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Mousavi SM, Yazdanirad S, Althubiti S, Majdabadi MA, Najarian F, Sepehr P. Determination and prioritization of factors affecting the occurrence of needle stick injuries among healthcare workers using techniques of Delphi and fuzzy analytical hierarchy process (FAHP). BMC Public Health 2023; 23:2009. [PMID: 37845650 PMCID: PMC10577925 DOI: 10.1186/s12889-023-16969-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 10/11/2023] [Indexed: 10/18/2023] Open
Abstract
INTRODUCTION Needlestick injuries (NSIs) are a major hazard in the workplace for healthcare workers. To prevent these injuries, it is essential to determine the important factors affecting the occurrence of them. This study aimed to identify, classify and prioritize these factors using techniques of Delphi and fuzzy analytical hierarchy process (FAHP). METHODS This descriptive-analytical study was conducted in 2022. Firstly, the factors affecting the occurrence of needlestick injuries were identified by the literature review. Moreover, the Delphi technique was used to identify the factors. 20 experts (physicians, nurses, and occupational health experts) participated in the steps of the Delphi method. Then, these factors were grouped into six groups. In the next step, the fuzzy analytical hierarchy process (FAHP) was applied to prioritize the factors. For this purpose, the pairwise comparison questionnaire was designed and filled out by 20 experts. Finally, data were analyzed using MATLAB software (version 2018a). RESULTS 42 factors (31 factors extracted from the literature review and 11 factors obtained from the Delphi technique) were identified in this study. These factors were categorized into six groups. Based on the results, the relative weight of non-demographic personal factors, tool and technology factors, job factors, organizational factors, demographic personal factors, and environmental factors were computed by 0.200, 0.185, 0.184, 0.157, 0.142, and 0.133, respectively. CONCLUSION These results determined the importance of the factors affecting the occurrence of needlestick injuries. These findings can be useful for planning preventive measures.
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Affiliation(s)
- Seyed Mahdi Mousavi
- Department of Occupational Health and Safety Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeid Yazdanirad
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
- School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Sara Althubiti
- Department of Computer Science, College of Computer and Information Sciences, Majmaah University, Al-Majmaah, Saudi Arabia
| | - Masoud Askari Majdabadi
- Department of Occupational Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Faranak Najarian
- Department of Occupational Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Parvin Sepehr
- Department of Occupational Health, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ravi A, Shetty PK, Singh P, Wakode D, Modica SF, Kodaganallur Pitchumani P, Thomas DC. Needlestick injuries in dentistry: Time to revisit. J Am Dent Assoc 2023; 154:783-794. [PMID: 37530693 DOI: 10.1016/j.adaj.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Blood-borne pathogens (BBPs) are infectious microorganisms that are found in human blood and can cause diseases in humans. Health care workers such as physicians, surgeons, nurses, dentists, dental students, dental assistants, laboratory technicians, personnel handling infectious waste, and other health care employees are at increased risk of exposure to these pathogens. Percutaneous injuries from needles or other sharp objects are the major sources of BBPs in the workplace. Needlestick injuries (NSIs) have the most potential to transmit and have the easiest mode of transmission of BBPs. TYPES OF STUDIES REVIEWED The authors searched electronic databases (PubMed, Web of Science, Google Scholar, Scopus, Embase, MEDLINE-Ovid) for studies and articles focused on the various aspects of NSIs, their possible causes, prevention, and management protocols. RESULTS There is a lack of literature on the global prevalence of NSIs among dental practitioners and underreporting of NSIs by clinicians. The authors also found that dental students and inexperienced practitioners were the most vulnerable. They found apparent inconsistencies in guidelines and recommendations from various regulatory and statutory agencies in charge of limiting and managing NSIs. CONCLUSION The most significant occupational risks for health care workers globally are NSIs. Dentists are recognized as one of the high-risk groups for exposure to NSIs. Although the reporting rate was noticeably low, the frequency of NSIs among dental students was alarmingly high. PRACTICAL IMPLICATIONS Appropriate and succinct training of dental health care workers is crucial for prevention and management of NSIs. It is recommended that dentists familiarize themselves with recommendations from such agencies and organizations as the Center for Disease Control and Prevention, Occupational Safety and Health Administration, and American Dental Association.
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Alshehri N, Aldhahi S, Elbadawi AS, Allahim W, Alhowiti A, Hassan K, Abdelgwad W. Prevalence and Characteristics of Needle Stick and Sharp Injuries Among King Salman Armed Forces Hospital Personnel in Tabuk City: A Retrospective Hospital-Based Study. Cureus 2023; 15:e43692. [PMID: 37724215 PMCID: PMC10505494 DOI: 10.7759/cureus.43692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND This study aimed to determine the prevalence and associated characteristics of needle stick and sharp injuries (NSSIs) among King Salman Armed Forces Hospital (KSAFH) personnel. METHODS Data was collected by reviewing all reported NSSIs among KSAFH personnel between January 2020 to December 2022. RESULTS The prevalence of NSSIs was 2.05%, with nurses being the most commonly affected. Most injuries occurred in patients' rooms/wards and among health care workers (HCWs) aged < 40 years. Of the injured workers, 93.8% were immunized against hepatitis B virus (HBV). CONCLUSION Educational and training programs targeting high-risk age groups and professions should be developed. Policies related to locations and situations where injuries occur frequently should be reviewed regularly to reduce the risk of NSSIs.
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Affiliation(s)
- Norah Alshehri
- Preventive Medicine, King Salman Armed Forces Hospital, Tabuk, SAU
| | | | | | - Wareef Allahim
- Preventive Medicine, King Salman Armed Forces Hospital, Tabuk, SAU
| | - Aydah Alhowiti
- Preventive Medicine, King Salman Armed Forces Hospital, Tabuk, SAU
| | - Khalid Hassan
- Family Medicine, King Salman Armed Forces Hospital, Tabuk, SAU
| | - Walaa Abdelgwad
- Family Medicine, King Salman Armed Forces Hospital, Tabuk, SAU
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Kumah A, Forkuo-Minka AO. Advancing Staff Safety: Assessment of Quality Improvement Interventions in Reducing Needlestick Injuries Among Staff at Nyaho Medical Centre. GLOBAL JOURNAL ON QUALITY AND SAFETY IN HEALTHCARE 2023; 6:55-61. [PMID: 37333756 PMCID: PMC10275633 DOI: 10.36401/jqsh-22-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 04/01/2023] [Accepted: 04/10/2023] [Indexed: 06/20/2023]
Abstract
Introduction Needlestick injury, which occurs when the skin is accidentally punctured, is linked to infection transmission of HIV, hepatitis B, and hepatitis C. Because of the associated risks, hospitals are keen to do everything necessary to prevent needlestick injuries to their staff. This is a quality improvement project aimed at reducing needlestick injuries among staff at Nyaho Medical Centre (NMC). Methods A facility-based assessment of the incidence of needlestick injury recorded and quality intervention employed was conducted between 2018 and 2021. Quality improvement tools such as the fishbone (cause and effect analysis) and the run chart were used to analyze and evaluate improvements made over time. Results NMC staff have greatly reduced the incidence of needlestick injuries from 2018 to 2021 (from 11 needlestick injuries in 2018 to 3 recorded needlestick injuries in 2021). Conclusion Using root cause analysis to investigate the possible cause of needlestick injury and use of the run chart to monitor the implemented improvement strategies (interventions) helped reduce the incidence of needlestick injuries among staff and thereby improved staff safety. The introduction of the incident reporting management systems saw an increase in the culture of incident reporting in general. Other incidents, such as medical errors and patient falls, were being reported using the incident reporting system. The inclusion of infection prevention and control training as part of NMC's onboarding for new employees helped in the knowledge and awareness creation of needlestick injuries and safety measures to prevent injury from needles and sharps. Policy changes and audit with feedback sharing key performance indicators with frontline team members were identified to have had the most effect.
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Shift work organization on nurse injuries: A scoping review. Int J Nurs Stud 2023; 138:104395. [PMID: 36481596 DOI: 10.1016/j.ijnurstu.2022.104395] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Extended work hours and shift work can result in mistimed sleep, excessive sleepiness, and fatigue, which affects concentration and cognition. Impaired concentration and cognition negatively affect employee safety. OBJECTIVE To examine the evidence of the impact of shift work organization, specifically work hours and scheduling, on nurse injuries including needlestick and sharps injuries, drowsy driving and motor vehicle crashes, and work-related accidents causing a near miss or actual injury to the nurse. METHODS A scoping review was conducted using search results from five bibliographic databases. RESULTS Through database searching, 7788 articles were identified. During the title and abstract screening, 5475 articles were excluded. Full text screening eliminated 1971 articles. During the data extraction phase, 206 articles were excluded leaving 34 articles from 14 countries in the scoping review. The results of the review suggest a strong association in nurses between long work hours and overtime and an increased risk for needlestick and sharps injuries, drowsy driving and motor vehicle crashes, and other work-related accidents. Rotating shifts increase the risk for needlestick and sharps injuries and other work-related accidents while night and rotating shifts increase the risk for drowsy driving and motor vehicle crashes. CONCLUSIONS Proper management of work hours and scheduling is essential to maximize recovery time and reduce or prevent nurse injuries. Nurse leaders, administrators, and managers, have a responsibility to create a culture of safety. This begins with safe scheduling practices, closely monitoring for near miss and actual nurse injuries, and implementing evidence-based practice strategies to reduce these occurrences.
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Yamaguchi S, Sato M, Sumi N, Ito YM, Winwood PC, Yano R. Psychometric properties of the Japanese version of the Occupational Fatigue Exhaustion Recovery Scale among shift-work nurses. J Occup Health 2022; 64:e12325. [PMID: 35502532 PMCID: PMC9176737 DOI: 10.1002/1348-9585.12325] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 02/25/2022] [Accepted: 03/16/2022] [Indexed: 11/09/2022] Open
Abstract
Objectives Shift‐work nurses are at a higher risk of inadequate recovery from fatigue and developing maladaptive fatigue with significant health consequences. Therefore, it is necessary to monitor fatigue and recovery levels with a reliable scale. We investigated psychometric properties of the Japanese version of the Occupational Fatigue Exhaustion Recovery scale (OFER‐J) for shift‐work nurses. Methods Japanese shift‐work nurses responded to self‐administered questionnaires at baseline (n = 942) and one month later (n = 334). The confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were conducted to verify the structural validity and the correlation analysis and one‐way analysis of variance were conducted to test the construct and discriminative validity. Cronbach's alpha coefficient, intra‐class correlation coefficient (ICC), and smallest detectable change (SDC) were calculated to assess reliability. Results The CFA showed high correlations between the factors and whilst the goodness‐of‐fit of the three‐factor model was suboptimal, it was in an acceptable range. Most modifications included the error covariance of the Acute Fatigue (AF) and Intershift Recovery (IR) items. The EFA showed that Chronic Fatigue (CF) and AF were not clearly separated, indicating that the two AF items dropped out. Construct and discriminative validity were also well indicated. Cronbach's alpha coefficients were 0.75–0.85. Only CF showed sufficient reproductivity (ICC = 0.74). The SDC for CF, AF, and IR was 14.0, 17.1, and 18.7, respectively. Conclusions The validity and reliability of the OFER‐J were verified as acceptable for shift‐work nurses. The OFER‐J could contribute to a data‐based approach to fatigue management in nursing management practice.
