Needle Stick Injuries and their Related Safety Measures among Nurses in a University Hospital, Shiraz, Iran

Needle stick injuries and post-exposure prophylaxis practices among healthcare personnel working at tertiary care hospitals in Punjab, Pakistan

BACKGROUND

Healthcare workers face a high risk of blood-borne infections due to needlestick injuries, especially in developing countries like Pakistan.

OBJECTIVE

This study aims to evaluate the prevalence of needlestick injuries, reporting practices, and post-exposure prophylaxis measures among healthcare personnel in tertiary care hospitals in Punjab.

METHODS

A cross-sectional study was conducted from May to July 2019. Data were collected from healthcare personnel working in teaching hospitals across six randomly selected cities of Punjab. Data were collected from 600 healthcare personnel using a pretested, self-administered questionnaire, employing stratified random sampling to ensure representative sampling. Descriptive statistics were applied, and differences in needlestick injuries across demographic segments were assessed using the Mann-Whitney U and Kruskal-Wallis H tests.

RESULTS

Among the 600 respondents, 533 returned the complete questionnaire, yielding a response rate of 88.8%. The majority of respondents were female (n = 341, 64.2%). The mean years of service was 5.58 (±5.78), with most participants falling in the 0.5-5 years category (n = 338, 66.4%). The prevalence of self-reported needlestick injuries in the last six months was 35.25%. Most injuries occurred during sampling (n = 95, 35.85%), followed by recapping (n = 63, 23.77%). Reporting of needlestick injuries to the respective department was poor, with only 82 (21.87%) injuries reported. The frequency of needlestick injuries differed significantly across profession, working department, and education categories (p < 0.05). Sanitary staff were more likely to sustain needlestick injuries during garbage collection and waste handling. Post-exposure screening for blood-borne infections was received by 79 (42.93%) individuals, and post-exposure prophylaxis (PEP) was administered to 67 (36.41%).

CONCLUSION

The high prevalence of needlestick injuries among healthcare personnel occurred primarily during sampling and recapping. Reporting of NSIs was inadequate, and post-exposure testing and prophylaxis practices were substandard. Enhanced policies and protocols are necessary for effective NSI surveillance and the administration of pre- and post-exposure prophylaxis.

Prevalence of needle-stick injury in Iranian nurses: an updated systematic review and meta-analysis of observational studies

BACKGROUND

The aim of this study was to conduct a systematic review and meta-analysis to estimate the prevalence of needle-stick injury among Iranian nurses.

METHODS

We conducted a systematic review and meta-analysis to estimate the prevalence of needle-stick injury among Iranian nurses. A comprehensive search of Web of Science, PubMed, Scopus, Scientific Information Database, and MagIran was performed, yielding 29 observational articles comprising 8842 nurses. The studies ranged from 2006 to 2023, with sample sizes varying from 68 to 1555 individuals. Methodological quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist. The pooled prevalence was calculated using the random-effects model, and subgroup analyses were conducted based on hospital type and gender. The data was analyzed using Stata software version 16.

RESULTS

The pooled prevalence of needle-stick injury among Iranian nurses was found to be 46% (95% Confidence Interval [CI]: 39-53%). Subgroup analysis revealed significant difference in prevalence between teaching hospitals (47%; 95% CI: 39-54%) and military hospitals (38%; 95% CI: 31.1-44%). The prevalence of NSI in region 1 (Tehran and surrounding provinces) and other regions was 45.1% (95% CI: 37-54%) and 49.17% (95% CI: 36.5-61.7%). Gender-based analysis showed higher prevalence in women (58%; 95% CI: 44-71%) compared to men (55%; 95% CI: 43-66%).

CONCLUSION

Needle stick injuries has a high prevalence among Iranian nurses, especially nurses working in teaching hospitals. Therefore, it seems necessary to use interventions to reduce it.

Needle Stick Injury Among Healthcare Workers in a Tertiary Care Setting in Dehradun, Sub-Himalayan Region: A Four-Year Record-Based Study

INTRODUCTION

Needlestick injuries (NSIs) represent a significant occupational health risk in healthcare settings. These injuries, caused by contaminated sharps such as needles, vials, and scalpel blades, can lead to percutaneous exposure to infectious materials. Despite the severity of NSIs, they often go unreported, highlighting a critical gap in occupational safety protocols.

AIMS

This study aimed to investigate the occurrence of NSIs among healthcare workers (HCWs) by sex, profession, and working areas. It also sought to explore the underlying reasons for these injuries and the factors contributing to their underreporting.

METHODOLOGY

Adhering to the RECORD guidelines (Reporting of studies Conducted using Observational Routinely Collected Data), this record-based study involved a retrospective analysis of reported NSIs. Data were collected from voluntary reports by HCWs who experienced NSIs or exposure to potentially infectious materials such as blood and body fluids. Statistical analysis was conducted using IBM SPSS Statistics for Windows, Version 16 (Released 2007; IBM Corp., Armonk, New York) and Microsoft Excel 2010 (Microsoft Corporation, Redmond, Washington).

RESULTS

Data from 142 participants indicated a higher proportion of females experiencing NSIs compared to males, with rates of 57.7% pre-COVID and 60.6% during COVID. There were notable shifts in NSI rates across professions, with increases observed among staff nurses and ward attendants/helpers. Analysis of injury circumstances revealed a decrease in sampling procedure-related injuries but an increase during intravenous procedures and biomedical waste segregation. Injuries occurring on the right-hand index finger decreased from 52.1% pre-COVID to 31% during COVID, while those on the left-hand index finger increased from 19.7% pre-COVID to 39.4% during COVID. Statistically significant associations were found between the injury site and the place of occurrence (p=0.021). Healthcare professionals commonly cleansed the site with disinfectants and used personal protective equipment (PPE) kits, with increased PPE usage noted during the COVID-19 pandemic. These findings emphasize the evolving dynamics of NSIs among HCWs and underscore the importance of tailored preventive measures during pandemics.

How Sharp Objects Injuries Impact our Healthcare Workers: Unveiling Perspective and Preventive Imperatives

Introduction Sharp object injuries in the medical field present a considerable occupational hazard for healthcare workers (HCWs), encompassing a spectrum of consequences from immediate discomfort to enduring health consequences. These injuries may expose HCWs to potential infections. Despite efforts to control sharp object injuries in healthcare environments, they are present at every stage involving using or disposing of medical sharp instruments. In Jordan, limited research has focused on sharp object injuries, with most data included from studies concentrating on practicing nurses or nursing students. Consequently, further research is necessary to comprehend the causes behind the high sharp object injury rate and the insufficient knowledge of safety practices and preventive guidelines. Objectives This study was conducted to investigate the impact of sharp object injuries on HCWs, underlying causes, and potential consequences causes of needlestick injuries. To highlight perspective and preventive imperatives. Methods and patients This retrospective institutional-based cross-sectional chart analysis was conducted by reviewing all sharp object injuries report sheets and extracting data directly from these reports for analysis. The study encompassed all reported cases occurring between 2018 and 2023. All the participants' data handling was accomplished according to the Declaration of Helsinki (2013) and the Health Insurance Portability and Accountability (HIPAA) Acts.  Results A total of 146 self-reported hospital workers were included in the study. Within the final cohort, 52.73% of the participants were male (77/146), with an average age at diagnosis of 38.6±7.87 years (ranging from 20 to 52 years). Conversely, females comprised 47.27% of the cohort population (69/146) and had an average age at diagnosis of 34.73±6.73 years (ranging from 19 to 47 years). The age group 20-29 years was the most prominent age group, statistical analysis of age and gender data revealed significant differences. The overall prevalence of sharp object injuries was 11.83%, indicating that a sizable portion of HCWs is at risk of exposure to bloodborne pathogens. Among the different professional categories, Physicians constituted the majority of sharp object injuries reported victims in 41 cases (28.08%), followed by nurses in 38 cases (26.02%). Statistical analysis of the profession's data revealed significant differences (P<0.001). Notably, sharp object injuries were most reported in wards. The leading procedures that caused sharp object injuries were identified as during needle recapping in 53 instances (36.30%), then followed by medical waste treatment in 32 cases (21.92%). The left hand was the most affected body part, reported in 83 cases (56.84%). All injured individuals reported the incident promptly. No seroconversions were documented within the reviewed cases during the study period. Conclusion Injuries caused by sharp objects persist as a significant danger for hospital employees, posing immediate harm and long-term health risks linked to bloodborne pathogens. The findings stress the continuous responsibility of healthcare institutions to prioritize staff safety by addressing the root causes of sharp object injuries and fostering reporting and prevention cultures. Underreporting reasons are diverse, encompassing factors like time constraints, fear of consequences, and the misconception of injury insignificance.

