 37% of MS, 33% of NS, and 46% of residents attributed "lack of concentration" as cause of injury. Residents had the lowest percentage of underreporting (33%), with rates of 40% and 83% among MS and NS, respectively. Top reasons for non-reporting included the injury being perceived as "trivial" (22%) and patient being "low-risk" (18%). A majority stated pre-operative "high-risk" announcements should be required (91%), and would promote "culture of safety" (82%), reporting of injuries (85%), and increased concentration during procedures (70%).

CONCLUSIONS

We recommend routine announcements during pre-operative time-out and nursing/resident hand-offs that state a patient is "high-risk" if applicable. We hypothesize such policy will promote a "culture of safety," situational awareness, and incident reporting.

Magnitude of Needlestick and Sharp Injury and Its Associated Factors Among Nurses Working at Health Institutions in Western Ethiopia, 2020

Background

Needlestick and sharp injury represent a major occupational hazard in the healthcare environment with nurses experiencing a large proportion of the burden. It is a potential for transmission of bloodborne pathogens including the human immunodeficiency virus, hepatitis B and C virus. Needlestick and sharp injuries are neglected and are often not reported. Few studies have been conducted in Ethiopia, and no study was conducted particularly in the Western part of a country. Therefore, this study aimed to assess needlestick and sharp injuries and associated factors among nurses working at health institutions in western Ethiopia, 2020.

Methods

An institutional based cross-sectional study was conducted on 297 nurses, from January 15 to 30, 2020. The study participants were selected by a simple random sampling method and data were collected using a self-administered questionnaire. Multivariable logistic regression was used to identify associated factors of needlestick and sharp injury. The association between needle stick and sharp injury and associated factors were measured using the odds ratio at a 95% confidence interval. The statistical significance was made at a p-value of less than 0.05.

Results

Out of 297 nurses who participated in the study, 100 (33.7%) had encountered needlestick and sharp injury in the past 12 months. Recapping the needle (AOR=3.99 95% CI: 2.20, 7.21), non-utilization of infection prevention guideline (AOR= 2.69, 95% CI: 1.29, 5.60), not taking injection safety training (AOR = 2.25, 95% CI: 1.22, 4.13) and having job-related stress (AOR= 1.93, 95% CI: 1.10, 3.41) were significantly associated with the needlestick and sharp injury.

Conclusion

In this study, the magnitude of needlestick and the sharp injury was high. The nurse should not recap the needles, should utilize infection prevention guidelines, should minimize stress, and routine injection safety training should be given to minimize needlestick and sharp injuries.

Prevalence of occupational exposure to needle-stick injury and associated factors among healthcare workers of developing countries: Systematic review

BACKGROUND

Healthcare workers are at high risk of infection from blood-borne pathogens, such as Hepatitis B and C Virus, and Human Immunodeficiency. Occupational exposure to needle-stick injuries (NSIs) continue to have a major health problem in the healthcare systems of developing countries. Thus, this review article aimed to provide the evidence on the prevalence of NSI and associated factors among healthcare workers of developing countries.

METHODS

The studies published from 2012 to 2019 were identified through systematic searches of electronic databases such as PubMed, Google Scholar, CINAHL, MEDLINE, Scopus, Med Nar, and Science Direct. The MeSH terms and/or keywords was used in conjunction with "AND" or "OR" (Boolean logic operators). All identified keywords and an index terms were checked across the included databases. Assessment and evaluation were taken to confirm the quality and relevance of the included articles, followed by extraction and analysis of data.

RESULT

Overall, 2021 articles were identified using specified search terms from the initial searches of the literature (2012-2019). A total of 13 articles met eligibility criteria were included in the review. Among 6513 participants, 1009 and 2201 participants involved to determine 1-year and throughout career prevalence, respectively. The prevalence of NSI ranged from 19.9% to 54.0% with an overall prevalence of 35.7% and 38.5 to 100% with an overall prevalence of 64.1% in the previous 1 year and throughout career, respectively. Sex, workload, needle recapping, overuse of injection, and practice of universal precautions, training, occupation, working experience, and personal protective equipment were among the factors associated with the prevalence of NSIs in developing countries.