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Affiliation(s)
- Shinya Yamaguchi
- Graduate School of Health Sciences, Hokkaido University, Hokkaido, Japan
| | - Miho Sato
- Faculty of Health Sciences, Hokkaido University, Hokkaido, Japan
| | - Naomi Sumi
- Faculty of Health Sciences, Hokkaido University, Hokkaido, Japan
| | - Yoichi M Ito
- Data Science Center, Promotion Unit, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Hokkaido, Japan
| | - Peter C Winwood
- School of Psychology, Social Work, and Social Policy, University of South Australia, Adelaide, South Australia, Australia
| | - Rika Yano
- Faculty of Health Sciences, Hokkaido University, Hokkaido, Japan
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Chen YH, Yeh CJ, Jong GP. Association of overtime work and obesity with needle stick and sharp injuries in medical practice. World J Clin Cases 2021; 9:10937-10947. [PMID: 35047604 PMCID: PMC8678866 DOI: 10.12998/wjcc.v9.i35.10937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 07/22/2021] [Accepted: 09/07/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Needle stick and sharps injuries (NSIs) may cause infections among medical personnel. Obesity and overtime work among medical personnel increase the incidence of work injuries. AIM To investigate whether overtime work and obesity increase the risk of NSIs. METHODS This cross-sectional study used the data of 847 hospital personnel, including 104 doctors, 613 nurses, 67 medical laboratory scientists, 54 specialist technicians, and nine surgical assistants. Of them, 29 participants notified the hospital of having at least one NSI in 2017. The data collected included age, overtime work, body mass index, medical specialty such as doctor or nurse, and professional grade such as attending physician or resident. The χ 2 and Fisher's exact tests were used to compare categorical variables. Multiple logistic regression analysis and the Sobel test were used to assess the risk of NSIs. RESULTS Overtime work, body weight, and medical specialty were significantly associated with NSIs (P < 0.05). After adjustment for risk factors, heavy overtime work was an independent risk factor for NSIs, and healthy body weight and nursing specialty were independent protective factors against NSIs. After adjustment for risk factors, medical personnel with healthy body weight has half as many NSIs as those with unhealthy body weight; the proportion of NSIs in doctors with healthy body weight was 0.2 times that in doctors with unhealthy body weight; the proportion of injuries among residents was 17.3 times higher than that among attending physicians; the proportion of injuries among junior nurses was 3.9 times higher than that among experienced nurses; the proportion of injuries among nurses with heavy overtime work was 6.6 times higher than that among nurses with mild overtime work; and the proportion of injuries among residents was 19.5 times higher than that among junior nurses. Heavy overtime work mediated the association of medical specialty with NSIs. CONCLUSION In addition to promoting the use of safety needles and providing infection control education, managers should review overtime schedules, and medical personnel should be encouraged to maintain a healthy weight.
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Affiliation(s)
- Yong-Hsin Chen
- Department of Occupational Safety and Health, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
- Department of Public Health, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Chih-Jung Yeh
- Department of Public Health, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Gwo-Ping Jong
- Department of Internal Medicine, Chung Shan Medical University Hospital and Chung Shan Medical University, Taichung 40201, Taiwan
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Ferrario MM, Veronesi G, Borchini R, Cavicchiolo M, Dashi O, Dalla Gasperina D, Martinelli G, Gianfagna F. Time Trends of Percutaneous Injuries in Hospital Nurses: Evidence of the Interference between Effects of Adoption of Safety Devices and Organizational Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084371. [PMID: 33924104 PMCID: PMC8074301 DOI: 10.3390/ijerph18084371] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/09/2021] [Accepted: 04/16/2021] [Indexed: 01/14/2023]
Abstract
Few studies have focused on the combined effects of devices and work organization on needlestick injuries trends. The aim of the study was to estimate trends of percutaneous injury rates (IR) in nurses (N) and nurse assistants (NA) over a 10 year period, in which passive safety devices were progressively adopted. Percutaneous and mucocutaneous injuries registered in a University Hospital in Northern Italy in Ns and NAs in 2007–2016 were analyzed. Organizational data were also available on shift schedules, turnover, downsizing and age- and skill-mix. We estimated IRs per 100 full-time equivalent workers from Poisson models and their average annual percent changes (APC) from joinpoint regression model. In the entire period, monotonic decreases in percutaneous IRs occurred among day-shift Ns (APC = −20.9%; 95% CI: −29.8%, −12%) and NAs (APC = −15.4%; −32.9%, 2.2%). Joinpoint modeling revealed a turning point in 2012 for night-shift Ns, with a steady decline in 2007–2012 (APC = −19.4%; −27.9%, −10.9%), and an increase thereafter (APC = +13.5%; 1.5%, 25.5%). In comparison to 2008 and 2012, in 2016 night-shift Ns were 5.9 and 2.5 times more likely to be younger and less qualified or experienced than day-shift Ns. The observed declines in percutaneous injury rates occurred in a time period when safety devices were progressively implemented. The causal nature of multiple exposures and organizational procedures in affecting injury time trends should be further addressed by quasi-experimental studies.
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Affiliation(s)
- Marco M. Ferrario
- Department of Medicine and Surgery, School of Medicine, University of Insubria, 21100 Varese, Italy; (G.V.); (D.D.G.); (F.G.)
- Occupational, Preventive and Toxicology Unit, ASST Sette Laghi, 21100 Varese, Italy
- Correspondence:
| | - Giovanni Veronesi
- Department of Medicine and Surgery, School of Medicine, University of Insubria, 21100 Varese, Italy; (G.V.); (D.D.G.); (F.G.)
| | - Rossana Borchini
- Occupational and Preventive Medicine Unit, ASST Lariana, 22100 Como, Italy;
| | - Marco Cavicchiolo
- School of Specialization in Occupational Medicine, University of Insubria, 21100 Varese, Italy; (M.C.); (O.D.)
| | - Oriana Dashi
- School of Specialization in Occupational Medicine, University of Insubria, 21100 Varese, Italy; (M.C.); (O.D.)
| | - Daniela Dalla Gasperina
- Department of Medicine and Surgery, School of Medicine, University of Insubria, 21100 Varese, Italy; (G.V.); (D.D.G.); (F.G.)
| | | | - Francesco Gianfagna
- Department of Medicine and Surgery, School of Medicine, University of Insubria, 21100 Varese, Italy; (G.V.); (D.D.G.); (F.G.)
- Mediterranea Cardiocentro, 80122 Napoli, Italy
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Cheetham S, Ngo HT, Liira J, Liira H. Education and training for preventing sharps injuries and splash exposures in healthcare workers. Cochrane Database Syst Rev 2021; 4:CD012060. [PMID: 33871067 PMCID: PMC8094230 DOI: 10.1002/14651858.cd012060.pub2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND In healthcare settings, health care workers (HCWs) are at risk of acquiring infectious diseases through sharps injuries and splash exposures to blood or bodily fluids. Education and training interventions are widely used to protect workers' health and safety and to prevent sharps injuries. In certain countries, they are part of obligatory professional development for HCWs. OBJECTIVES To assess the effects of education and training interventions compared to no intervention or alternative interventions for preventing sharps injuries and splash exposures in HCWs. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, NHSEED, Science Citation Index Expanded, CINAHL and OSH-update (from all time until February 2016). In addition, we searched the databases of Global Health, AustHealth and Web of Science (from all time until February 2016). The original search strategy was re-run in November 2019, and again in February 2020. In April 2020, the search strategy was updated and run in CINAHL, MEDLINE, Scopus and Web of Science (from 2016 to current). SELECTION CRITERIA We considered randomized controlled trials (RCTs), cluster-randomized trials (cluster-RCTs), controlled clinical trials (CCTs), interrupted time series (ITS) study designs, and controlled before-and-after studies (CBA), that evaluated the effect of education and training interventions on the incidence of sharps injuries and splash exposures compared to no-intervention. DATA COLLECTION AND ANALYSIS Two authors (SC, HL) independently selected studies, and extracted data for the included studies. Studies were analyzed, risk of bias assessed (HL, JL) , and pooled using random-effect meta-analysis, where applicable, according to their design types. As primary outcome we looked for sharps injuries and splash exposures and calculated them as incidence of injuries per 1000 health care workers per year. For the quality of evidence we applied GRADE for the main outcomes. MAIN RESULTS Seven studies met our inclusion criteria: one cluster-RCT, three CCTs, and three ITS studies. The baseline rates of sharps injuries varied from 43 to 203 injuries per 1000 HCWs per year in studies with hospital registry systems. In questionnaire-based studies, the rates of sharps injuries were higher, from 1800 to 7000 injuries per 1000 HCWs per year. The majority of studies utilised a combination of education and training interventions, including interactive demonstrations, educational presentations, web-based information systems, and marketing tools which we found similar enough to be combined. In the only cluster-RCT (n=796) from a high-income country, the single session educational workshop decreased sharps injuries at 12 months follow-up, but this was not statistically significant either measured as registry-based reporting of injuries (RR 0.46, 95% CI 0.16 to 1.30, low-quality evidence) or as self-reported injuries (RR 0.41, 95% CI 0.14 to 1.21, very low-quality evidence) In three CCTs educational interventions decreased sharps injuries at two months follow-up (RR 0.68, 95% CI 0.48 to 0.95, 330 participants, very low-quality evidence). In the meta-analysis of two ITS studies with a similar injury rate, (N=2104), the injury rate decreased immediately post-intervention by 9.3 injuries per 1000 HCWs per year (95% CI -14.9 to -3.8). There was a small non-significant decrease in trend over time post-intervention of 2.3 injuries per 1000 HCWs per year (95% CI -12.4 to 7.8, low-quality evidence). One ITS study (n=255) had a seven-fold higher injury rate compared to the other two ITS studies and only three data points before and after the intervention. The study reported a change in injury rate of 77 injuries per 1000 HCWs (95% CI -117.2 to -37.1, very low-quality evidence) immediately after the intervention, and a decrease in trend post-intervention of 32.5 injuries per 1000 HCWs per year (95% CI -49.6 to -15.4, very low quality evidence). None of the studies allowed analyses of splash exposures separately from sharps injuries. None of the studies reported rates of blood-borne infections in patients or staff. There was very low-quality evidence of short-term positive changes in process outcomes such as knowledge in sharps injuries and behaviors related to injury prevention. AUTHORS' CONCLUSIONS: We found low- to very low-quality evidence that education and training interventions may cause small decreases in the incidence of sharps injuries two to twelve months after the intervention. There was very low-quality evidence that educational interventions may improve knowledge and behaviors related to sharps injuries in the short term but we are uncertain of this effect. Future studies should focus on developing valid measures of sharps injuries for reliable monitoring. Developing educational interventions in high-risk settings is another priority.
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Affiliation(s)
- Shelley Cheetham
- Medical School, The University of Western Australia, Perth, Australia
| | - Hanh Tt Ngo
- School of Primary, Aboriginal and Rural Health Care, The University of Western Australia, Crawley, Australia
| | - Juha Liira
- Research and Development in Occupational Health Services, Finnish Institute of Occupational Health, Helsinki, Finland
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Effatpanah M, Effatpanah H, Geravandi S, Tahery N, Afra A, Yousefi F, Salmanzadeh S, Mohammadi MJ. The prevalence of nosocomial infection rates and needle sticks injuries at a teaching hospital, during 2013–2014. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.01.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Improving fatigue risk management in healthcare: A scoping review of sleep-related/ fatigue-management interventions for nurses and midwives (reprint). Int J Nurs Stud 2020; 112:103745. [PMID: 32847675 DOI: 10.1016/j.ijnurstu.2020.103745] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Nurses and midwives make up almost 50% of the global healthcare shift working workforce. Shift work interferes with sleep and causes fatigue with adverse effects for nurses' and midwives' health, as well as on patient safety and care. Where other safety-critical sectors have developed Fatigue Risk Management Systems, healthcare is behind the curve; with published literature only focussing on the evaluation of discreet sleep-related/fatigue-management interventions. Little is known, however, about which interventions have been evaluated for nurses and midwives. Our review is a critical first step to building the evidence-base for healthcare organisations seeking to address this important operational issue. OBJECTIVES We address two questions: (1) what sleep-related/fatigue-management interventions have been assessed in nurses and midwives and what is their evidence-base? and (2) what measures are used by researchers to assess intervention effectiveness? DESIGN AND DATA SOURCES The following databases were searched in November, 2018 with no limit on publication dates: MEDLINE, PsychINFO and CINAHL. REVIEW METHODS We included: (1) studies conducted in adult samples of nurses and/or midwives that had evaluated a sleep-related/fatigue-management intervention; and (2) studies that reported intervention effects on fatigue, sleep, or performance at work, and on measures of attention or cognitive performance (as they relate to the impact of shift working on patient safety/care). RESULTS The search identified 798 potentially relevant articles, out of which 32 met our inclusion criteria. There were 8619 participants across the included studies and all were nurses (88.6% female). We did not find any studies conducted in midwives nor any studies conducted in the UK, with most studies conducted in the US, Italy and Taiwan. There was heterogeneity both in terms of the interventions evaluated and the measures used to assess effectiveness. Napping could be beneficial but there was wide variation regarding nap duration and timing, and we need to understand more about barriers to implementation. Longer shifts, shift patterns including nights, and inadequate recovery time between shifts (quick returns) were associated with poorer sleep, increased sleepiness and increased levels of fatigue. Light exposure and/or light attenuation interventions showed promise but the literature was dominated by small, potentially unrepresentative samples. CONCLUSIONS The literature related to sleep-related/fatigue-management interventions for nurses and midwives is fragmented and lacks cohesion. Further empirical work is warranted with a view to developing comprehensive Fatigue Risk Management Systems to protect against fatigue in nurses, midwives, and other shift working healthcare staff.