Predictors of hospital nursing staff's adherence to safe injection guidelines: application of the protection motivation theory in Fars province, Iran

BACKGROUND

Needle stick injuries (NSI) can lead to dangerous infectious diseases for health care workers. This study aimed to determine the predictors of observance of safe injection guidelines in hospital nursing staff, based on protection motivation theory.

METHODS

This cross-sectional study was conducted on the nursing staff of five randomly selected teaching and general hospitals of Shiraz University of Medical Sciences, Fars province, Iran, in 2021. Data were collected using a researcher-made questionnaire which was developed based on protection motivation theory. Data were processed and analyzed using SPSS 22 and Amos 24 at a significance level of  < 0.05. Pearson's correlation coefficient, Multiple linear regression, and Structural Equation Modeling were used.

RESULTS

The mean age of the participants (No = 280) was 32.5 ± 8.09 years. Most of the participants [80%] had encountered NSI, patients' blood, or body fluids at least once. Protection motivation was the only predictor of protective behaviors (β = 0.573), while perceived efficacy (β = 0.142) and perceived rewards (β = -0.229) were the strongest predictors of motivation. The structural equation modeling analysis showed that standardized total effects of protection motivation, perceived response costs, rewards, and efficacy on the protective behaviors were 0.573, -0.159, -.104, and 0.81, respectively. While standardized total effects of perceived rewards, efficacy, and response cost on protection motivation were -0.229, 0.142, and -0.033, respectively. The model fit indices indicated the acceptable final model fit.

CONCLUSION

The results suggest that perceived efficacy, perceived effectiveness, and perceived rewards were the most important predictors of adherence to Safe Injection Guidelines in nursing staff.

Investigation ways of causes needle sticks injuries, risk factors affecting on health and ways to preventive

Needle sticks injuries (NSIs) has caused many health concerns, including the widespread infection disease. Needle sticks injuries can have high threaten health human especially, all those who are in contact with health and medical centers. The purpose of this review study was the determination the effects of needle sticks injuries (NSIs) on health care worker and patents. In this a review study of literature studied conducted on international databases included Google Scholar, ISI/WOS (Web of Science), Springer, Scopus, Medline/PubMed. The literature signs a notable undesirable affect from potential needle sticks injuries related to ways to preventive and risks factors among patents and health care worker. The literature was shown needle stick injuries can cause with a variety of ways including needle recapping, non-standard safety boxes, thin gloves, and inadequate personal protective equipment. According to the result this study, needle stick injuries can transfer infectious disease (Human Immunodeficiency viruses [HIV], Hepatitis C virus [HCV]) and increase risk health on health care worker and patients. According to research related to the subject, the ways to prevent reduce needle sticks include personal protective equipment, holding retraining courses for medical staff in the direction to raise awareness can significantly reduce cases of needle sticks injuries. Further research using more sophisticated methodology is warranted.

Direct Care Nurses' Needlestick Injury Experiences: A Qualitative Descriptive Study

BACKGROUND

Even when education and the use of safety equipment are emphasized, nurses frequently experience needlestick injuries. Understanding the risk situations and coping mechanisms for needlestick injuries experienced by nurses facilitates their prevention.

OBJECTIVES

We aimed to explore and describe the phenomenon of needlestick injuries through the research questions: (1) What causes nurses to suffer from needlestick injuries? (2) How to cope after a needlestick injury? and (3) What are the recommendations for needlestick injury prevention?

METHODS

This qualitative descriptive study involved focus group interviews with 31 direct care nurses in 6 groups who had experienced needlestick injuries while working in different acute care hospitals across 3 regions in South Korea. Data were collected from January 29 to March 29, 2022, and analyzed using thematic analysis.

RESULTS

The average age of the participating nurses was 29.7 years. The following 3 themes were identified: various needlestick injury experiences, post-needlestick injury coping, and expectations regarding needlestick injuries.

CONCLUSIONS

Risk situations and coping mechanisms of nurses who experienced needlestick injuries were diverse. Emergency situations and novice nurses were the causes of most of the needlestick injuries. Often, personal protective equipment was found cumbersome. Reporting needlestick injuries depended on the work environment.

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

Background

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

Materials and Methods

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

Results

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

Conclusion

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

A large-scale survey on epidemiology and underreporting of needlestick and sharp injuries among healthcare workers in China

Background

Needlestick and sharp injuries (NSI) carry the risk of transmitting numerous bloodborne pathogens, leading to both health and economic burdens. The underreporting of NSIs among healthcare workers (HCWs) is a global issue of concern, as timely treatment and prevention of complications rely on proper reporting. Underreporting further impedes accurate surveillance and appropriate resource allocation, with developed and developing nations facing disparities due to differences in healthcare policy.

Purpose

The purpose of this research is to examine the epidemiology of NSIs and NSI underreporting, as well as to identify the determinants associated with the occurrence of NSIs and the underreporting of such injuries.

Method

A retrospective online survey was conducted from January 15 to January 31, 2022 among healthcare workers (HCWs) across Gansu Province, China.

Results

A total of 7,283 healthcare workers (HCWs) from various institutions participated in this study. After quality assurance checks, 6,464 (88.77%) responses were included in the final analysis. Results revealed a 32.86% self-reported needlestick and sharp injury (NSI) incidence among respondents, with 28.53% of NSIs going unreported. Contrary to common belief, more experienced HCWs exhibited higher rates of both NSIs and underreporting compared to their less experienced peers. The primary reasons cited for NSIs and underreporting were lapses in concentration and not perceiving patients as infectious. Multivariate regression analysis exposes the significant influence of training frequency, occupation, department and years of services on the occurrence of NSIs. Conversely, the reporting of NSIs is primarily influenced by training, reimbursement,occupation, department and hospital grade. Compared to HCWs with no training, those who received ≥3 training sessions per year showed a 12.16% lower NSI incidence (27.12% vs. 39.28%, p < 0.001) and a 55.68% lower underreporting rate (14.61% vs. 70.29%, p < 0.001).

Conclusion

There is a pressing need for enhanced surveillance, tailored training programs, and more efficient reporting mechanisms to combat this significant occupational health challenge.