CONCLUSION

The review indicated that NSIs have been identified as one of the most serious issues that affect the health and well-being of healthcare workers in the majority of healthcare systems of developing countries. There is a need to apply safety practices or other measures to reduce the risk of NSIs.

Assessment of needle stick and sharp injuries among health care workers in central zone of Tigray, northern Ethiopia

Objective

Accidental occupational injuries to health care workers (HCWs) continue to have a significant problem in the healthcare system. Thus, the aim of this study was to assess prevalence of needle sticks and sharp injury and associated factors among health care workers working in Central Zone Tigray northern Ethiopia.

Result

The prevalence of needle stick and sharp injury in the past 12 months preceding the study and entire job were 25.9% and 38.5% respectively. Nearly one-third (31%) of the injuries occurred in emergency unit and 122 (71.3%) of the materials caused injury were used on patients. Practice of needle recap, ever used cigarette in last 12 months, training, work hours > 40 per week, job dissatisfaction and work experience less than 5 years were found factors significantly associated with needle stick and sharp injury for health care workers. The magnitude of Needle stick and sharp injury is high in the study area. Policy makers should formulate strategies to improve the working condition for healthcare workers and increase their adherence to universal precautions.

National Evaluation of Needlestick Events and Reporting Among Surgical Residents

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.

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.

Current Knowledge, Attitudes, and Practice of Medical Students Regarding the Risk of Hepatitis B Virus Infection and Control Measures at Qassim University

BACKGROUND:

Medical students are exposed to occupational health hazards in hospitals during their studies and lack sufficient education about infection control measures. Injury to medical students is a substantial problem and students have an increased risk of hepatitis B virus (HBV). To understand how medical students think about infection control, it is important to identify the strengths and weaknesses of their education.

AIM:

To assess current knowledge, attitudes, and practice of medical students regarding HBV infection and control measures at Qassim University, Saudi Arabia.

MATERIAL AND METHODS:

A cross-sectional study was conducted at a medical college. Participants completed a 39-item self-administered questionnaire assessing demographics, knowledge, attitudes, and practice. Item response frequencies were calculated. Responses were recorded into yes (strongly agree and agree) and no (neutral, disagree, and strongly disagree) answers. Correct responses were totalled and categorised as good or poor performance. A scale cut-off of less than 75% correct responses was considered poor, and 75% or more correct responses was considered good. Odds ratios and 95% confidence intervals were calculated, and the chi-square test was used for analysis.

RESULTS:

A total of 21%, 41%, and 8% of students expressed good knowledge, attitudes, and practice, respectively. There was no statistically significant difference between males and females on knowledge (p = 0.089), attitudes (p = 0.829), and practice (p = 0.248). There was a statistically significant difference between academic years on knowledge (p = 0.0001), attitudes (p = 0.0001), and practice (p = 0.0001).

CONCLUSION:

Most medical students have poor knowledge, attitudes, and practice regarding the risk of HBV infection. It is recommended that a policy is implemented for training on infection prevention for all medical students before they start clinical practice. Prevention programs about HBV infection should be instituted, and existing programs must be strengthened.

Prevalence of Needlestick Injuries, Attitude Changes, and Prevention Practices Over 12 Years in an Urban Academic Hospital Surgery Department

OBJECTIVE

Needlestick injury prevalence, protection practices, and attitudes were assessed. Current medical students were compared with 2003 data to assess any changes that occurred with engineered safety feature implementation.

BACKGROUND

Risk of occupational exposure to bloodborne pathogens is elevated in the operating room particularly with surgeons in training and nurses.

METHODS

A cross-sectional survey was distributed to medical students (n = 358) and Department of Surgery staff (n = 247).