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Saadeh R, Khairallah K, Abozeid H, Al Rashdan L, Alfaqih M, Alkhatatbeh O. Needle Stick and Sharp Injuries Among Healthcare Workers: A retrospective six-year study. Sultan Qaboos Univ Med J 2020; 20:e54-e62. [PMID: 32190370 PMCID: PMC7065705 DOI: 10.18295/squmj.2020.20.01.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 07/22/2019] [Accepted: 08/22/2019] [Indexed: 12/16/2022] Open
Abstract
Objectives This study aimed to examine the proportion of needle stick and sharp injuries (NSSIs) among healthcare workers at King Hussein Medical Center (KHMC), Amman, Jordan. Methods All NSSI reports referred from departments at KHMC to the Preventive Medicine Department between 2013-2018 were retrospectively reviewed. Proportion of NSSIs were calculated and stratified according to age, gender, job title, place and site of injury and the procedure/task during which the injury occurred. Results There were a total of 393 NSSIs. A significant association was found between the proportion of NSSIs and all tested variables (P <0.001). The reported proportion of NSSIs was highest among nurses (39.7%) followed by cleaners (36.3%), physicians (10.4%), other workers (7.4%) and lab technicians (5.9%) during the study's six-year period. Hospital wards were the most common locations (46.1%) where injuries took place. Injuries also occurred most frequently during medical waste collection (38.2%). Conclusion The proportion of NSSIs was highest among nurses and cleaners. Safety policies and training among high-risk groups should be reviewed to reduce the risk of NSSIs. Multicentre studies at a national level should be conducted to examine whether this study's findings reflect national trends.
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Affiliation(s)
- Rami Saadeh
- Department of Public Health & Community Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Khaled Khairallah
- Department of Public Health & Community Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Hussein Abozeid
- Department of Preventive Medicine, Jordanian Royal Medical Services, Amman, Jordan
| | | | - Mahmoud Alfaqih
- Department of Physiology and Biochemistry, Jordan University of Science and Technology, Irbid, Jordan
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Querstret D, O'Brien K, Skene DJ, Maben J. Improving fatigue risk management in healthcare: A systematic scoping review of sleep-related/fatigue-management interventions for nurses and midwives. Int J Nurs Stud 2019; 106:103513. [PMID: 32283414 DOI: 10.1016/j.ijnurstu.2019.103513] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 12/04/2019] [Accepted: 12/24/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Nurses and midwives make up almost 50% of the global healthcare shift working workforce. Shift work interferes with sleep and causes fatigue with adverse effects for nurses' and midwives' health, as well as on patient safety and care. Where other safety-critical sectors have developed Fatigue Risk Management Systems, healthcare is behind the curve; with published literature only focussing on the evaluation of discreet sleep-related/fatigue-management interventions. Little is known, however, about which interventions have been evaluated for nurses and midwives. Our review is a critical first step to building the evidence-base for healthcare organisations seeking to address this important operational issue. OBJECTIVES We address two questions: (1) what sleep-related/fatigue-management interventions have been assessed in nurses and midwives and what is their evidence-base? and (2) what measures are used by researchers to assess intervention effectiveness? DESIGN AND DATA SOURCES The following databases were searched in November, 2018 with no limit on publication dates: MEDLINE, PsychINFO and CINAHL. REVIEW METHODS We included: (1) studies conducted in adult samples of nurses and/or midwives that had evaluated a sleep-related/fatigue-management intervention; and (2) studies that reported intervention effects on fatigue, sleep, or performance at work, and on measures of attention or cognitive performance (as they relate to the impact of shift working on patient safety/care). RESULTS The search identified 798 potentially relevant articles, out of which 32 met our inclusion criteria. There were 8619 participants across the included studies and all were nurses (88.6% female). We did not find any studies conducted in midwives nor any studies conducted in the UK, with most studies conducted in the US, Italy and Taiwan. There was heterogeneity both in terms of the interventions evaluated and the measures used to assess effectiveness. Napping could be beneficial but there was wide variation regarding nap duration and timing, and we need to understand more about barriers to implementation. Longer shifts, shift patterns including nights, and inadequate recovery time between shifts (quick returns) were associated with poorer sleep, increased sleepiness and increased levels of fatigue. Light exposure and/or light attenuation interventions showed promise but the literature was dominated by small, potentially unrepresentative samples. CONCLUSIONS The literature related to sleep-related/fatigue-management interventions for nurses and midwives is fragmented and lacks cohesion. Further empirical work is warranted with a view to developing comprehensive Fatigue Risk Management Systems to protect against fatigue in nurses, midwives, and other shift working healthcare staff.
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Affiliation(s)
- Dawn Querstret
- Faculty of Sport, Health and Applied Science, St Mary's University, London TW1 4SX, UK.
| | - Katie O'Brien
- Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7YH, UK
| | - Debra J Skene
- Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7YH, UK
| | - Jill Maben
- Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7YH, UK
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Kunishima H, Yoshida E, Caputo J, Mikamo H. Estimating the national cost burden of in-hospital needlestick injuries among healthcare workers in Japan. PLoS One 2019; 14:e0224142. [PMID: 31697746 PMCID: PMC6837393 DOI: 10.1371/journal.pone.0224142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 10/07/2019] [Indexed: 12/11/2022] Open
Abstract
Background Needlestick injury (NSI) is one of the most burdensome professional hazards in any medical setting; it can lead to transmission of fatal infectious diseases, such as hepatitis B, hepatitis C and human immunodeficiency virus. In the United States, the annual cost burden was estimated as somewhere between $118 million to $591 million; in the United Kingdom it is approximated to be £500,000 (US$919,117.65) per the National Health Service. Method This is the first published paper on the national cost burden of NSIs in Japan. A systematic literature review was conducted to review previous study design in global studies and to extract parameter values from Japanese studies. We conducted abstract searches through PubMed and the Japan Medical Abstracts Society (Ichushi), together with grey literature and snowball searches. A simple economic model was developed to calculate cost burden of NSIs from a societal perspective over a one-year time horizon. We assumed all NSIs are reported and perfect adherence in post NSI management that presented in the labour compensation scheme. Local guidelines were also referenced to extract resource utilization. Lastly, a deterministic sensitivity analysis was conducted and a scenario analysis which considered a payer perspective was also included. Result and conclusion The national cost burden of in-hospital NSIs is estimated as ¥33.4 billion (US$302 million) annually, based on an average cost per NSI of ¥63,711 (US$577) and number of NSIs at 525,000/year. 70% of the cost is due to initial laboratory tests, followed by productivity loss, estimated at 20% of the total cost. Cost of contaminated NSIs remains at 5% of the total cost. Change in number of NSIs significantly influences outcomes. Variation in post-exposure management practices suggests a need for NSI specific National guidelines and holistic labour compensation scheme development in Japan.
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Affiliation(s)
- Hiroyuki Kunishima
- Department of Infectious Diseases, St. Marianna University, Kanagawa, Japan
| | | | - Joe Caputo
- Vista Health Pte. Ltd., Singapore, Singapore
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
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15
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Min A, Min H, Hong HC. Psychometric properties of the Korean version of the Occupational Fatigue Exhaustion Recovery Scale in a nurse population. Res Nurs Health 2019; 42:358-368. [PMID: 31410868 DOI: 10.1002/nur.21980] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 08/02/2019] [Indexed: 11/11/2022]
Abstract
Most nurses in Korea work rotating shifts, an important contributor to fatigue. The Occupational Fatigue Exhaustion Recovery (OFER) Scale assesses work-related fatigue among nurses. In this study, we aimed to translate and culturally adapt the Korean version of this scale (OFER-K) with nurses working rotating shifts in Korea. Instrument adaptation was performed using committee-based translation, cognitive interviewing, and expert panel interviewing. Criterion validity, convergent validity, construct validity, internal consistency, and test-retest reliability were examined as psychometric properties of the OFER-K. An online survey was completed by 331 nurses; 107 of these nurses completed a second survey after 1 month to assess test-retest reliability. The overall Cronbach's alpha was 0.88. The correlation between participants' initial and retest responses for the total scale was 0.64 (p < .001). The chronic fatigue subscale was stable over time, t(106) = -1.76, p = .08. Criterion and convergent validity were supported by correlations between the OFER-K scale and the Chalder Fatigue Questionnaire, Epworth Sleepiness Scale, and Pittsburgh Sleep Quality Index. Confirmatory factor analysis showed a good fit using a three-factor model. The findings of this study showed that the OFER-K scale is a reliable and valid instrument for assessing chronic fatigue, acute fatigue, and inter-shift recovery in Korean nurses. Future research using this scale may lead to a better understanding of the antecedents and consequences of nurse fatigue and could provide important information to nurse researchers, administrators, and policymakers for developing interventions to reduce nurse fatigue.
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Affiliation(s)
- Ari Min
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
| | - Haeyoung Min
- College of Nursing, Gyeongsang National University, Jinju, South Korea
| | - Hye C Hong
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea
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16
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Matsumoto H, Sunakawa M, Suda H, Izumi Y. Analysis of factors related to needle-stick and sharps injuries at a dental specialty university hospital and possible prevention methods. J Oral Sci 2019; 61:164-170. [PMID: 30918213 DOI: 10.2334/josnusd.18-0127] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Needle-stick and sharps injuries (NSIs) can happen even when dental health care workers (DHCWs) act in compliance with standard precautions to prevent transmitting blood-borne infections. The objective of this study was to investigate causes of NSIs that had occurred at a dental specialty university hospital during the past 12 academic years. A total of 215 NSIs were reported during the investigation period, and NSIs ascribed to female DHCWs (n = 148; 68.8%) were significantly (P < 0.05) more common than those ascribed to male DHCWs (n = 67; 31.2%). One hundred twenty-six NSIs (58.6%) were caused by DHCWs with little experience (P < 0.05), and 37 of those (17.2% of the total) were ascribed to undergraduate students during clinical training (P < 0.05). The NSIs occurred both during treatment (n = 119; 55.3%) and during cleaning up used devices (n = 89; 41.4%). The NSIs at the dental hospital occurred with a probability of 0.004% of total therapeutic opportunities. Prevention of NSIs should be the responsibility of dental students and DHCWs, and should be a part of education about infection control to prevent the nosocomial transmission of blood-borne pathogens.