Magnitude of occupational exposure to sharp injuries among nurses working in South Gondar zone public hospitals, Northcentral Ethiopia: institution-based cross-sectional study

OBJECTIVE

This study aimed to determine the magnitude of occupational exposure to sharp injuries and identify its associated factors among nurses.

DESIGN

Institution-based cross-sectional study design was conducted from 1 to 30 November 2022.

ANALYSIS

The collected data were entered into EpiData V.4.2; then, exported to Stata V.14 for analysis. Variables with a p value of <0.05 at 95% CI were considered significantly associated with occupational exposure to sharp injuries.

SETTING

The study was conducted in South Gondar zone public hospitals.

PARTICIPANTS

Nurses working in South Gondar zone public hospitals.

RESULTS

Of the total respondents, 213 (56.65%) were between the ages of 25 and 34 with the mean±SD of age 30.22±6.63 years. Similarly, 202 (53.72%) of the respondents were women. This study finding showed that the magnitude of occupational exposure to sharp injuries among nurses was 52.39% (95% CI: 47.92% to 56.37%). Moreover, this study finding showed that year of service >10 years (adjusted OR (AOR)=2.35, 95% CI: 1.21 to 4.57), lack of infection prevention training (AOR=1.85, 95% CI: 1.09 to 3.45), job-related stress (AOR=2.24, 95% CI: 1.27 to 3.89) and presence of contaminated sharps at the workplace (AOR=2.76, 95% CI: 1.67 to 4.72) were significantly associated with occupational exposure to sharp injuries among nurses.

CONCLUSIONS

Generally, this study finding reported that the magnitude of occupational exposure to sharp injuries among nurses was high. This study finding also showed that years of service >10 years, lack of infection prevention training, job-related stress and the presence of contaminated sharps at the workplace were independent predictors of occupational exposure to sharp injuries among nurses. Hence, all the concerned bodies should strengthen regular provision of infection prevention training to nurses at all levels. Nurses should practice proper use of safety box more than ever in order to avoid the presence of contaminated needles and other sharp materials at the workplace.

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)

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.

Assessment of immunization session practices in primary health care centers in Al-Najaf province

Immunization has played a vital role in improving global health by reducing the transmission of infectious diseases. To ensure the successful implementation of immunization programs, it is crucial to thoroughly examine various elements within the Primary Health Care Centers, including immunization session management, cold-chain and logistics management, supervision, and reporting. The study aims to assess the immunization session practices in selected primary healthcare centers in Al-Najaf governorate. A descriptive cross-sectional study was conducted at 26 primary healthcare centers, selected using simple random sampling, across six districts in Najaf governorate. A total of 143 healthcare workers, comprising 122 vaccinators and 21 doctors, were included in the study. questionnaires were utilized to assess immunization session practices. Data collection commenced on December 2, 2022, and concluded on March 2, 2023. Immunization session practices were evaluated as having poor vaccine and diluent management, fair cold chain management, communication with clients and caregivers, vaccine preparation and administration practices, and waste management practices. However, immunization session equipment availability, as well as card review and registration during immunization, received good evaluations. The overall assessment of immunization session practices was determined to be fair. In addition, the study identified significant associations between immunization practices and the number of non-vaccinators working in the immunization unit (P=0.035), and the average number of daily vaccine recipients in primary healthcare centers (P=0.046). The immunization session practices achieved a fair level of assessment, The increased number of daily visitors to the immunization unit and the number of health workers who are non-vaccinator in the unit affected negatively the immunization session practices.

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

BACKGROUND

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

OBJECTIVES

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

DESIGN

Systematic review and meta-analysis.

METHODS

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

RESULTS

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

CONCLUSION

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

RELEVANCE TO CLINICAL PRACTICE

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

NO PATIENT OR PUBLIC CONTRIBUTION

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

The Prevalence of Occupational Accidents and the Associated Factors Among Janitorial Staff at a University Teaching Hospital in South Ethiopia

Background

The healthcare industry is widely regarded as a high-risk environment for workers' occupational health and safety. As a result, healthcare workers are constantly exposed to a wide range of hazards, including biological, chemical, physical, ergonomic, and psychosocial hazards. Consequently, janitorial staff are the most vulnerable section of the healthcare workforce to occupational injuries when compared to others due to the nature of their work. Therefore, this study aims at assessing the magnitude of occupational accidents and associated factors among Janitorial staff at Dilla University Teaching Hospital.

Methods

This cross-sectional institutional-based study was conducted from August to September 2022 at a University Teaching Hospital in South Ethiopia. A total of 105 janitorial staff were included in the study with a response rate of 93.8%. The data were collected using a structured interviewer-administered questionnaire. Data were entered using Epi Info version 7.2.5 and exported to IBM SPSS statistics 22 for further cleaning and analysis. The binary logistic regression model was used to identify predictors of occupational accidents and variables with a p-value of <0.05 during the multivariable analysis were considered statistically significant.

Results

The prevalence of occupational accidents is 61% (95% CI: 51.4, 70.5). Of the total study participants, 52 (45.5%) and 33 (31.4%) of the participants had reported that they have experienced chemical splash and needle stick injury, respectively. The age of participants was one of the factors for occupational accidents. The participants who did not receive training were 3 times [AOR=2.9, 95% CI (1.04, 8.02)] more likely exposed. Having good practice was protective against occupational injuries.

Conclusion

The study highlights the high prevalence of occupational accidents, particularly chemical splashes, and needle stick injuries, among janitors in the study settings. The study emphasizes the importance of age, training, awareness, and adherence to infection prevention and control strategies as factors influencing the likelihood of experiencing occupational injuries.

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

OBJECTIVES

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

CONTENT

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

SUMMARY AND OUTLOOK

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

Shift work organization on nurse injuries: A scoping review

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.

Needlestick and sharp injuries and its associated factors among healthcare workers in Southern Ethiopia

Background

Needlesticks and sharp injuries are occupational hazards for healthcare workers that result from the accidental piercing of the skin. Needlestick injuries expose healthcare workers to blood and body fluids that may be infected and can be transmitted to them. Healthcare workers have been exposed to blood-borne pathogens through contaminated needles and other sharp materials every day. Around 20 blood-borne diseases can be transmitted through casual needlesticks and sharp injuries.

Objective

To assess needlestick and sharp injuries and its associated factors among healthcare workers in Southern Ethiopia, 2021.

Methods

The hospital-based cross-sectional study design was conducted among 341 healthcare workers in Worabe Comprehensive Specialized Hospital from June 10 to July 6, 2021. A stratified sampling technique was used and data were collected using standardized structural questionnaires by BSc nursing professionals. The collected data were checked for completeness and consistency by the investigator. The completed questionnaire was given an identification number and entered into EpiData version 3.5.1. The data were coded and analyzed using SPSS version 26 using a binary logistic regression model and presented with texts, tables, and graphs.

Results

The finding revealed that 30.6% of healthcare workers had experienced needlestick and sharp injuries within their working area. Healthcare workers not trained on safety measures of needlestick and sharp injury (adjusted odds ratio: 7.179 (3.494-14.749)), working in the delivery unit (adjusted odds ratio: 6.528 (3.171-11.834)), being older age (adjusted odds ratio: 3.394 (1.775-7.126)), working in inpatient unit (3.278 (1.804-5.231)), working in an emergency unit (adjusted odds ratio: 5.718 (4.326-6.398)), working in an operation room theater (adjusted odds ratio: 2.359 (1.781-4.430)), working as a medical laboratory technician (adjusted odds ratio: 1.070 (1.432-3.304)), working in pediatrics unit (adjusted odds ratio: 1.063 (1.431-2.843)), working as cleaners (adjusted odds ratio: 0.018 (0.002-0.195)), working <40 h per week (adjusted odds ratio: 0.036 (0.004-0.345)), and seldom needle recapping (adjusted odds ratio: 0.043 (0.015-0.125)) were statistically associated with needlestick and sharp injury.