RESULTS

The survey response rate was 24.8%. Needlestick injuries were reported by 38.7% of respondents (11% high risk), and the most common cause was "careless/accidental." Needlestick injury prevalence increased from medical students to residents and fellows (100%). Thirty-three percent of injured personnel had at least one unreported injury, and the most common reason was "inconvenient/too time consuming." Needlestick injury prevalence and double-glove use in medical students did not differ from 2003, and 25% of fellows reported always wearing double gloves. The true seroconversion rate for bloodborne pathogens was underestimated or unknown. The concern for contracting a bloodborne pathogen significantly decreased (65%) compared to 2003, and there were significantly less medical students with hepatitis B vaccinations (78.3%). Level of concern for contracting a bloodborne pathogen was predictive of needlestick injury.

CONCLUSIONS

Needlestick injury and occupational exposure to bloodborne pathogens are significant hazards for surgeons and nurses. Attitudes regarding risk are changing, and the true seroconversion risk is underestimated. Educational efforts focused on needlestick injury prevalence, seroconversion rates, and double-glove perforation rates may be effective in implementing protective strategies.

Occupational blood exposures in health care workers: incidence, characteristics, and transmission of bloodborne pathogens in South Korea

BACKGROUND

Health care workers (HCWs) are at high risk for occupational blood exposures (OBEs) and transmission of bloodborne pathogens. This study elucidated the incidence rate and epidemiological characteristics of OBEs among HCWs and investigated the pathogen transmission rate for hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV).

METHODS

Self-reported OBEs from January 1, 2011 to December 31, 2015 were obtained from the electronic recording system. OBE incidence densities per 100 person-years and per 100 bed-years were calculated with a 5-year trend analysis. OBE characteristics and pathogen transmission rates were evaluated.

RESULTS

Among 10,452 HCWs and 1072 average yearly beds, 1076 OBEs were reported. OBE incidence rate was 5.6 cases per 100 person (full-time equivalent)-years and 20.3 per 100 bed-years. Incidence rate decreased and was significantly associated with a decrease of beds served per HCW. Housekeeping showed the highest OBE rate (14.8%) followed by doctors (8.5%) and nurses (6.2%). OBEs occurred in wards, emergency rooms, and operating rooms (38.1%, 13.3% and 12.2%, respectively) via percutaneous (86.7%) and mucocutaneous exposures (13.2%). Of OBEs associated with HBV (n = 133), HCV (n = 126), and HIV (n = 25), only one led to an infection (HCV; transmission rate of 0.8%). Neither HBV nor HIV infection occurred.

CONCLUSIONS

OBE incidence rate in a Korean university hospital was 5.6 cases per 100 person-years and 20.3 per 100 bed-years and was related to HCW workload and work proficiency. Though the actual bloodborne pathogen transmission rate was low, efforts to prevent OBE should be made for hospital safety.

Knowledge about Blood-borne Pathogens and the Prevalence of Needle Stick Injuries among Medical Students in Serbia

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.

Preventive Training among Medical Interns in Mexico City and Its Association with Needlestick and Sharp Injuries - A Cross Sectional Study

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.

Occupational Exposures to Blood and Body Fluid

Medical students and health professions students may be at high risk for occupational exposures to blood-borne pathogens. This retrospective chart review explored the rates and types of self-reported blood and body fluid exposures among medical students and health professions students at Eastern Virginia Medical School (EVMS), the University of Virginia School of Medicine, and Virginia Commonwealth University School of Medicine between January 1, 2001, and December 31, 2005, to determine an average rate of exposure reported by the student population at EVMS and in Virginia. Students at EVMS reported 126 exposures: 105 were needlestick and sharps injuries and 21 were blood and body fluid exposures. Fifty-one percent of the EVMS students reported not being the original user of the device causing their exposure. Students in Virginia reported 519 exposures. The majority of the exposures occurred in the operating room. Limitations of this study included student curricula not being reviewed and the medical schools' data collection methods not being compared. Student blood and body fluid exposures should be considered a serious and possibly deadly occupational hazard. Students must be deemed competent in basic health care procedures, universal precautions, and suturing techniques before being allowed to assist with or perform patient procedures.