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Affiliation(s)
- Hiroyuki Matsumoto
- Infection Control Office, Dental Hospital, Tokyo Medical and Dental University.,Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Mitsuhiro Sunakawa
- Infection Control Office, Dental Hospital, Tokyo Medical and Dental University.,Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Hideaki Suda
- Infection Control Office, Dental Hospital, Tokyo Medical and Dental University.,Pulp Biology and Endodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Yuichi Izumi
- Infection Control Office, Dental Hospital, Tokyo Medical and Dental University.,Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
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17
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Akbari H, Ghasemi F, Akbari H, Adibzadeh A. Predicting needlestick and sharps injuries and determining preventive strategies using a Bayesian network approach in Tehran, Iran. Epidemiol Health 2018; 40:e2018042. [PMID: 30130955 PMCID: PMC6232661 DOI: 10.4178/epih.e2018042] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 08/20/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Recent studies have shown that the rate of needlestick and sharps injuries (NSIs) is unacceptably high in Iranian hospitals. The aim of the present study was to use a systematic approach to predict and reduce these injuries. METHODS This cross-sectional study was conducted in 5 hospitals in Tehran, Iran. Eleven variables thought to affect NSIs were categorized based on the Human Factors Analysis and Classification System (HFACS) framework and modeled using a Bayesian network. A self-administered validated questionnaire was used to collect the required data. In total, 343 cases were used to train the model and 50 cases were used to test the model. Model performance was assessed using various indices. Finally, using predictive reasoning, several intervention strategies for reducing NSIs were recommended. RESULTS The Bayesian network HFACS model was able to predict 86% of new cases correctly. The analyses showed that safety motivation and fatigue were the most important contributors to NSIs. Supervisors' attitude toward safety and working hours per week were the most important factors in the unsafe supervision category. Management commitment and staffing were the most important organizational-level factors affecting NSIs. Finally, promising intervention strategies for reducing NSIs were identified and discussed. CONCLUSIONS To reduce NSIs, both management commitment and sufficient staffing are necessary. Supervisors should encourage nurses to engage in safe behavior. Excessive working hours result in fatigue and increase the risk of NSIs.
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Affiliation(s)
- Hamed Akbari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Fakhradin Ghasemi
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hesam Akbari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amir Adibzadeh
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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18
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Feelings about Nursing Assistants that Enhance the Work Motivation of Japanese Registered Nurses and Licensed Practical Nurses. J UOEH 2018; 39:259-269. [PMID: 29249739 DOI: 10.7888/juoeh.39.259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Registered nurses and licensed practical nurses have received professional education, but to enhance their work motivation it is necessary to create work environments in which they can concentrate on their jobs as specialists. One of the methods to develop such work environments is to use nursing assistants effectively. We investigated professional nurses' feelings toward nursing assistants and then examined the associations between those feelings and their work motivation. The analyzed subjects were 2,170 female nurses working in 25 hospitals with from 55 to 458 beds. The average age of the respondents was 38.0 (standard deviation, 10.6 years). Factor analyses extracted four factors of professional nurses' feelings toward nursing assistants: 1. knowledge related to healthcare, 2. nursing assistants' attitudes toward work, 3. human relations, and 4. distinguishing between professional nurses' work and nursing assistants' work. Using multiple linear regression analysis, our results revealed that scores of maintaining a high motivation to work thanks to nursing assistants became lower as the ages of the respondents increased. Scores of maintaining a high motivation to work thanks to nursing assistants became higher as professional nurses gained satisfaction from: knowledge related to healthcare, nursing assistants' attitudes toward work, and human relations. Hospital managers should consider these findings to improve working environments in which professional nurses can feel motivated to work.
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Barbe T, Kimble LP, Rubenstein C. Subjective cognitive complaints, psychosocial factors and nursing work function in nurses providing direct patient care. J Adv Nurs 2017; 74:914-925. [PMID: 29148076 DOI: 10.1111/jan.13505] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2017] [Indexed: 11/29/2022]
Abstract
AIMS The aim of this study was to examine relationships among subjective cognitive complaints, psychosocial factors and nursing work function in nurses providing direct patient care. BACKGROUND Cognitive functioning is a critical component for nurses in the assurance of error prevention, identification and correction when caring for patients. Negative changes in nurses' cognitive and psychosocial functioning can adversely affect nursing care and patient outcomes. DESIGN A descriptive correlational design with stratified random sampling. METHOD The sample included 96 nurses from the major geographic regions of the United States. Over 9 months in 2016-2017, data were collected using a web-based survey. Stepwise multiple linear regression analyses were used to examine relationships among subjective cognitive complaints, psychosocial factors and nursing work function. RESULTS Overall, participants reported minimal work function impairment and low levels of subjective cognitive complaints, depression and stress. In multivariate analyses, depression was not associated with nurses' work function. However, perceived stress and subjective concerns about cognitive function were associated with greater impairment of work function. CONCLUSION Nurses experiencing subjective cognitive complaints should be encouraged to address personal and environmental factors that are associated with their cognitive status. Additionally, stress reduction in nurses should be a high priority as a potential intervention to promote optimal functioning of nurses providing direct patient care. Healthcare institutions should integrate individual and institutional strategies to reduce factors contributing to workplace stress.
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Affiliation(s)
- Tammy Barbe
- Georgia Baptist College of Nursing, Mercer University, Atlanta, GA, USA
| | - Laura P Kimble
- Georgia Baptist College of Nursing, Mercer University, Atlanta, GA, USA
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20
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Reddy VK, Lavoie M, Verbeek JH, Pahwa M. Devices for preventing percutaneous exposure injuries caused by needles in healthcare personnel. Cochrane Database Syst Rev 2017; 11:CD009740. [PMID: 29190036 PMCID: PMC6491125 DOI: 10.1002/14651858.cd009740.pub3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Percutaneous exposure injuries from devices used for blood collection or for injections expose healthcare workers to the risk of blood borne infections such as hepatitis B and C, and human immunodeficiency virus (HIV). Safety features such as shields or retractable needles can possibly contribute to the prevention of these injuries and it is important to evaluate their effectiveness. OBJECTIVES To determine the benefits and harms of safety medical devices aiming to prevent percutaneous exposure injuries caused by needles in healthcare personnel versus no intervention or alternative interventions. SEARCH METHODS We searched CENTRAL, MEDLINE, EMBASE, NHSEED, Science Citation Index Expanded, CINAHL, Nioshtic, CISdoc and PsycINFO (until 11 November 2016). SELECTION CRITERIA We included randomised controlled trials (RCT), controlled before and after studies (CBA) and interrupted time-series (ITS) designs of the effect of safety engineered medical devices on percutaneous exposure injuries in healthcare staff. DATA COLLECTION AND ANALYSIS Two of the authors independently assessed study eligibility and risk of bias and extracted data. We synthesized study results with a fixed-effect or random-effects model meta-analysis where appropriate. MAIN RESULTS We included six RCTs with 1838 participants, two cluster-RCTs with 795 participants and 73,454 patient days, five CBAs with approximately 22,000 participants and eleven ITS with an average of 13.8 data points. These studies evaluated safe modifications of blood collection systems, intravenous (IV) systems, injection systems, multiple devices, sharps containers and legislation on the implementation of safe devices. We estimated the needlestick injury (NSI) rate in the control groups to be about one to five NSIs per 1000 person-years. There were only two studies from low- or middle-income countries. The risk of bias was high in 20 of 24 studies. Safe blood collection systems:We found one RCT that found a safety engineered blood gas syringe having no considerable effect on NSIs (Relative Risk (RR) 0.2, 95% Confidence Interval (95% CI) 0.01 to 4.14, 550 patients, very low quality evidence). In one ITS study, safe blood collection systems decreased NSIs immediately after the introduction (effect size (ES) -6.9, 95% CI -9.5 to -4.2) but there was no further decrease over time (ES -1.2, 95% CI -2.5 to 0.1, very low quality evidence). Another ITS study evaluated an outdated recapping shield, which we did not consider further. Safe Intravenous systemsThere was very low quality evidence in two ITS studies that NSIs were reduced with the introduction of safe IV devices, whereas one RCT and one CBA study provided very low quality evidence of no effect. However, there was moderate quality evidence produced by four other RCT studies that these devices increased the number of blood splashes when the safety system had to be engaged actively (relative risk (RR) 1.6, 95% CI 1.08 to 2.36). In contrast there was low quality evidence produced by two RCTs of passive systems that showed no effect on blood splashes. Yet another RCT produced low quality evidence that a different safe active IV system also decreased the incidence of blood leakages. Safe injection devicesThere was very low quality evidence provided by one RCT and one CBA study showing that introduction of safe injection devices did not considerably change the NSI rate. One ITS study produced low quality evidence showing that the introduction of safe passive injection systems had no effect on NSI rate when compared to safe active injection systems. Multiple safe devicesThere was very low quality evidence from one CBA study and two ITS studies. According to the CBA study, the introduction of multiple safe devices resulted in a decrease in NSI,whereas the two ITS studies found no change. Safety containersOne CBA study produced very low quality evidence showing that the introduction of safety containers decreased NSI. However, two ITS studies evaluating the same intervention found inconsistent results. LegislationThere was low to moderate quality evidence in two ITS studies that introduction of legislation on the use of safety-engineered devices reduced the rate of NSIs among healthcare workers. There was also low quality evidence which showed a decrease in the trend over time for NSI rates.Twenty out of 24 studies had a high risk of bias and the lack of evidence of a beneficial effect could be due to both confounding and bias. This does not mean that these devices are not effective. AUTHORS' CONCLUSIONS For safe blood collection systems, we found very low quality evidence of inconsistent effects on NSIs. For safe passive intravenous systems, we found very low quality evidence of a decrease in NSI and a reduction in the incidence of blood leakage events but moderate quality evidence that active systems may increase exposure to blood. For safe injection needles, the introduction of multiple safety devices or the introduction of sharps containers the evidence was inconsistent or there was no clear evidence of a benefit. There was low to moderate quality evidence that introduction of legislation probably reduces NSI rates.More high-quality cluster-randomised controlled studies that include cost-effectiveness measures are needed, especially in countries where both NSIs and blood-borne infections are highly prevalent.
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Affiliation(s)
- Viraj K Reddy
- Finnish Institute of Occupational HealthCochrane Work Review GroupNeulaniementie 4KuopioFinland70101
| | - Marie‐Claude Lavoie
- University of Maryland Baltimore110 South Paca Street4th Floor, RM 4‐100BaltimoreMarylandUSA21201
| | - Jos H Verbeek
- Finnish Institute of Occupational HealthCochrane Work Review GroupNeulaniementie 4KuopioFinland70101
| | - Manisha Pahwa
- University of TorontoDalla Lana School of Public Health155 College Street, 6th floorTorontoONCanadaM5T 3M7
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He L, Lu Z, Huang J, Zhou Y, Huang J, Bi Y, Li J. An Integrated Intervention for Increasing Clinical Nurses' Knowledge of HIV/AIDS-Related Occupational Safety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111094. [PMID: 27828002 PMCID: PMC5129304 DOI: 10.3390/ijerph13111094] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 10/27/2016] [Accepted: 10/31/2016] [Indexed: 12/28/2022]
Abstract
Background: Approximately 35 new HIV (Human Immunodeficiency Virus, HIV) cases and at least 1000 serious infections are transmitted annually to health care workers. In China, HIV prevalence is increasing and nursing personnel are encountering these individuals more than in the past. Contaminated needle-stick injuries represent a significant occupational burden for nurses. Evidence suggests that nurses in China may not fully understand HIV/AIDS (Acquired immunodeficiency syndrome, AIDS) and HIV-related occupational safety. At this time, universal protection precautions are not strictly implemented in Chinese hospitals. Lack of training may place nurses at risk for occupational exposure to blood-borne pathogens. Objectives: To assess the effectiveness of integrated interventions on nurses’ knowledge improvement about reducing the risk of occupationally acquired HIV infection. Methods: We audited integrated interventions using 300 questionnaires collected from nurses at the Affiliated Hospital of Xiangnan University, a public polyclinic in Hunan Province. The intervention studied was multifaceted and included appropriate and targeted training content for hospital, department and individual levels. After three months of occupational safety integrated interventions, 234 participants who completed the program were assessed. Results: Of the subjects studied, 94.3% (283/300) were injured one or more times by medical sharp instruments or splashed by body fluids in the last year and 95.3% considered their risk of occupational exposure high or very high. After the intervention, awareness of HIV/AIDS-related knowledge improved significantly (χ2 = 86.34, p = 0.00), and correct answers increased from 67.9% to 82.34%. Correct answers regarding risk perception were significantly different between pre-test (54.4%) and post-test (66.6%) (χ2 = 73.2, p = 0.00). When coming into contact with patient body fluids and blood only 24.0% of subjects used gloves regularly. The pre-test knowledge scores on universal precautions were relatively high. Correct answers about universal precautions improved significantly from pre-test (83.71%) to post-test (89.58%; χ2 = 25.00, p = 0.00). After the intervention, nurses’ attitude scores improved significantly from pre-test (3.80 ± 0.79) to post-test (4.06 ± 0.75; t = 3.74, p = 0.00). Conclusions: Integrated educational interventions enhance nurses’ knowledge of risk reduction for occupationally acquired HIV infections and improve the observance of universal precautionary procedures. This enhancement allows nurses to assume a teaching role for prevention and management of HIV/AIDS.