Conclusions

In this study, there is a high magnitude of needlestick or sharp injuries among healthcare workers. Lack of training on work-related safety measures; working in delivery; being older age; working in the inpatient unit, emergency, operation room, and pediatrics units; being laboratory technicians, and cleaners; working hours per week; and seldom needle recapping were significant predictors of needlestick and sharp injury.

Healthcare Waste-A Serious Problem for Global Health

Healthcare waste (HCW) is generated in different healthcare facilities (HCFs), such as hospitals, laboratories, veterinary clinics, research centres and nursing homes. It has been assessed that the majority of medical waste does not pose a risk to humans. It is estimated that 15% of the total amount of produced HCW is hazardous and can be infectious, toxic or radioactive. Hazardous waste is a special type of waste which, if not properly treated, can pose a risk to human health and to the environment. HCW contains potentially harmful microorganisms that can be spread among healthcare personnel, hospital patients and the general public, causing serious illnesses. Healthcare personnel are the specialists especially exposed to this risk. The most common medical procedure, which pose the highest risk, is injection (i.e, intramuscular, subcutaneous, intravenous, taking blood samples). The World Health Organization (WHO) estimates that around 16 billion injections are administered worldwide each year. However, if safety precautions are not followed, and needles and syringes are not properly disposed of, the risk of sharps injuries increases among medical staff, waste handlers and waste collectors. What is more, sharps injuries increase the risk of human immunodeficiency virus (HIV), hepatitis B and C viruses (HBV/HCV), tuberculosis (TB), diphtheria, malaria, syphilis, brucellosis and other transmissions. Disposing of medical waste in a landfill without segregation and processing will result in the entry of harmful microorganisms, chemicals or pharmaceuticals into soil and groundwater, causing their contamination. Open burning or incinerator malfunctioning will result in the emission of toxic substances, such as dioxins and furans, into the air. In order to reduce the negative impact of medical waste, waste management principles should be formulated. To minimize health risks, it is also important to build awareness among health professionals and the general public through various communication and educational methods. The aim of this paper is to present a general overwiev of medical waste, its categories, the principles of its management and the risks to human health and the environment resulting from inappropriate waste management.

Occupational-Related Injuries and Associated Risk Factors Among Healthcare Workers Working in Developing Countries: A Systematic Review

Background

Occupational-related diseases or illnesses account for an estimated 2.4 million deaths worldwide every year. Currently, occupational hazards threaten healthcare workers' (HCWs) lives, safety, and well-being. Therefore, providing the prevalence and major causes of occupational-related diseases may enable injury reduction and the creation of safer working environments, which are important for providing higher quality services. The current study aimed to determine the prevalence of occupational-related injuries and associated risk factors among HCWs, particularly in developing countries.

Methods

The articles published in English were retrieved using a combination of Boolean logic operators (AND, OR, and NOT), Medical Subject Headings (MeSH), and keywords in electronic databases (SCOPUS/Science Direct, Web of Science, DOAJ, PubMed/MEDLINE, CINAHL, and Google Scholars). Using Joanna Briggs Institute critical appraisal tools, a quality assessment was conducted to determine the articles' relevance. In addition, the relevant articles were identified through a series of assessment and evaluation stages.

Results

About 721 studies were searched using electronic databases, of which 36 articles included 139,578 HCWs. The average prevalence of occupational-related injuries among HCWs in the career and previous last year accounted for 60.17%, ranged from 32% to 87.8% and 39.16%, ranged from 1.14% to 87%, respectively. The current study found that sex and hours worked, stress at work, occupation, age, training in infection prevention, use of universal precautions, recapping needles, ward work experience, staffing and resource adequacy, awareness, outdated guidelines, and previous exposure to sharp injury were statistically associated with occupational-related injuries.

Conclusions

This study revealed that 39% and 60% of HCWs experienced occupational-related injuries in the last year and during their career, respectively. Therefore, the appropriate measures must be taken to reduce the burden of occupational-related injuries by following standard precautions or occupational health and safety measures.

Factors Influencing Turnover Intention among Nurses and Midwives in Ghana

BACKGROUND

Nurse turnover intention, defined as a measure of nurses' desire to leave their positions, is a global public health issue with a grave impact on the healthcare workforce. However, literature on it is limited in sub-Saharan Africa, an at-risk region. This study aimed to determine the predictors of turnover intention among nursing staff at a tertiary hospital in Kumasi, Ghana.

METHODS

This was an institution-basedcross-sectional study conducted among 226 randomly selected nurses and midwives working at a tertiary healthcare center in Kumasi, Ghana. Data were collected by using a structured questionnaire. Significant predictors of turnover intention were analyzed by using multivariate logistic regression analysis. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) and p value <0.05 was used.

RESULTS

The prevalence of turnover intention among study participants was 87.2% (197/226). About two-thirds (61.5%, 139/226) of the participants were exposed to a high level of workplace hazards. Management support (AOR = 3.09, 95% CI = 1.09-8.75), salary (AOR = 0.07, 95% CI = 0.01-0.46), inadequate number of staff on duty per shift (AOR = 3.36, 95% CI = 1.08-10.47) and participants' rank (AOR = 6.81, 95% CI = 1.18-39.16) were significantly associated with turnover intention.

CONCLUSION

Overall, the turnover intention was high. Hence, there is a need for policymakers, health administrators, and nurse managers to implement strategies such as increasing staff strength, providing adequate support, incentives, and other forms of motivation for nurses and midwives to help reduce the rate of turnover intention.

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Reported Injuries from Sharp Objects among Healthcare Workers in Central Greece

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

Knowledge, Attitude, and Practice Regarding Needle Stick Injuries Among Health Care Workers in Baghdad Teaching Hospital and Ghazy Al-Hariri Hospital for Surgical Specialties in 2020

Background: Needle stick injuries are serious occupational hazards in the transmission of a variety of bloodborne diseases, more than twenty pathogens can be transmitted through NSI including hepatitis B virus, hepatitis C virus, and human immunodeficiency virus (AIDS) among healthcare workers. Objectives: Assess the knowledge, attitude and practice of health care workers towards needle stick injuries. Determine the prevalence of needle stick injuries among healthcare workers and its predisposing factors.  Methods: Cross-sectional descriptive study, a convenient sample of 260 health care workers was selected from Baghdad Teaching hospital and Ghazy Al Hariri hospital in Baghdad, Iraq. Data were collected by an anonymous questionnaire from January to June 2020. The collected data were analyzed by using statistical package for the social sciences (SPSS version 23). Results Prevalence of NSIs among HCWs was found to be 53.8%, which was higher in nurses (29.3%) and laboratory technicians (28.5%) followed by surgeon doctors (15.7%), assistant surgeons (13.6%) and dentists (12.9%) .The highest number of needle stick injuries occurred by recapping of needles (41.4%) followed by during drug administration (27.9%), from hand to hand  (10.7%) and during blood drawing (7.9%). A proportion of (64.5%) of  health care workers whom sustained needle stick injury had reported their Injury. Doctors scored better than others regarding mean scores of knowledge, attitude and practice. There was a highly significant association among knowledge, attitude and practice scores of the HCWs (P<0.001). A considerable percentage of the participants (80.2%) were completely immunized against HBV. Conclusions: The study showed a high prevalence of NSIs among health care workers. The score of knowledge was high, moreover acceptable responses were obtained in most attitude and practice statements, except for recapping of needles statements.  