Factors Associated with Occupational Needle Stick and Sharps Injuries among Hospital Healthcare Workers in Bale Zone, Southeast Ethiopia

BACKGROUND

Needle stick and sharps injuries are occupational hazards to healthcare workers. Every day healthcare workers are exposed to deadly blood borne pathogens through contaminated needles and other sharp objects. About twenty blood borne pathogens can be transmitted through accidental needle stick and sharp injury. The study was conducted to determine the lifetime and past one year prevalence of needle stick and sharps injuries and factors associated with the past one year injuries among hospital healthcare workers in Southeast Ethiopia.

METHODS

An institutional based cross sectional study was conducted in December 2014 among healthcare workers in four hospitals of Bale zone, Southeast of Ethiopia. A total of 362 healthcare workers were selected randomly from each department in the hospitals. Data were collected using self-administered questionnaire. The collected data were entered into Epi-Info version 3.5 and analyzed using SPSS version 20.0. Multivariable logistic regression analysis was used to identify the independent effect of each independent variable on the outcome variable. Written informed consent was secured from the participants.

RESULTS

The prevalence of lifetime needle stick and sharp injury was 37.1% with 95% CI of 32.0% to 42.5%. The prevalence of injury within the past one year was 19.1% with 95% CI of 14.9% to 23.3%. Emergency ward was a department with highest needle stick and sharp injury (31.7%). The main cause of injury was syringe needles (69.8%). Participants who practiced needle recapping had higher odds of needle stick and sharp injury within the past 12 months (AOR = 3.23, 95% CI: 1.78, 5.84) compared to their counterparts.

CONCLUSIONS

Nearly one out of five respondents had experienced needle stick and/or sharp injury at least once within past one year. There were practices and behaviors that put healthcare workers at risk of needle stick and sharp injury at the study area. Needle recapping was key modifiable risk behavior. Health policy makers and hospital administrators should formulate strategies to improve the working condition for healthcare workers and increase their adherence to universal precautions.

Risk and safety concerns in anesthesiology practice: The present perspective

Newer developments and advancements in anesthesiology, surgical, and medical fields have widened the functional scope of anesthesiologist thus increasing his professional responsibilities and obligations. While at workplace, anesthesiologist is exposed to a wide array of potential hazards that can be detrimental to his overall health. Numerous risks and safety concerns have been mentioned in the literature, but the magnitude of challenges in anesthesiology practice are far greater than those cited and anticipated. Many times these challenging situations are unavoidable and the attending anesthesiologist has to deal with them on an individual basis. These hazards not only affect the general health but can be extremely threatening in various other ways that can increase the potential risks of morbidity and mortality. This article is an attempt to bring a general awareness among anesthesia fraternity about the various health hazards associated with anesthesia practice. Also, a genuine attempt has been made to enumerate the various preventive methods and precautions that should be adopted to make practice of anesthesiology safe and smooth.

Prevention of Nosocomial Infection and Standard Precautions: Knowledge and Source of Information Among Healthcare Students

Objective.

To evaluate the knowledge of healthcare students after four curricula on infection control and to identify sources of information.

Design.

Cross-sectional study.

Setting.

Four healthcare schools at Rouen University (Rouen, France).

Participants.

Medical students, nursing students, assistant radiologist students, and physiotherapist students taking public health courses.

Methods.

To measure students' knowledge of infection control and their sources of information, 6 multiple-choice questions were asked about 3 specific areas: standard precautions, hand hygiene, and nosocomial infection. Each questionnaire section had 10 possible points, for an overall perfect score of 30. The sources of information for these 3 areas were also recorded: self-learning, practice training in wards, formal training in wards, and teaching during the curriculum. A logistic regression analysis was performed to identify factors associated with acceptable level of knowledge.