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Affiliation(s)
- Liping He
- School of Public Health, Wuhan University, Wuhan 430072, China.
- School of Public Health, Xiangnan University, Chenzhou 423000, China.
| | - Zhiyan Lu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan 430072, China.
| | - Jing Huang
- The Affiliated Hospital of Xiangnan University, Chenzhou 423000, China.
| | - Yiping Zhou
- School of Public Health, Xiangnan University, Chenzhou 423000, China.
| | - Jian Huang
- Chenzhou City Center for Disease Control and Prevention, Chenzhou 423000, China.
| | - Yongyi Bi
- School of Public Health, Wuhan University, Wuhan 430072, China.
| | - Jun Li
- School of Public Health, Xiangnan University, Chenzhou 423000, China.
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Jahangiri M, Rostamabadi A, Hoboubi N, Tadayon N, Soleimani A. Needle Stick Injuries and their Related Safety Measures among Nurses in a University Hospital, Shiraz, Iran. Saf Health Work 2016; 7:72-7. [PMID: 27014494 PMCID: PMC4792920 DOI: 10.1016/j.shaw.2015.07.006] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 06/30/2015] [Accepted: 07/19/2015] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND This study aimed to determine the prevalence and factors related to needle stick injuries (NSIs) and to assess related safety measures among a sample of Iranian nurses. METHODS In this cross-sectional study, a random sample of 168 registered active nurses was selected from different wards of one of the hospitals of Shiraz University of Medical Sciences (SUMS). Data were collected by an anonymous questionnaire and a checklist based observational method among the 168 registered active nurses. RESULTS The prevalence of NSIs in the total of work experience and the last year was 76% and 54%, respectively. Hollow-bore needles were the most common devices involved in the injuries (85.5%). The majority of NSIs occurred in the morning shift (57.8%) and the most common activity leading to NSIs was recapping needles (41.4%). The rate of underreporting NSIs was 60.2% and the major reasons for not reporting the NSIs were heavy clinical schedule (46.7%) and perception of low risk of infection (37.7%). A statistically significant relationship was found between the occurrence of NSIs and sex, hours worked/week, and frequency of shifts/month. CONCLUSION The study showed a high prevalence of NSIs among nurses. Supportive measures such as improving injection practices, modification of working schedule, planning training programs targeted at using personal protective equipment, and providing an adequate number of safety facilities such as puncture resistant disposal containers and engineered safe devices are essential for the effective prevention of NSI incidents among the studied nurses.
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Affiliation(s)
- Mehdi Jahangiri
- Department of Occupational Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Akbar Rostamabadi
- Department of Occupational Health, Ashtian Health Care Center, Arak University of Medical Sciences, Arak, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Naser Hoboubi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Tadayon
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Soleimani
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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Cheetham S, Thompson SC, Liira J, Afilaka OA, Liira H. Education and training for preventing sharps injuries and splash exposures in healthcare workers. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2016. [DOI: 10.1002/14651858.cd012060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Shelley Cheetham
- The University of Western Australia; School of Primary, Aboriginal and Rural Health Care; M706, 35 Stirling Highway Crawley WA Australia 6009
| | - Sandra C Thompson
- The University of Western Australia; Western Australian Centre for Rural Health (WACRH); M706, 35 Stirling Highway Crawley WA Australia 6009
| | - Juha Liira
- Finnish Institute of Occupational Health; Research and Development in Occupational Health Services; Topeliuksenkatu 41 a A Helsinki Finland FI-00250
| | - Olugbenga A Afilaka
- Aveley Medical Centre; 15 Flecker Promenade Aveley Perth Western Australia Australia 6069
| | - Helena Liira
- The University of Western Australia; School of Primary, Aboriginal and Rural Health Care; M706, 35 Stirling Highway Crawley WA Australia 6009
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Wang YJ, Meng ZH, Zheng XF, Tang XX, Sang LY, Du XM, Cheng YZ. The status of occupational blood and infectious body fluids exposures in five blood centres in China: a 5-year review. Transfus Med 2015; 25:399-405. [DOI: 10.1111/tme.12262] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 10/27/2015] [Accepted: 10/27/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Y.-J. Wang
- Key Laboratory of Blood Safety Research; Ministry of Health; Hangzhou Zhejiang People's Republic of China
| | - Z.-H. Meng
- Key Laboratory of Blood Safety Research; Ministry of Health; Hangzhou Zhejiang People's Republic of China
| | - X.-F. Zheng
- Key Laboratory of Blood Safety Research; Ministry of Health; Hangzhou Zhejiang People's Republic of China
| | - X.-X. Tang
- Blood Center of Ninbo city; Ningbo People's Republic of China
| | - L.-Y. Sang
- Blood Center of Shaoxin city; Shaoxin People's Republic of China
| | - X.-M. Du
- Blood Center of Jinhua city; Jinhua People's Republic of China
| | - Y.-Z. Cheng
- Blood Center of Huzhou city; Huzhou People's Republic of China
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Fukuda H, Yamanaka N. Reducing needlestick injuries through safety-engineered devices: results of a Japanese multi-centre study. J Hosp Infect 2015; 92:147-53. [PMID: 26601603 DOI: 10.1016/j.jhin.2015.09.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 09/28/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Quantitative information on the effectiveness of safety-engineered devices (SEDs) is needed to support decisions regarding their implementation. AIM To elucidate the effects of SED use in winged steel needles, intravenous (IV) catheter stylets and suture needles on needlestick injury (NSI) incidence rates in Japan. METHODS Japan EPINet survey data and device utilization data for conventional devices and SEDs were collected from 26 participating hospitals between 1 April 2009 and 31 March 2014. The NSI incidence rate for every 100,000 devices was calculated according to hospital, year and SED use for winged steel needles, IV catheter stylets and suture needles. Weighted means and 95% confidence intervals (CI) were used to calculate overall NSI incidence rates. FINDINGS In total, there were 236 NSIs for winged steel needles, 152 NSIs for IV catheter stylets and 180 NSIs for suture needles. The weighted NSI incidence rates per 100,000 devices for SEDs and non-SEDs were as follows: winged steel needles, 2.10 (95% CI 1.66-2.54) and 14.95 (95% CI 2.46-27.43), respectively; IV catheter stylets, 0.95 (95% CI 0.60-1.29) and 6.39 (95% CI 3.56-9.23), respectively; and suture needles, 1.47 (95% CI -1.14-4.09) and 16.50 (95% CI 4.15-28.86), respectively. All devices showed a significant reduction in the NSI incidence rate with SED use (P < 0.001 for winged steel needles, P = 0.035 for IV catheter stylets and P = 0.044 for suture needles). CONCLUSION SED use substantially reduces the incidence of NSIs, and is therefore recommended as a means to prevent occupational infections in healthcare workers and improve healthcare safety.
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Affiliation(s)
- H Fukuda
- Kyushu University Graduate School of Medical Sciences, Maidashi, Higashi-Ku, Fukuoka, Japan.
| | - N Yamanaka
- Kyushu University Graduate School of Medical Sciences, Maidashi, Higashi-Ku, Fukuoka, Japan; Kitakyushu General Hospital, Kitakyushu, Fukuoka, Japan
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Psychosocial work characteristics and needle stick and sharps injuries among nurses in China: a prospective study. Int Arch Occup Environ Health 2015; 88:925-32. [PMID: 25605612 DOI: 10.1007/s00420-015-1021-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 01/13/2015] [Indexed: 12/14/2022]
Abstract
PURPOSE Psychosocial work characteristics may be associated with needle stick and sharps injuries (NSIs) among nurses. The current evidence is, however, sparse, inconclusive, and mainly limited to cross-sectional investigations. We aimed to contribute prospective data. METHODS We conducted a prospective study among 1,791 female hospital nurses from China. At baseline and at a 1-year follow-up, fourteen psychosocial work characteristics were assessed by the short Copenhagen Psychosocial Questionnaire. At follow-up, any NSI in the workplace during the previous year was measured by participants' self-reports. We quantified associations between (1) psychosocial work characteristics at baseline and NSIs at follow-up by multivariate relative risks (Poisson regression) and (2) NSIs reported at follow-up with psychosocial work characteristics at follow-up (multivariate linear regression, among others, adjusted for psychosocial work characteristics at baseline). RESULTS The only psychosocial work characteristic associated with a slightly increased risk of subsequent NSIs was quantitative demands. Examining the opposite direction of effect, we found that NSIs during the year preceding the follow-up were associated with slightly worse ratings of seven psychosocial work characteristics at follow-up (i.e., influence at work, meaning of work, commitment to the workplace, quality of leadership, social support, social community at work, and job insecurity). CONCLUSIONS Overall, our study does not provide compelling evidence for an association of psychosocial work characteristics and subsequent occurrence of NSIs. By contrast, experience of NSIs may predict less favorable perceptions of psychosocial work characteristics.
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Venier AG, Vincent A, L'heriteau F, Floret N, Senechal H, Abiteboul D, Reyreaud E, Coignard B, Parneix P. Surveillance of Occupational Blood and Body Fluid Exposures Among French Healthcare Workers in 2004. Infect Control Hosp Epidemiol 2015; 28:1196-201. [PMID: 17828699 DOI: 10.1086/520742] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2007] [Accepted: 05/14/2007] [Indexed: 11/03/2022]
Abstract
Objective.To estimate the incidence rate of reported occupational blood and body fluid exposures among French healthcare workers (HCWs).Design.Prospective national follow-up of HCWs from January 1 to December 31, 2004.Setting.University hospitals, hospitals, clinics, local medical centers, and specialized psychiatric centers were included in the study on a voluntary basis.Participants.At participating medical centers, every reported blood and body fluid exposure was documented by the occupational practitioner in charge of the exposed HCW by use of an anonymous, standardized questionnaire.Results.A total of 375 medical centers (15% of French medical centers, accounting for 29% of hospital beds) reported 13,041 blood and body fluid exposures; of these, 9,396 (72.0%) were needlestick injuries. Blood and body fluid exposures were avoidable in 39.1% of cases (5,091 of 13,020), and 52.2% of percutaneous injuries (4,986 of 9,552) were avoidable (5.9% due to needle recapping). Of 10,656 percutaneous injuries, 22.6% occurred during an injection, 17.9% during blood sampling, and 16.6% during surgery. Of 2,065 splashes, 22.6% occurred during nursing activities, 19.1% during surgery, 14.1% during placement or removal of an intravenous line, and 12.0% during manipulation of a tracheotomy tube. The incidence rates of exposures were 8.9 per 100 hospital beds (95% confidence interval [CI], 8.7-9.0 exposures), 2.2 per 100 full-time—equivalent physicians (95% CI, 2.4-2.6 exposures), and 7.0 per 100 full-time—equivalent nurses (95% CI, 6.8-7.2 exposures). Human immunodeficiency virus serological status was unknown for 2,789 (21.4%) of 13,041 patients who were the source of the blood and body fluid exposures.Conclusion.National surveillance networks for blood and body fluid exposures help to better document their characteristics and risk factors and can enhance prevention at participating medical centers.