Occupational Exposure to Needle Stick Injuries among Health Care Workers in a Tertiary care hospital: A KAP study

Background: Needle stick injuries (NSIs) are serious occupational health problem related to accidental exposure of health care workers (HCWs) while involved in patient care services. The percutaneous exposure to potentially contaminated blood and body fluids with blood borne pathogens are responsible for significant prevalence of Hepatitis B, C & HIV infections amongst HCWs. Methods: This is a descriptive cross sectional study conducted in hospital settings over a period of one year. 178 HCWs were selected for study using systematic random sampling after proportional allocation for each professional category in the hospital. Collected data was processed on SPSS ver 24. The association between needle stick and associated factors were measured using the odds ratio at a 95% confidence interval. The statistical significance was made at a p-value of less than 0.05. Results Total of 62 incidences of sustaining a needle stick injury in a year was recorded amongst 178 HCWs. In this study, statistically significant results with p value less than 0.05 was obtained with association with variables like gender [AOR=1.36 (0.64 - 2.68)], experience in years as HCWs [AOR=1.23 (0.32 - 2.12)], profession [AOR=0.063 (0.001- 0.43)], observance of universal precautions as wearing gloves [AOR=0.33 (0.169 – 0.631)] or any training on PEP or universal precautions [AOR=2.29 (1.320 - 4.696)]. Conclusion:  NSIs have the potential to affect the health system both directly and indirectly. To lessen the dangers and impacts of NSIs stringent training should coordinate the endeavors toward preparing of health care workers, utilization of wellbeing designed gadgets, and diminishing patient burden per health care workers.

Awareness of hepatitis B post-exposure prophylaxis among healthcare providers in Wakiso district, Central Uganda

Background

Healthcare providers (HCPs) are at an elevated occupational health risk of hepatitis B virus infections. Post-exposure prophylaxis (PEP) is one of the measures recommended to avert this risk. However, there is limited evidence of HCPs’ awareness of hepatitis B PEP. Therefore, this study aimed to establish awareness of hepatitis B PEP among HCPs in Wakiso, a peri-urban district that surrounds Uganda’s capital, Kampala.

Methods

A total of 306 HCPs, selected from 55 healthcare facilities (HCFs) were interviewed using a validated structured questionnaire. The data were collected and entered using the Kobo Collect mobile application. Multivariable binary logistic regression was used to establish the factors associated with awareness of hepatitis B PEP.

Results

Of the 306 HCPs, 93 (30.4%) had ever heard about hepatitis B PEP and 16 (5.2%) had ever attended training where they were taught about hepatitis B PEP. Only 10.8% were aware of any hepatitis B PEP options, with 19 (6.2%) and 14 (4.6%) mentioning hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine, respectively as PEP options. Individuals working in the maternity department were less likely to be aware of hepatitis B PEP (AOR = 0.10, 95% CI = 0.02–0.53). There was a positive association between working in a healthcare facility in an urban setting and awareness of hepatitis B PEP (AOR = 5.48, 95% CI = 1.42–21.20). Hepatitis B screening and vaccination were not associated with awareness of PEP.

Conclusions

Only one-tenth of the HCPs were aware of any hepatitis B PEP option. Awareness of hepatitis B PEP is associated with the main department of work and working in a healthcare facility in an urban setting. This study suggests a need to sensitise HCPs, especially those in rural HCFs and maternity wards on hepatitis B PEP. The use of innovative strategies such as e-communication channels, including mobile text messaging might be paramount in bridging the awareness gap.

The impact of emotional intelligence and personality traits on the occurrence of unsafe behaviors and needle stick injuries among the nurses

This study was aimed to investigate the effect of emotional intelligence and some personality traits on safe behavior and needle stick injuries among the nurses. This cross-sectional study was performed on 200 nursing staff of a hospital in Iran. To collect data, individuals were asked to complete several questionnaires, including demographic questionnaire, domain-specific risk-taking questionnaire, Rosenberg self-confidence questionnaire, Buss-Perry aggression questionnaire, Goleman emotional intelligence questionnaire, and safe behavior questionnaire. Also, the number of needlestick injuries in the participants was extracted from their medical records. Data were analyzed using the SPSS software (version 22), and path analysis was performed using AMOS software. The prevalence of needle stick injuries in the subjects was estimated by 45.5 percent. The results showed that increasing risk-taking, increasing aggression, decreasing self-confidence, and decreasing emotional intelligence reduced safe behavior and increased the number of needle injuries (P < 0.001). In the present study, some personal traits affecting the occurrence of needlestick injuries were identified. It is recommended that people without these negative traits are applied in dangerous occupations with a high probability of needle stick injuries.

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

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

Factors associated with needlestick injuries among healthcare workers: implications for prevention

BACKGROUND

Our study sought to determine the frequency of Needlestick injuries (NSIs) among Healthcare Workers (HCWs) working at governmental hospital and to study the factors that associated with occurrence of NSIs, and to develop recommendations for a comprehensive program for prevention.

METHODS

Retrospective study of all reported cases of NSIs in the period from April 2016 to May 2018 among healthcare workers at a governmental hospital.

RESULTS

Incidence of NSIs over 26 months was 8.4% among all participants. Nurses were the most affected staff (52.5%) resulted commonly from disposing syringes (58.9%). In contrast, the incidence of NSIs among physicians was 24.9% where surgical devices were the primary source of NSIs among them (40%). Failure to complete all required hepatitis B vaccination was common among expatriates of the participants of this study.

CONCLUSIONS

NSIs was common among HCWs participated in this study. Preventive measures should be implemented including adequate hepatitis B immunization.

Prevalence and associated factors of needle stick and sharps injuries among healthcare workers in northwestern Ethiopia

Background

Needle stick and sharp injuries (NSSIs) are a common problem among healthcare workers (HCWs). Although the factors related to NSSIs for HCWs are well documented by several studies in Ethiopia, no evidence has been reported about the magnitude of and factors related to NSSIs in hospitals in northwestern Ethiopia.

Methods

An institution-based cross-sectional study was carried out from January to March 2019 among 318 HCWs in three randomly-selected hospitals of the eight hospitals found in South Gondar Zone. Sample sizes were proportionally allocated to professional categories. Study participants were selected by systematic random sampling methods using the monthly salary payroll for each profession as the sampling frame. Data were collected using a self-administered questionnaire. The outcome of this study was the presence (injured) or absence of NSSIs during the 12 months prior to data collection. A binary logistic regression model with 95% confidence interval (CI) was used for data analysis. Variables from the bi-variable analysis with a p-value ≤ 0.25 were retained into the multivariable analysis. From the multivariable analysis, variables with a p-value less than 0.05 was declared as factors significantly associated with NSSIs.

Main findings

The prevalence of NSSIs was 29.5% (95% CI: 24.2–35.5%) during the 12 months prior to the survey. Of these, 46.0% reported that their injuries were moderate, superficial (33.3%) or severe (20.7%). About 41.4% of the injuries were caused by a suture needle. Factors significantly associated with NSSIs were occupation as a nurse (adjusted odds ratio [AOR] = 2.65, 95% CI: 1.18–4.26), disposal of sharp materials in places other than in safety boxes (AOR = 3.93, 95% CI: 2.10–5.35), recapping of needles (AOR = 2.27, 95% CI: 1.13–4.56), and feeling sleepy at work (AOR = 2.24, 95% CI: 1.14–4.41).