Results.

Three hundred fifty students (107 medical students, 78 nursing students, 71 physiotherapist students, and 94 assistant radiologist students) were included in the study. The mean overall score (±SD) was 21.5 ± 2.84. Nursing students had a better mean overall score (23.2 ± 2.35) than did physiotherapist students (21.9 ± 2.36), medical students (21.1 ± 2.35), and assistant radiologist students (20.5 ± 3.04; P < .001). The mean scores (±SD) for the component sections of the questionnaire were 8.5 ±1.4 for standard precautions, 7.4 ± 1.26 for hand hygiene, and 5.7 ± 1.55 for nosocomial infections (P < .001). The main source of information was material taught during the curriculum. Results of multivariate analysis indicate that the probability of attaining acceptable knowledge in each area was smaller for medical students and assistant radiologist students than for nursing students.

Conclusion.

The overall score for infection control indicated that instruction was effective; however, knowledge levels were different by area (the best scores were results of tests of standard precautions) and curriculum (nursing students achieved the best overall score). Ward training for daily infection control practice (ie, bedside instructions training and course work) could be improved for healthcare students.

Hepatitis B: prevention, protection and occupational risk

ABSTRACT 

Since 1992, the inclusion of HBV vaccination has been recommended by the WHO for all immunization programs implemented by nations. In Europe, the introduction of HBV vaccination has markedly reduced the incidence of acute HBV, and before the introduction of HBV vaccine, healthcare workers (HCW) were at considerable risk of infection. The present review discusses the main problems regarding three fundamental issues in hospital settings: prevention of HBV in HCW, protection induced by vaccination (problems regarding nonresponders) and risk for HCW exposed to blood-borne pathogens (occupational risk). The screening of HBV markers plays a decisive role in evaluating the degree of immune coverage in subjects exposed to biological risk and permits an increase in immune coverage through vaccine implementation.

Hepatitis B vaccination coverage and postvaccination serologic testing among medical students at a public university in Brazil

The aim of this cross-sectional study was to determine the hepatitis B vaccination coverage among medical students at a public university in Rio de Janeiro, Brazil, and their compliance with the postvaccination serologic testing recommendations. Of the total of 858 students, 675 (78.7%) participated in the study. Among the participants, 48.9% (95% CI: 45.1% to 52.7%) were vaccinated against hepatitis B (received ≥ 3 doses of the vaccine), 31.6% were not (received 0, 1 or 2 doses), and 19.6% did not know their vaccination status. Hepatitis B vaccination coverage increased from 26.0% among first-year students to 70.6% among sixth-year students while the prevalence of unknown vaccination status decreased from 39.7% among first-year students to 2.4% among sixth-year students. The frequency of unvaccinated students ranged from 23.7% among fifth-year students to 34.4% among first-year students. Only 34.8% of the vaccinated students performed the anti-HBs testing after vaccination. Among these medical students, we found a low adherence to the hepatitis B vaccination and to the postvaccination serologic testing. A comprehensive hepatitis B immunization program should be offered to students at this medical school.

Sharps injuries in the operating room

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.

Occupational exposures to body fluids and behaviors regarding their prevention and post-exposure among medical and nursing students at a Brazilian public university

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.

Medical graduates' knowledge of bloodborne viruses and occupational exposures

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.

Assessment of knowledge and practice towards hepatitis B among medical and health science students in Haramaya University, Ethiopia

Introduction

Hepatitis B (HB) is a serious infection that affects liver and caused by hepatitis B virus (HBV). HB is a serious global public health problem and the health professionals are most at risk. It is contagious and easy to be transmitted from one infected individual to another by blood to blood contact, mother to child, unprotected sexual intercourse, sharing of eating utensils and other barber shop and beauty salon equipment. The aim of this study was to assess knowledge and practices about transmissions and prevention of hepatitis B among medical and health science students on clinical attachment in Haramaya University.