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Affiliation(s)
- A G Venier
- Southwestern France Infection Control Coordinating Center, France
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Markovic-Denic L, Maksimovic N, Marusic V, Vucicevic J, Ostric I, Djuric D. Occupational exposure to blood and body fluids among health-care workers in Serbia. Med Princ Pract 2014; 24:36-41. [PMID: 25376432 PMCID: PMC5588185 DOI: 10.1159/000368234] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Accepted: 09/09/2014] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES The aim of this study was to examine the epidemiology of occupational accidents and self-reported attitude of health-care workers (HCWs) in Serbia. SUBJECTS AND METHODS A cross-sectional study was conducted among HCWs in selected departments of five tertiary care hospitals and in one secondary care hospital in February 2012. A previously developed self-administered questionnaire was provided to HCWs who had direct daily contact with patients. χ(2) test and Student's t test were used for statistical analysis of the data. RESULTS Of the 1,441 potential participants, 983 (68.2%) completed the questionnaire: 655 (66.7%) were nurses/medical technicians, 243 (24.7%) were physicians and 85 (8.6%) were other personnel. Of the 983 participants, 291 (29.6%) HCWs had had at least one accident during the previous year and 106 (40.2%) of them reported it to the responsible person. The highest prevalence (68.6%) of accidents was among nurses/technicians (p = 0.001). Accidents occurred more often in large clinical centers (81.1%; p < 0.001) and in the clinical ward, intensive care unit and operating theater (p = 0.003) than in other departments. Seventy-six (13.1%) nurses/medical technicians had an accident during needle recapping (p < 0.001). Of all the HCWs, 550 (55.9%) were fully vaccinated, including significantly more doctors (154, 63.4%) than participants from other job categories (p < 0.001). CONCLUSION There was a relatively high rate of accidents among HCWs in our hospitals, most commonly amongst nurses and staff working in clinical wards, intensive care units and operating theaters. The most common types of accidents were needlestick injuries and accidents due to improper handling of contaminated sharp devices or occuring while cleaning instruments or by coming into contact with blood through damaged skin or through the conjunctiva/mucous membranes.
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Affiliation(s)
- Ljiljana Markovic-Denic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Republic of Serbia
| | - Natasa Maksimovic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Republic of Serbia
| | - Vuk Marusic
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Republic of Serbia
| | | | - Irena Ostric
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Republic of Serbia
| | - Dusan Djuric
- Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Republic of Serbia
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Han K, Trinkoff AM, Geiger-Brown J. Factors associated with work-related fatigue and recovery in hospital nurses working 12-hour shifts. Workplace Health Saf 2014; 62:409-14. [PMID: 25199168 DOI: 10.3928/21650799-20140826-01] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 07/01/2014] [Indexed: 11/20/2022]
Abstract
Nurse fatigue threatens both nurse and patient safety; fatigue affects nurses' neurocognitive functioning and hinders their work performance. The authors assessed the association of work and non-work factors with acute and chronic fatigue and intershift recovery among hospital nurses working 12-hour shifts. This study used survey data from 80 nurses who provided full-time direct patient care on medical-surgical and critical care units in a large teaching hospital. Psychological job demands (e.g., work load and social support from supervisor or coworker) were significantly associated with acute and chronic fatigue and intershift recovery. Rotating shifts were significantly related to acute fatigue. Findings suggest the need for a comprehensive approach to fatigue management, including organizational support to provide healthful work schedules and favorable nursing work environments, fewer psychological and physical demands, and assistance to improve nurses' sleep quality and quantity. [Workplace Health Saf 2014;62(10):409-414.].
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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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Ghanei Gheshlagh R, Zahednezhad H, Shabani F, Hameh M, Ghahramani M, Farajzadeh M, Esmaeili M. Needle Sticks Injuries and its Related Factors among Nurses. نشریه پرستاری ایران 2014. [DOI: 10.29252/ijn.27.89.21] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Incidence of ambulatory care visits after needlestick and sharps injuries among healthcare workers in Taiwan: a nationwide population-based study. Kaohsiung J Med Sci 2014; 30:477-83. [PMID: 25224772 DOI: 10.1016/j.kjms.2014.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Revised: 03/01/2014] [Accepted: 12/25/2013] [Indexed: 10/25/2022] Open
Abstract
Healthcare professionals have a high risk of needlestick and sharps injuries (NSIs), which have a high potential for disease transmission. Ambulatory care follow up is essential, but is usually overlooked. This study aimed to investigate the annual and cumulative (age-, sex-, and subtype-specific) incidences of ambulatory care visits after NSIs. This study was also designed to evaluate the incidences of blood-borne diseases associated with NSIs among Taiwanese health professionals in Taiwan between 2004 and 2010. Data were obtained from the National Health Insurance Research Database, which contains anonymized records representing approximately 99% of the Taiwan population. A total of 4443 nurse healthcare workers (NHCWs) and 3138 non-nurse healthcare workers (NNHCWs), including physicians, medical technologists, and other health professionals were included in this longitudinal study. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. The Mantel-Haenszel method was used to adjust for sex, age, and type of affiliation. Results showed that the annual incidence of ambulatory care visits of NHCWs increased from 0.7% in 2004 to 1.9% in 2010; this incidence was significantly higher than that of NNHCWs (from 0.3% in 2004 to 0.5% in 2010) in any yearly comparison (p < 0.05). The sex-adjusted 7-year cumulative incidence rate was 3.23 (95% CI = 1.23-8.45) in males and 3.92 (95% CI = 2.70-5.69) in females (p < 0.05). The age-adjusted 7-year cumulative incidence rate was 2.74 (95% CI = 1.99-3.77) and 2.14 (95% CI = 1.49-3.07) in subjects ≤ 30 and ≥31 years old, respectively (p < 0.0005). The affiliation-adjusted 7-year cumulative incidence rate was 1.89 (95% CI = 1.21-2.94) in medical centers and 3.33 (95% CI = 2.51-4.41) in nonmedical centers (p < 0.01). In conclusion, NSIs increased steadily from 2004 to 2010 in Taiwan with NHCWs having higher NSIs incidences than NNHCWs. A routine ambulatory care visit after NSIs can prevent blood-borne transmission, especially for NHCWs. Educational programs may be helpful for reducing the incidence of NSIs and increasing ambulatory care visit ratios after NSIs.
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Lavoie MC, Verbeek JH, Pahwa M. Devices for preventing percutaneous exposure injuries caused by needles in healthcare personnel. Cochrane Database Syst Rev 2014:CD009740. [PMID: 24610008 DOI: 10.1002/14651858.cd009740.pub2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Needlestick injuries from devices used for blood collection or for injections expose healthcare workers to the risk of blood borne infections such as hepatitis B and C, and human immunodeficiency virus (HIV). Safety features such as shields or retractable needles can possibly contribute to the prevention of these injuries and it is important to evaluate their effectiveness. OBJECTIVES To determine the benefits and harms of safety medical devices aiming to prevent percutaneous exposure injuries caused by needles in healthcare personnel versus no intervention or alternative interventions. SEARCH METHODS We searched CENTRAL, MEDLINE, EMBASE, NHSEED, Science Citation Index Expanded, CINAHL, Nioshtic, CISdoc and PsycINFO (until January 2014) and LILACS (until January 2012). SELECTION CRITERIA We included randomised controlled trials (RCT), controlled before and after studies (CBA) and interrupted time-series (ITS) designs on the effect of safety engineered medical devices on needlestick injuries in healthcare staff. DATA COLLECTION AND ANALYSIS Two authors independently assessed study eligibility and risk of bias and extracted data. We synthesized study results with a fixed-effect or random-effects model meta-analysis where appropriate. MAIN RESULTS We included four RCTs with 1136 participants, two cluster-RCTs with 795 participants and 73,454 patient days, four CBAs with approximately 22,000 participants and seven ITS with an average of seven data points. These studies evaluated safe modifications of blood collection systems, intravenous (IV) systems, injection systems, multiple devices and sharps containers. The needlestick injury (NSI) rate in the control groups was estimated at about one to five NSIs per 1000 person-years. There was only one study from a low- or middle-income country. The risk of bias was high in most studies.In one ITS study that evaluated safe blood collection systems, NSIs decreased immediately after the introduction (effect size (ES) -6.9, 95% confidence interval (CI) -9.5 to -4.2) and there was no clear evidence of an additional benefit over time (ES -1.2, 95% CI -2.5 to 0.1). Another ITS study used an outdated recapping shield.There was very low quality evidence that NSIs were reduced with the introduction of safe IV devices in two out of four studies but the other two studies showed no clear evidence of a trend towards a reduction. However, there was moderate quality evidence in four other studies that these devices increased the number of blood splashes where the safety system had to be engaged actively (relative risk (RR) 1.6, 95% CI 1.08 to 2.36).There was no clear evidence that the introduction of safe injection devices changed the NSI rate in two studies.The introduction of multiple safety devices showed a decrease in NSI in one study but not in another. The introduction of safety containers showed a decrease in NSI in one study but inconsistent results in two other studies.There was no evidence in the included studies about which type of device was better, for example shielding or retraction of the needle. AUTHORS' CONCLUSIONS For safe blood collection systems, we found very low quality evidence in one study that these decrease needlestick injuries (NSIs). For intravenous systems, we found very low quality evidence that they result in a decrease of NSI compared with usual devices but moderate quality evidence that they increase contamination with blood. For other safe injection needles, the introduction of multiple safety devices or the introduction of sharps containers the evidence was inconsistent or there was no clear evidence of a benefit. All studies had a considerable risk of bias and the lack of evidence of a beneficial effect could be due both to confounding and bias. This does not mean that these devices are not effective.Cluster-randomised controlled studies are needed to compare the various types of safety engineered devices for their effectiveness and cost-effectiveness, especially in low- and middle-income countries.
