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Jeyaraman M, Jeyaraman N, Iyengar KP, Selvaraj P, Ramasubramanian S, Jain VK. Assessment of Needlestick and Sharps Injuries (NSSIs) Amongst Orthopaedic Surgeons in Clinical Practice: A Pan-India Cross-Sectional Study. Indian J Orthop 2024; 58:1239-1247. [PMID: 39170655 PMCID: PMC11333663 DOI: 10.1007/s43465-024-01178-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 05/04/2024] [Indexed: 08/23/2024]
Abstract
Introduction Needlestick and sharps injuries (NSSIs) represent an existential occupational hazard risk to orthopaedic surgeons during their career due to the interaction with various devices, instruments and bone fragments. Consequently, NSSIs have the potential to transmit infections such as Hepatitis B (HBV), Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV) leading to serious illness. The purpose of this cross-sectional study was to identify the clinical settings predisposing orthopaedic surgeons to NSSIs and assess their adherence to safety protocols in the Indian context. Materials and Methods An online cross-sectional survey of 618 orthopaedic surgeons in India, stratified by experience into two groups: under five years and with 5 years or more was undertaken. The data were collected via an expert-validated online questionnaire to evaluate demographic distribution, injury characteristics, knowledge of safety protocols, and adherence to these protocols. Descriptive statistics summarized the data, Chi-square tests assessed variable associations, and odds ratios were computed for significant variables. Ethical integrity was maintained via electronic informed consent and for confidentiality assurances. Results The study revealed that orthopaedic surgeons with less than 5 years of clinical experience had higher risks for NSSIs as compared to those with 5 or more years of clinical practice. Conversely, the latter group was more susceptible to bone spike injuries and viral positive needlestick incidents. The analysis shows that whilst the more experienced practitioners displayed greater proficiency in the application of universal precautions and NSSI prevention, they were also less likely to report injuries, often due to discomfiture. Risk profiles were consistent across different practice settings and affiliations, regardless of experience level. Conclusion This cross-sectional study reveals less experienced orthopaedic surgeons face higher risks of NSSIs, possibly due to inadequate education or awareness. More experienced practitioners encounter distinct risks, likely owing to long-term exposure and traditional practices. There is an immediate need to raise awareness of the potential risks of NSSIs, enhanced education, appropriate training, collaboration with the hospital risk management team and developing a culture of transparent reporting to mitigate these risks. The emphasis should be on reducing the incidence and fostering open reporting of NSSIs to protect clinicians and promote health safety.
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Affiliation(s)
- Madhan Jeyaraman
- Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu 600077 India
| | - Naveen Jeyaraman
- Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu 600077 India
| | - Karthikeyan P. Iyengar
- Trauma and Orthopaedic Surgeon, Southport and Ormskirk Hospitals, Mersey and West Lancashire Teaching NHS Trust, Southport, PR8 6PN UK
| | - Preethi Selvaraj
- Department of Community Medicine, Faculty of Medicine, Sri Lalithambigai Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu 600095 India
| | - Swaminathan Ramasubramanian
- Department of Orthopaedics, Government Medical College, Omandurar Government Estate, Chennai, Tamil Nadu 600002 India
| | - Vijay Kumar Jain
- Department of Orthopaedics, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, 110001 India
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Li X, He Q, Zhao H. Situation and associated factors of needle stick and sharps injuries among health-care workers in a tertiary hospital: a cross-sectional survey. BMC Health Serv Res 2024; 24:1002. [PMID: 39198839 PMCID: PMC11360859 DOI: 10.1186/s12913-024-11439-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 08/14/2024] [Indexed: 09/01/2024] Open
Abstract
PURPOSE This study aimed to assess the prevalence of and factors associated with needle stick and sharps injuries (NSSIs) among health-care workers (HCWs) in a tertiary hospital in China. MATERIALS AND METHODS This retrospective survey was conducted with 562 HCWs at a tertiary hospital in China in July 2023. Information was collected using a self-designed questionnaire, and all enrolled members were required to fill in the demographic characteristics, occurrence of NSSIs and other associated factors in the past year. Logistic analysis was used to identify variables associated with NSSIs. RESULTS The proportion of participants with at least one injury within the year preceding the investigation was 21.2%. Male (AOR = 2.116 [1.265, 3.538]), working hours per week > 40 (AOR = 1.718 [1.056,2.796]), rarely checking blood-borne infections before invasive operations (AOR = 2.219 [1.303,3.782]) were significantly associated with NSSIs. CONCLUSION The prevalence of NSSIs was not low in the survey area, especially in male, individuals with longer working hours, and rarely checking blood-borne infections before invasive operations. Therefore, it is necessary to promote educational programs to enhance awareness of standard prevention measures, especially for key populations, and reduce heavy workloads to decrease the occurrence of such injuries.