Conclusion

This study showed that almost one-third of HCWs had sustained NSSIs, a proportion that is high. Factors significantly associated with NSSIs were occupation as a nurse, habit of needle recapping, disposal of sharp materials in places other than in safety boxes and feeling sleepy at work. Observing proper and regular universal precautions for nurses during daily clinical activities and providing safety boxes for the disposal of sharp materials, practicing mechanical needle recapping and preventing sleepiness by reducing work overload among HCWs may reduce the incidence of NSSIs.

Occupational exposure to blood/body fluid splash and its predictors among midwives working in public health institutions at Addis Ababa city Ethiopia, 2020. Institution-based cross-sectional study

BACKGROUND

Blood/body fluid splash are hazards to health care professionals in their working area. Around twenty bloodborne pathogens are known to be transmitted through these occupational injuries. This problem alters the health status of health care professionals in different ways, including physically, mentally, and psychologically. Even though health professionals especially midwives who are working in delivery rooms are highly affected, little is known about the exposure. So, this study was aimed to assess the prevalence of exposure to blood/body fluid splash and its predictors among midwives working in public health institutions of Addis Ababa city.

METHODS

Institution based cross-sectional study was conducted among 438 study participants in public health institutions in Addis Ababa. Data was collected from March 1-20, 2020 by a self-administered questionnaire. The data were entered into Epi data version 3.1 and then exported to SPSS version 24 for analysis. All variables with P<0.25 in the bivariate analysis were included in a final model and statistical significance was declared at P< 0.05.

RESULTS

In this study, a total of 424 respondents respond yielding a response rate of 97%. The prevalence of blood and body fluid splashes (BBFs) was 198 (46.7%). Not training on infection prevention, working in two shifts (> 12 hours), not regularly apply universal precautions, job-related stress, an average monthly salary of 5001-8000 were independent predictors of blood and body fluid splashes.

CONCLUSION

The study revealed that nearly half of midwives were exposed to BBFS. This highlights the need for key stakeholders such as policymakers and service providers to design appropriate policies to avert this magnitude and making the environment enabling to comply with standard precautions. We recommend that this study may be done by including rural setting institutions and by including other health professionals that are susceptible to BBFS at work. Formal training on infection prevention and safety practice to apply universal precautions will be needed from the concerned bodies to prevent exposures to blood/body fluid splash.

Nurses' experience of caring for people living with HIV: a focused ethnography

BACKGROUND

Healthcare providers have been found to have limited knowledge and skills in interacting with people living with HIV. These factors can adversely affect providers' practice, jeopardize their safety and compromise the care of the patients.

AIMS

This study aimed to explore the experiences of Iranian nurses who were caring for patients with HIV.

METHODS

A focused ethnography approach was used. Participants consisted of 12 nurses working in teaching hospitals affiliated to Urmia University of Medical Sciences and recruited by purposeful sampling. Semi-structured interviews, field observations and field notes were used for data collection. Data were analysed employing content analysis.

FINDINGS

Three main themes emerged from the analysis of the participants' experiences of providing care to patients with HIV: 'excessive fear of being infected', 'concerns about the possible consequences' and 'lack of self-confidence in care provision'.

DISCUSSION/CONCLUSION

Nurses have experienced a great deal of fear of self and cross-contamination when providing care to people living with HIV. Social stigma and discrimination against people living with HIV amplified the nurses' experience of fear. Providing appropriate education and training for nurses can improve their attitudes, emotions and self-confidence while providing care to such people and increasing the quality of care provided.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Planning more educational programmes focusing on improving their misunderstandings about HIV could result in positive outcomes: for nurses to provide high-quality care and for people living with HIV who receive this care. The healthcare system should consider the culture of care provided by nurses to these people.

Needle-stick and sharps injuries: awareness, prevalence and risk factors of a global problem in healthcare workers at Tanta University Hospitals, Egypt

Objectives. This study aimed to assess the level of awareness, prevalence and risk factors of needle-stick and sharps injuries (NSSIs) in Tanta University Hospitals, Egypt to develop a well-established preventive strategy. Methods. A total of 662 healthcare workers (HCWs), including nurses and physicians, who attended work during the last 6 months of 2019 were included. Data were collected on a structured questionnaire distributed during their working time. Results. Of 662 participating HCWs, 486 were nurses and 176 were physicians. Good awareness (86.1 and 83.1%) of the participants about safe injection policy and sharp disposal after use was observed. Nurses showed a significantly higher percentage of poor awareness score (79.1%) than physicians (20.9%). NSSIs in our hospitals reached 60.4%. Nurses (67.9%) had higher risk of NSSIs than physicians (39.8%; p < 0.001). NSSIs were significantly less likely to occur for HCWs who were aware of safe injection and sharp disposal policies. NSSIs were frequent with specimen collection (16.4%), injections (15.5%) and sharp disposal (14.6%). Only 110 (27.5%) have reported their injuries. Conclusion. A comprehensive program that addresses institutional, behavioral and device-related factors that contribute to the occurrence of NSSIs and reporting systems is needed.

Epidemiology and risk factors of needlestick injuries among healthcare workers in Iran: a systematic reviews and meta-analysis

BACKGROUND

Occupational contact with blood and body fluids poses a significant risk to healthcare workers. The aim of this systematic review is to investigate the epidemiology and risk factors affecting needlestick injuries (NSI) in healthcare personnel in Iran.

METHODS

In March 2020, researchers studied six international databases such as Medline/PubMed, ProQuest, ISI/WOS, Scopus, Embase, and Google Scholar for English papers and two Iranian databases (MagIran and SID) for Persian papers. Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess quality of studies. The method of reporting was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement.

RESULTS

A total of 43 articles were included in the analysis. Results showed that females (OR = 1.30, 95 % CI 1.06-1.58, P value = 0.009), younger age (OR = 2.75, 95 % CI 2.27-3.33, P value < 0.001, rotated shift workers (OR = 2.16, 95 % CI 1.47-3.15, P value < 0.001), not attending training courses (OR = 1.30, 95 % CI 1.07-1.56, P value = 0.006), working in the surgery ward (OR = 1.83, 95 % CI 1.33-2.50, P value < 0.001), less work experience (OR = 1.43, 95 % CI 1.04-1.95, P value = 0.025) apposed a greater risk factors for NSI among healthcare workers.

CONCLUSION

Based on the results of this review, factors such as young age, less work experience, work shift, and female gender are considered as strong risk factors for NSI injury in Iran. Preventive measures including education programs can reduce the burden of NSI among healthcare personnel.