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Affiliation(s)
- Marie-Claude Lavoie
- University of Maryland Baltimore, 110 South Paca Street, Rm 4-S-100, Baltimore, Maryland, USA, 21201
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Mischke C, Verbeek JH, Saarto A, Lavoie M, Pahwa M, Ijaz S. Gloves, extra gloves or special types of gloves for preventing percutaneous exposure injuries in healthcare personnel. Cochrane Database Syst Rev 2014; 2014:CD009573. [PMID: 24610769 PMCID: PMC10766138 DOI: 10.1002/14651858.cd009573.pub2] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Healthcare workers are at risk of acquiring viral diseases such as hepatitis B, hepatitis C and HIV through exposure to contaminated blood and body fluids at work. Most often infection occurs when a healthcare worker inadvertently punctures the skin of their hand with a sharp implement that has been used in the treatment of an infected patient, thus bringing the patient's blood into contact with their own. Such occurrences are commonly known as percutaneous exposure incidents. OBJECTIVES To determine the benefits and harms of extra gloves for preventing percutaneous exposure incidents among healthcare workers versus no intervention or alternative interventions. SEARCH METHODS We searched CENTRAL, MEDLINE, EMBASE, NHSEED, Science Citation Index Expanded, CINAHL, NIOSHTIC, CISDOC, PsycINFO and LILACS until 26 June 2013. SELECTION CRITERIA Randomised controlled trials (RCTs) with healthcare workers as the majority of participants, extra gloves or special types of gloves as the intervention, and exposure to blood or bodily fluids as the outcome. DATA COLLECTION AND ANALYSIS Two authors independently assessed study eligibility and risk of bias, and extracted data. We performed meta-analyses for seven different comparisons. MAIN RESULTS We found 34 RCTs that included 6890 person-operations as participating units and reported on 46 intervention-control group comparisons. We grouped interventions as follows: increased layers of standard gloves, gloves manufactured with special protective materials or thicker gloves, and gloves with puncture indicator systems. Indicator gloves show a coloured spot when they are perforated. Participants were surgeons in all studies and they used at least one pair of standard gloves as the control intervention. Twenty-seven studies also included other surgical staff (e.g. nurses). All but one study used perforations in gloves as an indication of exposure. The median control group rate was 18.5 perforations per 100 person-operations. Seven studies reported blood stains on the skin and two studies reported self reported needlestick injuries. Six studies reported dexterity as visual analogue scale scores for the comparison double versus single gloves, 13 studies reported outer glove perforations. We judged the included studies to have a moderate to high risk of bias.We found moderate-quality evidence that double gloves compared to single gloves reduce the risk of glove perforation (rate ratio (RR) 0.29, 95% confidence interval (CI) 0.23 to 0.37) and the risk of blood stains on the skin (RR 0.35, 95% CI 0.17 to 0.70). Two studies with a high risk of bias also reported the effect of double compared to single gloves on needlestick injuries (RR 0.58, 95% CI 0.21 to 1.62).We found low-quality evidence in one small study that the use of three gloves compared to two gloves reduces the risk of perforation further (RR 0.03, 95% CI 0.00 to 0.52). There was similar low-quality evidence that the use of one fabric glove over one normal glove reduces perforations compared to two normal gloves (RR 0.24, 95% CI 0.06 to 0.93). There was moderate-quality evidence that this effect was similar for the use of one special material glove between two normal material gloves. Thicker gloves did not perform better than thinner gloves.There was moderate to low-quality evidence in two studies that an indicator system does not reduce the total number of perforations during an operation even though it reduces the number of perforations per glove used.There was moderate-quality evidence that double gloves have a similar number of outer glove perforations as single gloves, indicating that there is no loss of dexterity with double gloves (RR 1.10, 95% CI 0.93 to 1.31). AUTHORS' CONCLUSIONS There is moderate-quality evidence that double gloving compared to single gloving during surgery reduces perforations and blood stains on the skin, indicating a decrease in percutaneous exposure incidents. There is low-quality evidence that triple gloving and the use of special gloves can further reduce the risk of glove perforations compared to double gloving with normal material gloves. The preventive effect of double gloves on percutaneous exposure incidents in surgery does not need further research. Further studies are needed to evaluate the effectiveness and cost-effectiveness of special material gloves and triple gloves, and of gloves in other occupational groups.
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Affiliation(s)
| | - Jos H Verbeek
- Finnish Institute of Occupational HealthCochrane Occupational Safety and Health Review GroupPO Box 310KuopioFinland70101
| | - Annika Saarto
- Finnish Institute of Occupational HealthLemminkäisenkatu 14‐18 BTurkuFinland20520
| | - Marie‐Claude Lavoie
- University of Maryland Baltimore110 South Paca StreetRm 4‐S‐100BaltimoreMarylandUSA21201
| | - Manisha Pahwa
- University of TorontoDalla Lana School of Public Health155 College Street, 6th floorTorontoOntarioCanadaM5T 3M7
| | - Sharea Ijaz
- Finnish Institute of Occupational HealthCochrane Occupational Safety and Health Review GroupPO Box 310KuopioFinland70101
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Smith DR, Zhao I, Wang L, Ho A. Dimensions and reliability of a hospital safety climate questionnaire in Chinese health-care practice. Int J Nurs Pract 2013; 19:156-62. [PMID: 23577973 DOI: 10.1111/ijn.12046] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The aim of the current study was to examine the dimensions and reliability of a hospital safety climate questionnaire in Chinese health-care practice. To achieve this, a cross-sectional survey of health-care professionals was undertaken at a university teaching hospital in Shandong province, China. Our survey instrument demonstrated very high internal consistency, comparing well with previous research in this field conducted in other countries. Factor analysis highlighted four key dimensions of safety climate, which centred on employee personal protection, employee interactions, safety-related housekeeping and time pressures. Overall, this study suggests that hospital safety climate represents an important aspect of health-care practice in contemporary China.
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Affiliation(s)
- Derek R Smith
- School of Health Sciences, Faculty of Health, University of Newcastle, Ourimbah, New South Wales, Australia.
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Yoshikawa T, Wada K, Lee JJ, Mitsuda T, Kidouchi K, Kurosu H, Morisawa Y, Aminaka M, Okubo T, Kimura S, Moriya K. Incidence rate of needlestick and sharps injuries in 67 Japanese hospitals: a national surveillance study. PLoS One 2013; 8:e77524. [PMID: 24204856 PMCID: PMC3813677 DOI: 10.1371/journal.pone.0077524] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2013] [Accepted: 09/04/2013] [Indexed: 12/17/2022] Open
Abstract
Background Determining incidence rates of needlestick and sharps injuries (NSIs) using data from multiple hospitals may help hospitals to compare their in-house data with national averages and thereby institute relevant measures to minimize NSIs. We aimed to determine the incidence rate of NSIs using the nationwide EPINet surveillance system. Methodology/Principal Findings Data were analyzed from 5,463 cases collected between April 2009 and March 2011 from 67 Japanese HIV/AIDS referral hospitals that participated in EPINet-Japan. The NSI incidence rate was calculated as the annual number of cases with NSIs per 100 occupied beds, according to the demographic characteristics of the injured person, place, timing, device, and the patients’ infectious status. The NSI incidence rates according to hospital size were analyzed by a non-parametric test of trend. The mean number of cases with NSIs per 100 occupied beds per year was 4.8 (95% confidence interval, 4.1–5.6) for 25 hospitals with 399 or fewer beds, 6.7 (5.9–7.4) for 24 hospitals with 400–799 beds, and 7.6 (6.7–8.5) for 18 hospitals with 800 or more beds (p-trend<0.01). NSIs frequently occurred in health care workers in their 20 s; the NSI incidence rate for this age group was 2.1 (1.6–2.5) for hospitals having 399 or fewer beds, 3.5 (3.0–4.1) for hospitals with 400–799 beds, and 4.5 (3.9–5.0) for hospitals with 800 or more beds (p-trend<0.01). Conclusions/Significance The incidence rate of NSIs tended to be higher for larger hospitals and in workers aged less than 40 years; injury occurrence was more likely to occur in places such as patient rooms and operating rooms. Application of the NSI incidence rates by hospital size, as a benchmark, could allow individual hospitals to compare their NSI incidence rates with those of other institutions, which could facilitate the development of adequate control strategies.
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Affiliation(s)
- Toru Yoshikawa
- Department of Research, The Institute for Science of Labour, Kawasaki, Japan
| | - Koji Wada
- Bureau of International Medical Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
- * E-mail:
| | - Jong Ja Lee
- Department of Infection Control and Prevention, Kobe University Hospital, Kobe, Japan
| | - Toshihiro Mitsuda
- Department of Infection Prevention and Control, Yokohama City University Hospital, Yokohama, Japan
| | | | - Hitomi Kurosu
- Department of Nursing, Tokyo Metropolitan Health and Medical Treatment Corporation Ebara Hospital, Tokyo, Japan
| | - Yuji Morisawa
- Department of Infection Prevention and Control, Jichi Medical University Hospital, Tochigi, Japan
| | | | - Takashi Okubo
- Department of Infection Prevention and Control, Tokyo Healthcare University Postgraduate School, Tokyo, Japan
| | | | - Kyoji Moriya
- Department of Infection control and prevention, The University of Tokyo, Tokyo, Japan
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Fujii C. Clarification of the characteristics of needle-tip movement during vacuum venipuncture to improve safety. Vasc Health Risk Manag 2013; 9:381-90. [PMID: 23901281 PMCID: PMC3726589 DOI: 10.2147/vhrm.s47490] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Complications resulting from venipuncture include vein and nerve damage, hematoma, and neuropathic pain. Although the basic procedures are understood, few analyses of actual data exist. It is important to improve the safety standards of this technique during venipuncture. This study aimed to obtain data on actual needle movement during vacuum venipuncture in order to develop appropriate educational procedures. METHODS Six experienced nurses were recruited to collect blood samples from 64 subjects. These procedures were recorded using a digital camera. Software was then used to track and analyze motion without the use of a marker in order to maintain the sterility of the needle. Movement along the X- and Y-axes during blood sampling was examined. RESULTS Approximately 2.5 cm of the needle was inserted into the body, of which 6 mm resulted from advancing or moving the needle following puncture. The mean calculated puncture angle was 15.2°. Given the hazards posed by attaching and removing the blood collection tube, as well as by manipulating the needle to fix its position, the needle became unstable whether it was fixed or not fixed. CONCLUSION This study examined venipuncture procedures and showed that the method was influenced by increased needle movement. Focusing on skills for puncturing the skin, inserting the needle into the vein, and changing hands while being conscious of needle-tip stability may be essential for improving the safety of venipuncture.
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Affiliation(s)
- Chieko Fujii
- Faculty of Nursing and Medical Care, Keio University, Kanagawa, Japan.
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Epidemiology of Needle Sticks and Sharp Injuries Among Nurses in an Iranian Teaching Hospital. ARCHIVES OF CLINICAL INFECTIOUS DISEASES 2012. [DOI: 10.5812/archcid.14409] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cheung K, Ching SSY, Chang KKP, Ho SC. Prevalence of and risk factors for needlestick and sharps injuries among nursing students in Hong Kong. Am J Infect Control 2012; 40:997-1001. [PMID: 22633132 DOI: 10.1016/j.ajic.2012.01.023] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Revised: 01/16/2012] [Accepted: 01/17/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although nursing students are at greater risk for needlestick injuries (NSIs) and sharps injuries (SIs) than staff nurses, there is a lack of research on NSIs and SIs in students, especially in different years of study. The purpose of this study was to identify the risk factors for and prevalence of NSIs and SIs among nursing students in different years of study. METHODS This was a cross-sectional survey study using a questionnaire confirmed to be valid and reliable, with a content validity index of 0.96 and reliability index of 0.82. RESULTS A total of 878 nursing students (response rate, 76.61%), participated in the study. NSIs/SIs, NSIs, and SIs were significantly increased by year of study (P < .001) in both the study period and 12-month prevalence. Four predictors for NSIs/SIs were final-year study (odds ratio [OR], 11.9; 95% confidence interval [CI], 3.9-36.7), perception of not receiving prevention training (OR, 2.8; 95% CI, 1.1-7.5), perception of not using a kidney dish to contain used needles and sharps (OR, 4.2; 95% CI, 1.7-10.3), and perception of not immediately discarding used needles and syringes into a sharps box (OR, 2.9; 95% CI, 1.2-7.4). CONCLUSIONS Preclinical training, reinforcement of kidney dish use, immediate discarding of used needles, and adequate clinical supervision are essential elements in reducing the risk of NSIs and SIs.
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Affiliation(s)
- Kin Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong.
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Effect of a Face-to-Face Education Program Versus an Official-Imperative Method on Needle-Disposal Behavior of Nurses Working in Kashan, Iran. Nurs Midwifery Stud 2012. [DOI: 10.5812/nms.7910] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Butsashvili M, Kamkamidze G, Kajaia M, Morse DL, Triner W, Dehovitz J, McNutt LA. Occupational exposure to body fluids among health care workers in Georgia. Occup Med (Lond) 2012; 62:620-6. [PMID: 22869786 DOI: 10.1093/occmed/kqs121] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Health care workers (HCWs) are at increased risk of being infected with blood-borne pathogens. AIMS To evaluate risk of occupational exposure to blood-borne viruses and determine the prevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) among HCWs in Georgia. METHODS The sample included HCWs from seven medical institutions in five cities in Georgia. A self-administered questionnaire was used to collect information on demographic, occupational and personal risk factors for blood-borne viruses. After obtaining informed consent, blood was drawn from the study participants for a seroprevalence study of HBV, HCV and HIV infections. RESULTS There were 1386 participating HCWs from a number of departments, including surgery (29%), internal medicine (19%) and intensive care (19%). Nosocomial risk events were reported by the majority of HCWs, including accidental needlestick injury (45%), cuts with contaminated instruments (38%) and blood splashes (46%). The most frequent risk for receiving a cut was related to a false move during a procedure, reassembling devices and handing devices to a colleague. The highest proportion of needlestick injuries among physicians (22%) and nurses (39%) was related to recapping of used needles. No HIV-infected HCW was identified. Prevalence of HCV infection was 5%, anti-HBc was present among 29% with 2% being HBsAg carriers. CONCLUSIONS Data from this study can be utilized in educational programs and implementation of universal safety precautions for HCWs in Georgia to help achieve similar reductions in blood-borne infection transmission to those achieved in developed countries.