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Affiliation(s)
- Xiaona Li
- Department of Infection Control, The First Affiliated Hospital of Anhui University of Chinese Medicine, 117 Meishan Road, Hefei, 230031, People's Republic of China
| | - Qian He
- Department of Infection Control, The First Affiliated Hospital of Anhui University of Chinese Medicine, 117 Meishan Road, Hefei, 230031, People's Republic of China
| | - Hong Zhao
- Department of Infection Control, The First Affiliated Hospital of Anhui University of Chinese Medicine, 117 Meishan Road, Hefei, 230031, People's Republic of China.
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Bevan V, Blake P, Radwan RN, Azzopardi E. Sharps and needlestick injuries within the operating room: Risk prone procedures and prevalence meta-analysis. J Perioper Pract 2023; 33:200-210. [PMID: 36597950 DOI: 10.1177/17504589221103810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Sharps and needlestick injuries pose a serious risk to operating theatre personnel with considerable morbidity, mortality and healthcare implications. The cost of prophylaxis and post-exposure treatment is a significant institutional economic burden. AIM The aim of the review was to identify the prevalence of sharps and needlestick injury within the operating theatre and to establish the most common critical steps. METHOD A systematic literature search was conducted. Abstracts of all studies published in English from 2015 onwards exploring sharps and needlestick injury within the operating theatre were reviewed. Primary outcome measure was sharps and needlestick injury prevalence. Secondary outcome measures included operational steps resulting in sharps and needlestick injury and costs of sharps and needlestick injury management. RESULTS Sixteen studies were identified and included in analysis. Cross-sectional studies reported a pooled prevalence of 41.5% (n = 537; 95% confidence interval = 15.961 to 70.220). Retrospective data analysis reported an annualised prevalence of 5.027% (95% confidence interval = 0.676 to 13.073) on a total pooled sample population of 12,929. Further analysis of operational steps identified a 22% prevalence (n= 3460; 95% confidence interval = 14.2 to 31.3) of sharps and needlestick injury occurring during a procedure involving handing or receiving an instrument. CONCLUSION Sharps and needlestick injuries are a significant but preventable risk in the operating theatre. Further research into the development of safety devices to reduce injury during instrument transfer is paramount.
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Affiliation(s)
| | - Paul Blake
- Swansea Bay University Health Board, Swansea, UK
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Al-Mugheed K, Farghaly SM, Baghdadi NA, Oweidat I, Alzoubi MM. Incidence, knowledge, attitude and practice toward needle stick injury among nursing students in Saudi Arabia. Front Public Health 2023; 11:1160680. [PMID: 37213613 PMCID: PMC10192570 DOI: 10.3389/fpubh.2023.1160680] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/03/2023] [Indexed: 05/23/2023] Open
Abstract
Background Needle stick injuries constitute the greatest threat to nursing students during clinical practice because of accidental exposure to body fluids and infected blood. The purpose of this study was to (1) determine the prevalence of needle stick injuries and (2) measure the level of knowledge, attitude and practice among nursing students about needle stick injuries. Methods Three hundred participants undergraduate nursing students at a private college in Saudi Arabia were included, of whom 281 participated, for an effective response rate of 82%. Results The participants showed good knowledge scores with a mean score of 6.4 (SD = 1.4), and results showed that students had positive attitudes (Mean = 27.1, SD = 4.12). Students reported a low level of needle stick practice (Mean = 14.1, SD = 2.0). The total prevalence of needle stick injuries in the sample was 14.1%. The majority, 65.1%, reported one incidence in the last year, while (24.4%) 15 students reported two incident of needle stick injuries. Recapping was the most prevalent (74.1%), followed by during injection (22.3%). Most students did not write a report (77.4%), and being worried and afraid were the main reasons for non-reports (91.2%). The results showed that female students and seniors scored higher level in all needle stick injuries domains (knowledge, attitude and practice) than male students and juniors. Students who had needle stick injuries more than three times last year reported a lower level of all needle stick injury domains than other groups (Mean = 1.5, SD =1.1; Mean = 19.5, SD =1.1; Mean = 9.5, SD =1.1, respectively). Conclusion Although the student's showed good knowledge and positive attitudes in NSI, the students reported a low level of needle stick practice. Raising awareness among nursing students and conducting continuing education related to sharp devices and safety and how to write an incident reporting is highly recommended.