The Correlation between Perceptions and Compliance in the Use of Personal Protective Equipment of Nurses at RSU Haji Surabaya

Introduction: According to previous studies, the level of compliance with the use of personal protective equipment of the nurses at RSU Haji Surabaya was still quite low. Only 17.8% of the nurses were compliant in using masks, whereas 82.2% of the nurses were not. Moreover, 57.8% nurses were compliant in using medical gloves, whereas 42.2% were not. The purpose of this study is to analyze the relationship between perception and compliance with the use of personal protective equipment of the nurses at at RSU Haji Surabaya. Methods: This study was an observational and cross-sectional study. The population used in this study was the nurses who served in the operating and lung room of at RSU Haji Surabaya. Total sampling technique was used to 33 samples. Moreover, the data were taken by questionnaires and observations. Data analysis was performed by coefficient contingency test by looking at the value of C. Results: The results show that 85.7% of nurses in the operating room are non-compliant and 33.3% nurses in the lung room are non- compliant with the use of PPE. The results also showthat the perception variable that has the strongest relationship with compliance is perception of severity (C = 0.312). Conclusion: The closest relationship between the two variables are the relationship of compliance of PPE usage with the gender of nurses, and the determination of nurses' perceptions is based on the Health Belief Model approach.Keywords: compliance, nurse, perception, personal protective equipment

Worldwide Prevalence of Occupational Exposure to Needle Stick Injury among Healthcare Workers: A Systematic Review and Meta-Analysis

Background

Healthcare workers are at high risk of occupational exposure to needle stick injury worldwide. Occupational exposure to needle stick injury represents the most common sources of infection such as hepatitis B virus, hepatitis C virus, and human immunodeficiency virus. Thus, this review aimed to determine the career time and previous one-year global pooled prevalence of occupational exposure to needle stick injury among healthcare workers.

Methods

The review considered articles written in English language and published from 2012 to 2020. The articles were searched using nine electronic databases (PubMed, Google Scholar, CINAHL, MEDLINE, Cochrane library, Web of Science, SCOPUS, MedNar, and ScienceDirect) using a combination of Boolean logic operators (AND, OR, and NOT), Medical Subject Headings, and keywords. Quality assessment was performed to determine the relevance of the articles using Joanna Briggs Institute critical appraisal tools. Several steps of assessment and evaluation were taken to select and analyze the relevant articles.

Results

The worldwide pooled prevalence of needle stick injuries among healthcare workers during career time and previous one year was 56.2% (95% CI: 47.1, 64.9) and 32.4% (95% CI: 22.0, 44.8), respectively. The career time pooled prevalence of needle stick injuries based on the socioeconomic development and study area was 54.8% and 55.1%, respectively, and one-year pooled prevalence of needle stick injury was 26.0% and 20.9%.

Conclusion

The review found a high prevalence of occupational exposure to needle stick injury among healthcare workers and suggests the need to improve occupational health and safety services in the healthcare systems.

Sharp injuries and their relationship with stress among nurses working in acute care settings

BACKGROUND

Sharp injuries are common reasons for the transmission of blood-borne diseases in acute care settings. Fear of sharp injuries and their consequences can expose nurses to high levels of stress (sharp injuries stress).

AIM

To examine the occurrence of sharp injuries and to assess their relationship with stress among nurses working in acute care settings.

DESIGN

This was a cross-sectional study.

METHODS

A total of 150 nurses working in 10 acute care settings in two selected hospitals in Alexandria, Egypt, were selected as the population of this study. Data on the occurrence of sharp injuries were collected using a sharp injuries circumstances questionnaire (including questions regarding number, instrument and reasons/procedures that caused sharp injuries, etc.), and two scales were used to measure sharp injuries stress (the Impact of Event Scale-Revised and the Post-Traumatic Stress Syndrome Questions Inventory).

RESULTS

More than 13% of nurses experienced sharp injuries, and 25% of injuries were caused by contaminated instruments. Sharp injuries stress scores were high in nurses, with 65% of nurses experiencing sharp injuries and 30.8% of nurses who did not experience sharp injuries having high Impact of Event Scale-Revised scores. In addition, 45% of nurses who experienced sharp injuries and 15.39% of nurses who did not experience sharp injuries had high Post-Traumatic Stress Syndrome Questions Inventory (PTSSQI) scores. There was a significant relationship between the occurrence of sharp injuries and stress scales at P < .05.

CONCLUSIONS

Nurses are exposed to sharp injuries, leading to sharp injury stress pre- and post-occurrence of injuries. Sharp injuries stress can make nurses prone to Post-Traumatic Stress Syndrome (PTSS).

RELEVANCE TO CLINICAL PRACTICE

Factors that lead to the occurrence of sharp injuries and sharp injuries stress should be investigated, and a psychological rehabilitation unit should be instituted to help nurses working in acute care settings deal with the sharp injuries-related stressors they are facing.

Magnitude and Determinants of Needlestick and Sharp Injuries among Nurses Working in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

Background

Needlestick and sharp injuries are a big risk to the health of nurses. Every day, nurses face the likelihood that they will injure themselves. Although many injuries will have no adverse effect, the possibility of acquiring infections like hepatitis C virus, hepatitis B virus, and human immunodeficiency virus can cause untold psychological harm. Nurses are in danger of injuries caused by needlestick and sharp instruments in hospitals.

Objective

The objective of this study was to assess the magnitude and determinants of needlestick and/or sharp injuries among nurses working at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2018.

Methods

An institution-based cross-sectional study was conducted among 268 nurses working at Tikur Anbessa Specialized Hospital from February to March 2018. A stratified random sampling technique was used to select the study participants. Data were collected using a self-administered questionnaire. A bivariate and multivariate logistic regression model was fitted to spot factors associated with needlestick and/or sharp injury. An adjusted odds ratio with a 95% confidence interval was computed to determine the level of significance.

Result

The prevalence of needlestick and/or sharp injuries among nurses was 36.2% (95% CI 30.2%, 42.3%). Presence of contaminated needles and/or sharp materials in the working area (AOR = 2.052 (95% CI 1.110, 3.791)), needle recapping after use (AOR = 1.780 (95% CI 1.025, 3.091)), working in the pediatric ward (AOR = 0.323 (95% CI 0.112, 0.930)), and being female (AOR = 0.461 (95% CI 0.252, 0.845)) were significantly associated with needlestick and/or sharp injury at p value of ≤0.05. Conclusion and Recommendation. The proportion of needlestick and/or sharp injury was high among nurses. The safety of nurses depends directly on the degree to which nurses can identify and control the numerous occupational hazards specific to jobs. Thus, working unit specific safety precautions, a safe working environment, and appropriate needle and sharp disposal improve nurses' safety practices and thereby decrease the injuries.

Assessment on knowledge and practice of postexposure prophylaxis of human immuno-deficiency virus among staff nurses and paramedical workers at a tertiary care hospital in South India

INTRODUCTION

Adequate knowledge about the presence of postexposure prophylaxis (PEP) against human immuno-deficiency virus (HIV) is imperative for health-care workers. This study focuses on the evaluation of the present knowledge and practice of nurses and paramedical workers on the post exposure prophylaxis against HIV.

AIM

The aim of this study is to assess and compare the knowledge and practice of PEP against HIV among Staff Nurses and Paramedical workers.

SUBJECTS AND METHODS

A descriptive cross-sectional questionnaire study about the knowledge and practice of PEP against HIV among Staff nurses and Paramedical workers done at a tertiary care hospital in South India. The analysis of the data was performed using SPSS software version 24. The statistical tests used to compare the knowledge between nurses and paramedical workers was Chi-square test. P < 0.05 was considered statistically significant.

RESULTS

About 339 nurses and 66 paramedical workers participated in the study. An overall of 65.4% of the study participants had a good level of knowledge, higher (P = 0.000) among nurses (71.1%) compared to paramedical workers (36.3%). However, only 23% of nurses and 14.3% of paramedical workers received PEP after a needle prick injury.