Methods and Findings

A cross sectional study was conducted among 322 health science and medical students who are starting clinical attachment (year II, III, IV, V and IV) from February 1–15, 2013. Self-administered structured questionnaire was used to collect information. Out of 322 distributed questionnaires, 322 were returned with a response rate of 100.0%. Majority of the students (91%) were in the age group 20–24 and 232 (72%) of the respondents were male. Majorities (95.3%) of students were not fully vaccinated against Hepatitis B and 48.4% of the students were not aware about the availability of post exposure prophylaxis for HB. Mean scores for knowledge and practice were 11.52±2.37 and 2.76±1.1 respectively. Significant and positive linear correlations between knowledge-practice (r = 0.173, p = 0.002) was observed. Study department was significantly associated with mean knowledge and practice of study respondents.

Conclusion

This study indicates that lack of awareness about Hepatitis B, its route of transmission and modes of prevention among the medical students entering into the profession. Similarly, 95.3% the students were not fully vaccinated against Hepatitis B, which makes them vulnerable to the disease.

[Hepatitis B: cross-sectional study of knowledge and immunization among students at University of Cocody, Ivory Coast]

BACKGROUND

To evaluate knowledge about hepatitis B and vaccination coverage among students at Cocody's University, Ivory Coast.

MATERIALS AND METHODS

A cross-sectional study was conducted during the academic year 2005-2006 (2557 students). Parameters were collected by interview using a survey chart. Factors influencing knowledge and vaccination against hepatitis B were analyzed by logistic regression.

RESULTS

The majority of students (n=1174, 69.4% [95% CI 68-71]) knew about hepatitis B. Only 17.5% and 26.1% of students respectively were aware of sexual and blood transmission. None of the students were aware of maternal-fetal transmission. Factors associated with knowledge of hepatitis B were enrollment in health sciences (Odds Ratio=24.19 [95% CI 8.65-76.63]) and having a scholarship (Odds Ratio=2.34 [95% CI 1.54-3.56]). Vaccination coverage against hepatitis B was low (Odds Ratio=3.7% [95% CI 3-4]). Factors associated with vaccination were: knowledge of hepatitis B (Odds Ratio=6.83 [95% CI 4.57-10.27]), enrollment in health sciences (Odds Ratio=3.59 [95% CI 2.60-4.96]), marriage (Odds Ratio=2.04 [95% CI 1.13-3.64]) and having a scholarship (Odds Ratio=1.60 [95% CI 1.09-2.35]).

CONCLUSION

Knowledge and vaccination coverage against hepatitis B among students at Cocody's University is low. Students should be given information about hepatitis B and access to free vaccination. Students enrolled in health sciences should be vaccinated before admission because of specific risks of contamination, for themselves and for their patients.

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.

Reduction of needlestick injuries in healthcare personnel at a university hospital using safety devices

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.

Standard precautions and infection control, medical students' knowledge and behavior at a Saudi university: the need for change

Background:

No previous studies have reported the knowledge of Saudi medical students about Standard Precautions (SPs) and infection control.

Objectives:

The objectives of this study were to assess medical students’ knowledge in clinical years at King Faisal University, Saudi Arabia about SPs’ and to explore their attitudes toward the current curricular/training in providing them with effective knowledge and necessary skills with regard to SPs.

Subjects and Methods:

This cross sectional study targeted students in clinical stage at College of Medicine, King Faisal University, Saudi Arabia. A pre-tested anonymous self administered data collection form was used. Inquires about students’ characteristics, general concepts of infection control/SPs, hand hygiene, personal protective equipment, sharp injuries and disposal, and care of health providers were included. The main source of information for each domain was also inquired. The second part dedicated to explore the attitudes toward the curricular and teaching relevant to SPs.

