Successful reduction of sharps injuries using a structured change process

Preclinical evaluation of performance, safety and usability of VAX-ID®, a novel intradermal injection device

The recent SARS-Cov2 pandemic and mpox health emergency have led to renewed interest in intradermal vaccination due to its dose sparing potential. Indeed, intradermal vaccination is particularly of interest for use in mass vaccination campaigns, pandemic preparedness programs, and/or for vaccines that are expensive or in short supply. Moreover, the rich immune network in the skin makes it an attractive target not only for prophylactic vaccination, but also for therapeutic vaccination, like immunotherapy and (dendritic) cell-based therapies. The aim of the current paper was to provide an overview of preclinical data generated with VAX-ID®, a novel intradermal drug delivery device, to allow assessing it performance, safety and usability. The device can overcome challenges seen with the Mantoux technique whereby the needle needs to be inserted under a shallow angle. Various parameters of VAX-ID® were evaluated, including dead-space volume, dose accuracy, penetration depth & liquid deposit in piglets, as well as usability by healthcare professionals. The device has shown to have a low dead volume and a high dose accuracy. Importantly, the device performed successful injections at a predefined depth into the dermis with a high safety profile as confirmed by visual and histological evaluation in piglets. Moreover, the device was rated as easy to use by healthcare professionals. The combined preclinical performance and usability findings indicate that VAX-ID® can provide reliable, standardized and accurate drug delivery in the dermal layer of the skin with a high ease of use. The device offers a solution for injection of various prophylactic as well as therapeutic vaccines.

Workplace hazards in forensic mortuaries in Saudi Arabia: A survey of forensic mortuary personnel

Forensic mortuaries have always presented a potential threat to workers who come into contact with dead bodies. This research aims to identify hazards faced by forensic mortuary personnel, including forensic pathologists and technicians working in forensic mortuaries in forensic medicine centres throughout Saudi Arabia, to recognise the prevalence of exposure to workplace hazards and to discover the degree of awareness and use of safety practices. A descriptive, cross-sectional study was conducted in a total of 20 forensic medicine centres, using an online questionnaire distributed among forensic mortuary personnel. A total of 113 participants responded to the questionnaire. Just over half (53%) of workplaces always provided personal protective equipment, and 75% of participants always used them. The most common hazards were needle-prick wounds and accidental slips or falls. Almost two thirds (64%) of participants witnessed or experienced a work-related accident in the forensic mortuary. The lack of previous studies concerning hazard exposure among forensic mortuary personnel in Saudi Arabia means that this study provides foundational evidence for future research concerning forensic autopsy-related work accidents in Saudi Arabia.

Central Line Placement for the Pediatric Oncology Patient: A Model of Advanced Practice Nurse Collaboration

Central lines are commonly placed in pediatric oncology patients during their therapy. Advanced practice nurses (APNs) play an important role in the coordination and facilitation of line placements so that they may be inserted in an expeditious manner. Collaboration between the Divisions of Oncology and Surgery is often key to attaining this goal. At the Children’s Hospital of Philadelphia, the APNs in Oncology and Surgery have developed a collaborative approach to the placement of central lines in oncology patients. Many positive changes ensued between these divisions after collaboration occurred and a system for line placements was put into place. A well-defined process for central line placement is currently being utilized that meets the needs of the patients. Central lines are being placed in a timelier manner, procedures are coordinated, and treatment is started earlier, which has increased the satisfaction of patients, families, and health care providers. Finally, this collaboration led to an improved relationship and better communication between the Divisions of Oncology and Surgery.

Reducing needle stick injuries in healthcare occupations: an integrative review of the literature

Needlestick injuries frequently occur among healthcare workers, introducing high risk of bloodborne pathogen infection for surgeons, assistants, and nurses. This systematic review aims to explore the impact of both educational training and safeguard interventions to reduce needlestick injuries. Several databases were searched including MEDLINE, PsycINFO, SCOPUS, CINAHL and Sciencedirect. Studies were selected if the intervention contained a study group and a control group and were published between 2000 and 2010. Of the fourteen studies reviewed, nine evaluated a double-gloving method, one evaluated the effectiveness of blunt needle, and one evaluated a bloodborne pathogen educational training program. Ten studies reported an overall reduction in glove perforations for the intervention group. In conclusion, this review suggests that both safeguard interventions and educational training programs are effective in reducing the risk of having needlestick injuries. However, more studies using a combination of both safeguards and educational interventions in surgical and nonsurgical settings are needed.

Prevalence of percutaneous exposure incidents amongst dentists in Queensland

BACKGROUND

Percutaneous exposure incidents (PEI) represent an important occupational health issue in dentistry, and one that can incur severe consequences from blood-borne infections. Given the importance of this topic, we considered it necessary to investigate the distribution and cause of PEI among Queensland dentists.

METHODS

In 2004, a self-reporting questionnaire was mailed to a random sample of 400 dentists on the register of the Queensland Branch of the Australian Dental Association.

RESULTS

A total of 285 questionnaires (73.1 per cent) were completed and returned. Of the respondents, 73.3 per cent were male and 26.7 per cent female, with a mean age of 45.2 years (SD = 11.9 years). Most were general dentists (89.1 per cent) with the remainder being specialists (10.9 per cent). More than three-quarters (78.5 per cent) reported damaging their gloves at least once during a clinical procedure in the previous 12-month period. Roughly one-quarter (27.7 per cent) had experienced at least one 'sharps' or needlestick injury in the previous 12 months, 16.1 per cent of which involved a contaminated instrument that had been previously used on a patient. The most common devices to cause 'sharps' injury in the previous 12 months were needles (14.4 per cent) and burs (10.2 per cent).

CONCLUSIONS

Although PEI clearly remains a major occupational health problem for Queensland dentists, the prevalence of needlestick injuries appears to be lower than other studies from developed countries. The identification of needlestick injuries as a common cause of PEI again stresses the importance of preventive strategies with respect to potential blood-borne infections. Further research is now needed to more carefully identify effective measures for reducing PEI among dental personnel.