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Affiliation(s)
- M Butsashvili
- National Center for Disease Control and Public Health, Tbilisi, Georgia.
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Cho E, Lee H, Choi M, Park SH, Yoo IY, Aiken LH. Factors associated with needlestick and sharp injuries among hospital nurses: a cross-sectional questionnaire survey. Int J Nurs Stud 2012; 50:1025-32. [PMID: 22854116 DOI: 10.1016/j.ijnurstu.2012.07.009] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Revised: 06/29/2012] [Accepted: 07/11/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND The current status of needlestick or sharp injuries of hospital nurses and factors associated with the injuries have not been systematically examined with representative registered nurse samples in South Korea. OBJECTIVE To examine the incidence to needlestick or sharp injuries and identify the factors associated with such injuries among hospital nurses in South Korea. DESIGN, SETTINGS AND PARTICIPANTS A cross-sectional survey of hospital nurses in South Korea. Data were collected from 3079 registered nurses in 60 acute hospitals in South Korea by a stratified random sampling method based on the region and number of beds. METHODS The dependent variable was the occurrence of needlestick or sharp injuries in the last year, and the independent variables were protective equipment, nurse characteristics, and hospital characteristics. This study employed logistic regression analysis with generalized estimating equation clustering by hospital to identify the factors associated with needlestick or sharp injuries. RESULTS The majority (70.4%) of the hospital nurses had experienced needlestick or sharp injuries in the previous year. The non-use of safety containers for disposal of sharps and needles, less working experience as a registered nurse, poor work environments in regards to staffing and resource adequacy, and high emotional exhaustion significantly increased risk for needlestick or sharp injuries. Working in perioperative units also significantly increased the risk for such injuries but working in intensive care units, psychiatry, and obstetrics wards showed a significantly lower risk than medical-surgical wards. CONCLUSIONS The occurrence of needlestick or sharp injuries of registered nurses was associated with organizational characteristics as well as protective equipment and nurse characteristics. Hospitals can prevent or reduce such injuries by establishing better work environments in terms of staffing and resource adequacy, minimizing emotional exhaustion, and retaining more experienced nurses. All hospitals should make safety-engineered equipment available to registered nurses. Hospitals as well as specific units showing higher risk for needlestick and sharp injuries should implement organizational strategies to prevent such injuries. It is also necessary to establish a monitoring system of needlestick and sharp injuries at a hospital level and a reporting system at the national level in South Korea.
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Affiliation(s)
- Eunhee Cho
- College of Nursing, Nursing Policy Research Institute, Yonsei University, Republic of Korea
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Wang S, Yao L, Li S, Liu Y, Wang H, Sun Y. Sharps injuries and job burnout: a cross-sectional study among nurses in China. Nurs Health Sci 2012; 14:332-8. [PMID: 22690707 DOI: 10.1111/j.1442-2018.2012.00697.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The present study investigated the relationship between sharps injuries and job burnout in nurses. Sharps injury questionnaires and the Maslach Burnout Inventory (MBI) questionnaires were used to investigate and analyze job burnout among 468 nurses, of which 458 effective questionnaires were collected, for a response rate of 97.86%. A total of 292 nurses had at least one sharps injury (63.76% of the 458 nurses). The dimension scores were higher for injured nurses compared with non-injured nurses. The difference between the dimensions of emotional exhaustion and depersonalization for nurses with sharps injuries was statistically significant (P < 0.05). A rank correlation analysis showed that these two dimensions had a positive correlation with sharps injuries (r = 0.69-0.78). The prevalence of sharps injuries in nursing is associated with depersonalization, as measured by the MBI. Nursing administrators should pay more attention to clinically burned-out nurses, and provide more opportunity to nurses for training and education to reduce the prevalence of sharps injuries.
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Affiliation(s)
- Shuhui Wang
- Institute of Social Medicine and Health Service Management, School of Public Health of Shandong University, Ji'nan, Shandong, China
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Lakbala P, Azar FE, Kamali H. Needlestick and sharps injuries among housekeeping workers in hospitals of Shiraz, Iran. BMC Res Notes 2012; 5:276. [PMID: 22676775 PMCID: PMC3419653 DOI: 10.1186/1756-0500-5-276] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2012] [Accepted: 05/18/2012] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Needlestick and sharps injuries (NSSIs) are one of the major risk factors for blood-borne infections (BBPs) at healthcare facilities. This study examines the current prevalence of NSSIs among housekeeping workers engaged in the handling and disposal of biomedical waste (BMW) at government and private hospitals in Shiraz, Iran, and furthermore, explores strategies for preventing these injuries. FINDINGS Using a cross-sectional study design, NSSI's and associated protective measures for housekeeping workers throughout hospitals in Shiraz were evaluated from 2009 onwards. Using a questionnaire, data was collected for 92 workers who had engaged directly with BMW. Data was analyzed using Chi-square, student t-test and where appropriate, SPSS version 12. 90.2 % of housekeeping workers were warned of the dangers associated with waste, 87.5 % in government and 93.2 % in private hospitals (P = 0.0444). 83.7 % had attended educational programs on biomedical waste (BMW) management and injury prevention at their hospital in the preceding year. 16.3 % had not been trained in biomedical waste management (P = 0.0379) and 88.9 % had a sufficient supply of safety wear. CONCLUSIONS NSSIs are a common risk factor for infection among health care workers within hospitals in Iran. For the effective prevention of these injuries, health boards and hospital trusts need to formulate strategies to improve the working conditions of health care workers, discourage the excessive use of injections, and increase their adherence to universal precautions.
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Affiliation(s)
- Parvin Lakbala
- Medical Record and Health Information Technology, Hormozgan University of Medical Science, Bandar Abbas, 79168319, Iran
| | - Farbood Ebadi Azar
- School of Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Hajeb Kamali
- Obstetrics and Gynecology, North Bristol NHS, Becks pool Road, Frenchay Bristol, Bs161JE, United Kingdom
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Needlestick Injuries, Short Peripheral Catheters, and Health Care Worker Risks. JOURNAL OF INFUSION NURSING 2012; 35:164-78. [DOI: 10.1097/nan.0b013e31824d276d] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Lin SC, Tsai KW, Chen MW, Koo M. Association between fatigue and Internet addiction in female hospital nurses. J Adv Nurs 2012; 69:374-83. [DOI: 10.1111/j.1365-2648.2012.06016.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Lavoie MC, Verbeek JH, Parantainen A, Pahwa M. Devices for preventing percutaneous exposure injuries caused by needles in health care personnel. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2012. [DOI: 10.1002/14651858.cd009740] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Cheng HC, Su CY, Yen AMF, Huang CF. Factors affecting occupational exposure to needlestick and sharps injuries among dentists in Taiwan: a nationwide survey. PLoS One 2012; 7:e34911. [PMID: 22509367 PMCID: PMC3318009 DOI: 10.1371/journal.pone.0034911] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Accepted: 03/10/2012] [Indexed: 01/05/2023] Open
Abstract
Background Although the risks of needlestick and sharps injuries (NSIs) for dentists are well recognized, most papers published only described the frequency of occupational exposure to NSIs. Less has been reported assessing factors contributing to exposure to NSIs. The purpose of this study was to update the epidemiology of NSIs among dentists in Taiwan and identify factors affecting NSIs in order to find preventive strategies. Methodology/Principal Findings A nationwide survey was conducted in dentists at 60 hospitals and 340 clinics in Taiwan. The survey included questions about factors supposedly affecting exposure to NSIs, such as dentist and facility characteristics, knowledge and attitudes about infectious diseases, and practices related to infection control. Univariate and multivariate logistic regression analyses were conducted to determine the association between risk factors and exposure to NSIs. In total, 434 (74.8%) of 580 dentists returned the survey questionnaires, and 100 (23.0%) reported that they had experienced more than one NSI per week. Our data showed that the risk of occupational NSIs is similarly heightened by an older age (odds ratio [OR], 3.18; 95% confidence interval [CI], 1.62–6.25), more years in practice (OR, 2.57; 95% CI, 1.41–4.69), working in clinics (OR, 1.73; 95% CI, 1.08–2.77), exhibiting less compliance with infection-control procedures (OR, 1.82; 95% CI, 1.04–3.18), having insufficient knowledge of blood-borne pathogens (OR, 1.67; 95% CI, 1.04–2.67), and being more worried about being infected by blood-borne pathogens (OR, 1.82; 95% CI, 1.05–3.13). Conclusions/Significance High rates of NSIs and low compliance with infection-control procedures highly contribute to the chance of acquiring a blood-borne pathogen infection and threaten occupational safety. This study reveals the possible affecting factors and helps in designing prevention strategies for occupational exposure to NSIs.
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Affiliation(s)
- Hsin-Chung Cheng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
- * E-mail:
| | - Chen-Yi Su
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Amy Ming-Fang Yen
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chiung-Fang Huang
- Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
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Parantainen A, Verbeek JH, Lavoie MC, Pahwa M. Extra gloves or special types of gloves versus a single pair of gloves for preventing percutaneous exposure injuries in healthcare personnel. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2012. [DOI: 10.1002/14651858.cd009573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Parantainen A, Verbeek JH, Lavoie MC, Pahwa M. Blunt versus sharp suture needles for preventing percutaneous exposure incidents in surgical staff. Cochrane Database Syst Rev 2011; 2011:CD009170. [PMID: 22071864 PMCID: PMC7387125 DOI: 10.1002/14651858.cd009170.pub2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Surgeons and their assistants are especially at risk of exposure to blood due to glove perforations and needle stick injuries during operations. The use of blunt needles can reduce this risk because they don't penetrate skin easily but still perform sufficiently in other tissues. OBJECTIVES To determine the effectiveness of blunt needles compared to sharp needles for preventing percutaneous exposure incidents among surgical staff. SEARCH METHODS We searched MEDLINE and EMBASE (until May 2011), CENTRAL, NHSEED, Science Citation Index Expanded, CINAHL, Nioshtic, CISdoc, PsycINFO, and LILACS (until September 2010). SELECTION CRITERIA Randomised controlled trials (RCTs) of blunt versus sharp suture needles for preventing needle stick injuries among surgical staff measured as glove perforations or self-reported needle stick injuries. DATA COLLECTION AND ANALYSIS Two authors independently assessed study eligibility and risk of bias in trials and extracted data. We synthesized study results with a fixed-effect model meta-analysis. MAIN RESULTS We located 10 RCTs involving 2961 participating surgeons performing an operation in which the use of blunt needles was compared to the use of sharp needles. Four studies focused on abdominal closure, two on caesarean section, two on vaginal repair and two on hip replacement. On average, a surgeon that used sharp needles sustained one glove perforation in three operations. The use of blunt needles reduced the risk of glove perforations with a relative risk (RR) of 0.46 (95% confidence interval (CI) 0.38 to 0.54) compared to sharp needles. The use of blunt needles will thus prevent one glove perforation in every six operations.In four studies, the use of blunt needles reduced the number of self-reported needle stick injuries with a RR of 0.31 (95% CI 0.14 to 0.68). Because the force needed for the blunt needles is higher, their use was rated as more difficult but still acceptable in five out of six studies.The quality of the evidence was rated as high. AUTHORS' CONCLUSIONS There is high quality evidence that the use of blunt needles appreciably reduces the risk of exposure to blood and bodily fluids for surgeons and their assistants over a range of operations. It is unlikely that future research will change this conclusion.
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Affiliation(s)
- Annika Parantainen
- Health Care and Social Services, Finnish Institute of Occupational Health, Turku, Finland.
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