Lessons regarding percutaneous injuries among healthcare providers

Knowledge, Practice, and Attitude Among Iranian Nurses, Midwives, and Students Regarding Standard Isolation Precautions

Our goal was to assess the knowledge, attitudes, and practices regarding infection control and standard precautions among a group of nursing and midwifery instructors and students in Iran. A survey questionnaire was completed by 273 nursing and midwifery instructors and students at Shiraz University Medical Sciences during the period from May to November 2002. Two hundred thirty-one (90.9%) of the participants reported that they needed additional infection control education, especially on standard isolation precautions. There was a linear positive correlation between knowledge, practice, and attitude scores for the group of nursing, auxiliary nursing, and midwifery instructors, as well as their students (P < .05). Our study shows that there is an urgent need for evaluating education on infection control practices and standard precautions in general, as well as for structured infection control programs among nursing and midwifery staff.

Knowledge, attitude and practice towards standard isolation precautions among Iranian medical students

OBJECTIVE

Health care workers especially medical students are at risk of being exposed to blood-borne pathogens. Therefore, the aim of this study was to determine the knowledge, attitude and practice of medical students towards standard isolation precautions (SIP).

METHODS

A standardized questionnaire was completed by 148 medical students from April to July of year 2009 to seek their knowledge, attitude and practice towards standard isolation precautions in a clinical setting at Qazvin University of Medical Sciences, Iran.

RESULTS

The mean score of knowledge, attitude and practice towards standard isolation precautions were 6.8±2.1 (maximum 10), 16.6±4.2 (maximum 20), and 18.05 ± 4.5 (maximum 30) respectively. Significant differences were observed between practice of female and male (P &lt; 0.008) and also knowledge of year 6 and year 7 students (P &lt;0.021).

DISCUSSION

Education on infection control based on standard isolation precaution must be stressed and barriers of appropriate practice must be removed.

Role of safety-engineered devices in preventing needlestick injuries in 32 French hospitals

OBJECTIVES

To evaluate safety-engineered devices (SEDs) with respect to their effectiveness in preventing needlestick injuries (NSIs) in healthcare settings and their importance among other preventive measures.

DESIGN

Multicenter prospective survey with a 1-year follow-up period during which all incident NSIs and their circumstances were reported. Data were prospectively collected during a 12-month period from April 1999 through March 2000. The procedures for which the risk of NSI was high were also reported 1 week per quarter to estimate procedure-specific NSI rates. Device types were documented. Because SEDs were not in use when a similar survey was conducted in 1990, their impact was also evaluated by comparing findings from the recent and previous surveys.

SETTING

A total of 102 medical units from 32 hospitals in France.

PARTICIPANTS

A total of 1,506 nurses in medical or intensive care units.

RESULTS

A total of 110 NSIs occurring during at-risk procedures performed by nurses were documented. According to data from the 2000 survey, use of SEDs during phlebotomy procedures was associated with a 74% lower risk (P<.01). The mean NSI rate for all relevant nursing procedures was estimated to be 4.72 cases per 100,000 procedures, for a 75% decrease since 1990 (P<.01); however, the decrease in NSI rates varied considerably according to procedure type. Between 1990 and 2000, decreases in the NSI rates for each procedure were strongly correlated with increases in the frequency of SED use (r=0.88; P<.02).

CONCLUSION

In this French hospital network, the use of SEDs was associated with a significantly lower NSI rate and was probably the most important preventive factor.

Knowledge, practice and attitude towards standard isolation precautions in Iranian medical students

Medical students are at high risk of being exposed to blood-borne pathogens. The aim of this study was to identify the levels of knowledge, attitude and practice of medical students regarding standard isolation precautions in Iran. A questionnaire was filled out by 468 medical students in their fifth to seventh year of study. Their mean knowledge, attitude and practice levels of standard isolation precautions were 6.1+/-1.5 (maximum possible score 9), 32.3+/-3.5 (out of 45), and 2.3+/-1.6 (out of 9), respectively. Statistically significant positive correlations were observed between knowledge and attitude, knowledge and practice, and practice and attitude. Ninety percent of medical students in Shiraz had received no education of standard isolation precautions, and 75% of respondents wanted more education on standard isolation precautions. Education on infection control issues should not only be focused on healthcare workers, but should also include medical students.

Complying with the Occupational Safety and Health Administration's Bloodborne Pathogens Standard: implementing needleless systems and intravenous safety devices

Preventing the transmission of bloodborne pathogens to healthcare workers has been a mission and a challenge of the healthcare industry for over 20 years. The development of the Occupational Safety and Health Administration Bloodborne Pathogens Standard in 1991 and the passing of the Needlestick Safety Act in 2000 mandated hospitals to develop an Exposure Control Plan to protect workers from these pathogens. Children's Hospital Boston began implementation of a needleless system in 1993. Employees readily accepted these systems into practice, because they were convenient and easy to use. A marked decrease in exposures to bloodborne pathogens naturally followed, which is consistent with the national data. The transition to intravenous (i.v.) safety devices at Children's Hospital began in 2000 and proved to be more of a challenge. First, the clinicians must choose a safety product, which requires developing and implementing a trial plan with potential catheters. This selection process is especially difficult in pediatrics where successful placement of the smallest-gauge catheter, no. 24, is imperative. After choosing an i.v. safety product, successful transition is dependent upon the thoroughness of i.v. safety device training and a commitment by the clinicians to the use of these products. Although the number of needlestick injuries and subsequent transmission of bloodborne pathogens have been further reduced with the use of i.v. safety devices, needlestick injuries still occur. This results from a lack of familiarity with the engineering of the device and therefore poor technique or a failure to activate the safety mechanism. Staff resistance due to loss of expertise with the new device and patient care concerns are additional barriers to the use of these new products. Addressing these obstacles and providing adequate training for all clinicians were required for successful implementation of these i.v. safety devices.