Results:

A total of 251 students were included. Knowledge scores in all domains were considerably low, 67 (26.7%) students scored ≥ 24 (out of 41points) which was considered as an acceptable level of knowledge, 22.2% in 4_th year, 20.5% in 5_th year and 36.8% in 6_th year. Sharp injuries, personal protective equipment and health care of the providers showed the least knowledge scores. The main sources of knowledge were self learning, and informal bed side practices The majority of students’ believed that the current teaching and training are insufficient in providing them with the necessary knowledge and skills regarding SPs.

Conclusion:

The overall knowledge scores for SPs were low especially in the domains of hand hygiene, sharp management, and personal protective equipment reflecting insufficient and ineffective instructions received by medical students through the current curriculum posing them vulnerable to health facilities related infections. Proper curricular reform and training are required to protect students and their patients.

Do nursing students know and practise the Universal Precautions to prevent transmission of infectious agents?

Background: Nursing students, like other healthcare students, are at high risk of occupational exposure to blood and bodily fluids. Studies have shown that use of the Universal Precautions(UPs) lowers this risk, but do students know and practise these precautions?Objectives: This study investigated the knowledge and practice of undergraduate nursing students regarding the UPs, and whether there was a correlation between knowledge of the UPs and their practice.Method: This was a descriptive quantitative study amongst undergraduate nursing students in years 2–4 (n = 253), who were selected by means of stratified random sampling. A questionnaire was administered to the participants by the researcher. The data collected were analysed through use of the Statistical Package for Social Sciences (SPSS 16.0) and content analysis.Results: It was established that there was indeed a lack of knowledge regarding the UPs,and that the students’ self-reported practice of the UPs was poor. There was no statistically significant correlation between knowledge and practice of the UPs.Conclusion: More structured educational programmes are needed to improve both knowledge and practice of the UPs. These programmes should be offered across all nursing student study years as continuous professional development.

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

Health care workers are attributed to the group at highest risk of occupationally acquired bloodborne diseases as the result of contact with blood and body fluids. A cross sectional study was conducted between November 2009 and February 2010 in the North of Portugal, to identify potential risk factors for needlestick and sharps injuries. A questionnaire was provided to 363 health care professionals. Logistic regression was used to identify risk factors associated to needlestick and sharps injuries, calculating odds ratio (OR) and their 95% confidence interval (CI). Sixty-five percent of health care workers (64.5%, 234/363) reported needlestick and sharps injuries in the previous 5 years. Of the injured workers, 74.8% were nurses. Of the total injuries reported, the commonest were from syringe needle unit. The multivariate logistic regression model showed that the strongest risk factor was having more than 10 years or more of work in health services (OR 3.37, 95% CI 1.82, 6.24). Another significantly related factor was being over 39 years-old (OR 1.94, 95% CI 1.03, 3.63). In Portugal, there is a lack of epidemiological evidence related to needlestick and sharps injuries. Considering that patients infected with hepatitis B and C virus are commonly encountered in the hospital environment and that the prevalence of HIV infection in Portugal is one of the highest in Europe, these results should be considered in the design of biosafety strategies at the Hospital Center.

Conhecimento e utilização de medidas de precaução-padrão por profissionais de saúde

O objetivo deste trabalho foi descrever o conhecimento sobre medidas de precaução-padrão (MPP), bem como analisar a sua utilização entre 266 profissionais de saúde do Estado do Rio de Janeiro. Foi utilizado um questionário autoaplicável com três domínios: A - Identificação e capacitação profissional; B - Conhecimento e suporte após acidente biológico; C - Utilização de MPP em atividades profissionais. Na população estudada, 174 (65,4%) relataram ter feito nos últimos dois anos algum curso de atualização em sua área, 106 (39,8%) fizeram algum curso contendo temas de biossegurança, e 31,9% relataram acidente de trabalho anteriormente. Observamos que os acidentados tinham maior mediana de idade e tempo de conclusão de curso. Concluímos que a maioria dos profissionais reconhece e utiliza as principais MPPs, porém uma parcela desta população ainda não utiliza estas medidas. É importante a capacitação em biossegurança a fim de minimizar o risco durante a atividade profissional.