CONCLUSION

This study revealed a low-level practice of HIV PEP among staff nurses and paramedical workers despite their good knowledge. This can be improved by providing formal training sessions to the health care workers.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Symptom Cluster of ICU Nurses Treating COVID-19 Pneumonia Patients in Wuhan, China

BACKGROUND

In treating highly infectious coronavirus disease-19 (COVID-19) pneumonia, intensive care unit (ICU) nurses face a high risk of developing somatic symptom disorder (SSD).The symptom clusters in one population may show overlaps and involvements, a phenomenon that should be deliberately resolved to improve the management efficiency.

OBJECTIVES

The present study aims to investigate the symptoms and causes of SSD of ICU nurses treating COVID-19 pneumonia. The research results are expected to provide evidence for the establishment of a better management strategy.

METHODS

This study enrolled a total of 140 ICU nurses who were selected by Jiangsu Province Hospital to work in Wuhan (the epicenter of the COVID-19 epidemic in China) on February 3, 2020. A questionnaire, Somatic symptom disorders for ICU nurses in Wuhan No. 1 Hospital, was designed based on the International Classification of Functioning, Disability and Health. Exploratory factor analysis was performed to cluster the symptoms and logistic regression analysis to find the risk factors of the symptoms.

RESULTS

Five major symptoms were chest discomfort and palpitation (31.4%), dyspnea (30.7%), nausea (21.4%), headache (19.3%), and dizziness (17.9%). In exploratory factor analysis, the symptoms were classified into three clusters: Cluster A of breathing and sleep disturbances (dizziness, sleepiness, and dyspnea); Cluster B of gastrointestinal complaints and pain (nausea and headache), and Cluster C of general symptoms (xerostomia, fatigue, as well as chest discomfort and palpitation). In Cluster A, urine/feces splash, sex, and sputum splash were independent predictive factors. In Cluster B, fall of protective glasses and urine/feces splash were independent predictive factors. In Cluster C, urine/feces splash and urine/feces clearance were independent predictive factors.

CONCLUSION

The ICU nurses in Wuhan showed varying and overlapping SSDs. These SSDs could be classified into three symptom clusters. Based on the characteristics of their SSDs, specific interventions could be implemented to safeguard the health of ICU nurses.

Multicenter cross-sectional study on the reporting status and influencing factors of needlestick injuries caused by insulin injection devices among nurses in Peking, China

BACKGROUND

Needlestick injuries (NSIs) most commonly occur in conjunction with insulin injections, and nurses had the highest rate of NSIs among different occupational groups. However, only few nurses have the awareness to report these incidents. We aimed to investigate the current reporting status and influencing factors of NSIs caused by insulin injection pen devices among nurses and nursing interns in Peking, China.

METHODS

The study consisted of 4,609 nurses and nursing interns in different hospital departments, namely endocrinology wards, medical (except endocrinology) and surgical departments, emergency, outpatient departments, operation theaters, intensive care units, and other departments from 16 districts of Peking, China. A researcher-devised questionnaire was designed to assess the rate of reporting of accidental NSIs and its influencing factors. Descriptive statistics, the χ² tests, and univariate and multivariate regression were used to analyze the independent influencing factors of reports on NSIs caused by insulin injection pen devices.

RESULTS

Among all participants, most of them were women (97.61%). More than half of the participants had been working as nurses over 5 years (59.58%). Approximately 63.66% of participants had been trained to prevent and deal with accidental NSIs within 1 year. Approximately 19.33% of the participants experienced NSIs before, but only 30.30% of them reported the injury to the management department or director. The main reasons for not reporting were complex/cumbersome reporting procedure (317 of 621; 51.05%), being too busy at work at the time of injury (301 of 621; 48.47%), and low-risk for personal health (197 of 621; 31.72%). Multivariate analysis showed that age (P = .014; odds ratios [OR; 1.063, 1.736]), prior needlestick training education (P = .018; OR [0.406, 0.917]), and written system for preventing (P < .001; OR [0.289, 0.622]) were independent factors associated with reporting of NSIs caused by insulin injection pen devices.

CONCLUSIONS

NSIs caused by insulin injection pen devices are common among nurses and are often not reported. It is necessary to provide nurses with regular training to prevent and deal with NSIs. Hospital management departments should adopt a simpler reporting procedure to understand the actual occurrence of NSIs to develop better prevention and improvement measures.

Awareness of safety protocols for prevention of needle stick injuries in anaesthesiologists from Maharashtra: A survey study

BACKGROUND AND AIM

Needle stick injury (NSI) has a serious risk of transmission of various blood borne pathogens amongst healthcare personnel and more so in anaesthesiologists. This survey assessed the prevalence of NSI and awareness of safety protocols for its prevention amongst the anaesthesiologists from Maharashtra, India.

METHODS

This self-administered survey was completed by 403 anaesthesiologists across Maharashtra from August 2019 to October 2019. The pre-validated and pretested 18-item questionnaire was administered using Google forms and the link was circulated amongst anaesthesiologists electronically. The questionnaire items included information on the awareness of safety protocols and immediate measure after NSI, knowledge of immunisation and safety practices followed in routine practice. Data were collected, tabulated and coded in Microsoft Excel. Descriptives are presented for the different items and prevalence of NSI. Comparison of prevalence of NSI in subgroups based on gender, period of experience and type of practice were analysed using Chi-square test.

RESULTS

The prevalence of NSI was 73.7% (n = 403) in anaesthesiologists with 71.1% (n = 235) in males and 77.4% (n = 168) in females. The anaesthesiologists from the medical schools had a prevalence of 75.0% (n = 148), those in private practice had a prevalence of 72.7% (n = 216), whereas those working in both medical school and private practice had a prevalence of 74.4% (n = 39). A greater prevalence was observed in those working for longer periods.

CONCLUSION

The prevalence of NSI's is alarmingly high amongst anaesthesiologists and there is an immediate need of creating awareness and practice safety protocols in routine practice. Training and education are required in the formative years of healthcare curriculum.

Needle Stick and Sharp Injuries Among Healthcare Workers: A retrospective six-year study

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.

Pattern and serological profile of healthcare workers with needle-stick and sharp injuries: A retrospective analysis

BACKGROUND

Needle-stick and sharp injuries (NSSIs) are very hazardous to healthcare workers (HCWs) working in any healthcare setting. The burden of NSSIs is more common in developing countries than in developed countries.

MATERIALS AND METHODS

A retrospective analysis was conducted in a multispeciality, tertiary level teaching medical institute. Total 78 NSSIs incidences from 2005 to 2013 were reviewed and included for the study. All the information were retrieved and entered in excel sheet for data analysis.

RESULTS

Total of 78 NSSIs cases were reported over a period of 9 years. Maximum incidences of NSSI were reported by nurses (61.5%). A higher proportion (41%) of cases occurred in critical units and emergency and the most common procedure (64.1%) was parenteral medication during which HCWs got NSSIs. Almost half (53.8%) of HCWs had received complete HBV vaccination. Out of 78, 40 HCWs only completed follow-up for 6 months and were found non-reactive for viral markers.

CONCLUSION

The healthcare workers who were involved in patient care are at risk to get NSSIs. The primary prevention of NSSIs is very important. Every institute should have policies on ongoing training programme, HBV vaccination protocol, smooth system of NSSIs reporting, post-exposure prophylaxis (PEP) facilities and follow-up of HCWs with NSSIs to prevent the occurrence.

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

BACKGROUND

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

METHODS

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

RESULT

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

CONCLUSION

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