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Affiliation(s)
- Khalid Al-Mugheed
- Adult Health Nursing and Critical Care, Riyadh Elm University, Riyadh, Saudi Arabia
- *Correspondence: Khalid Al-Mugheed,
| | - Sally Mohammed Farghaly
- Department of Nursing Management and Education, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Nadiah A. Baghdadi
- Department of Nursing Management and Education, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Islam Oweidat
- Department of Nursing Management, Zarqa University, Zarqa, Jordan
| | - Majdi M. Alzoubi
- Community Health Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
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Xu X, Yin Y, Wang H, Wang F. Prevalence of needle-stick injury among nursing students: A systematic review and meta-analysis. Front Public Health 2022; 10:937887. [PMID: 36045726 PMCID: PMC9421142 DOI: 10.3389/fpubh.2022.937887] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/28/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction Needle-stick injuries (NSI) are a serious threat to the health of healthcare workers, nurses, and nursing students, as they can expose them to infectious diseases. Different prevalence rates have been reported for this type of injury in different studies worldwide. Therefore, this study aimedto estimate the pooled prevalence of NSI among nursing students. Methods This study was conducted by searching for articles in Web of Science, PubMed, Scopus, Embase, and Google Scholar without time limitation using the following keywords: needle-stick, needle stick, sharp injury, and nursing student. The data were analyzed using the meta-analysis method and random-effects model. The quality of the articles was evaluated with Newcastle-Ottawa Quality Assessment Scale (NOS). The heterogeneity of the studies was examined using the I 2 index, and the collected data were analyzed using the STATA Software Version 16. Results Initially, 1,134 articles were retrieved, of which 32 qualified articles were included in the analysis. Nursing students reported 35% of NSI (95% CI: 28-43%) and 63% (95% CI: 51-74%) did not report their needle-stick injuries. The highest prevalence was related to studies conducted in Asia (39.7%; 95% CI: 31.7-47.7%). There was no significant correlation among NSI prevalence and age of samples, and article year of publication. Conclusion A third of nursing students reported experiencing NSI. Consequently, occupational hazard prevention training and student support measures need to be considered.
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Affiliation(s)
- Xu Xu
- Department of Emergency, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Yu Yin
- Department of Emergency, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Hao Wang
- Department of Emergency, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Fengxia Wang
- Disinfection Supply Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Richards H, Henderson T. Preventing Perioperative Sharps Injuries. AORN J 2022; 116:176-182. [PMID: 35880914 DOI: 10.1002/aorn.13751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 03/22/2022] [Indexed: 11/10/2022]
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Asanati K, Majeed A, Shemtob L, Cresswell F. Healthcare workers potentially exposed to HIV: an update. J R Soc Med 2022; 115:286-288. [PMID: 35722995 PMCID: PMC9340101 DOI: 10.1177/01410768221107122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Kaveh Asanati
- Department of Primary Care & Public Health, School of Public Health, Imperial College London, London W6 8RP, UK
| | - Azeem Majeed
- Department of Primary Care & Public Health, School of Public Health, Imperial College London, London W6 8RP, UK
| | - Lara Shemtob
- Department of Primary Care & Public Health, School of Public Health, Imperial College London, London W6 8RP, UK
| | - Fiona Cresswell
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, BN1 9PX, UK.,MRC-UVRI-London School of Hygiene and Tropical Medicine, Uganda Research Unit, Entebbe, PO Box 49, Uganda
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Lin C, Aljuaid M, Tirada N. Needlestick injuries in radiology: prevention and management. Clin Radiol 2022; 77:496-502. [PMID: 35487781 DOI: 10.1016/j.crad.2022.03.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 03/25/2022] [Indexed: 01/01/2023]
Abstract
Needlestick injuries are common and often underreported in invasive radiological procedures. Prior needlestick injuries have been reported in 86-91% of interventional radiologists, and on average, one needlestick injury occurs for every 5 years of practice. Of those that have had a needlestick injury, only 58% had formal education on needlestick injury prevention. Needlestick injuries can often result in long-term debility if not properly managed. Injuries can result in transmission of blood-borne pathogens, such as hepatitis B, hepatitis C, and human immunodeficiency virus. Preventative measures, such as vaccination, proper sharps selection, handling, and disposal during radiological procedures, minimising procedure time, and team communication, can decrease the risk of needlestick injuries and pathogen transmission rate. Initial management involves proper cleaning of the wound and activating the injury reporting system. Further lab testing and post-exposure prophylaxis will depend on the serology status of the source and exposed patient. Needlestick injuries with pathogen transmission can result in long-term health issues and psychological damage, therefore, it is imperative for radiologists to understand factors that increase the risk for transmission, methods to prevent injury, and how to manage an injury when it occurs.
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Affiliation(s)
- C Lin
- University of Maryland Medical Center, 22 South Greene St., Baltimore, MD 21201, USA.
| | - M Aljuaid
- University of Maryland Medical Center, 22 South Greene St., Baltimore, MD 21201, USA; King Saud University, Riyadh 11451, Saudi Arabia
| | - N Tirada
- University of Maryland Medical Center, 22 South Greene St., Baltimore, MD 21201, USA
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Hambridge K, Endacott R, Nichols A. Exploring the psychological effects of sharps injuries sustained by healthcare workers. Nurs Stand 2022; 37:e11785. [PMID: 35224918 DOI: 10.7748/ns.2022.e11785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2021] [Indexed: 11/09/2022]
Abstract
Much of the research into sharps injuries sustained by healthcare workers focuses on prevalence and incidence and to a lesser extent the financial implications of such injuries. An under-researched area is the psychological effects of such injuries. This article reports the findings of a narrative literature review that aimed to synthesise the evidence on this subject. Electronic databases and the grey literature were searched with no date limits set and 27 articles were included in the review. Findings suggested that healthcare workers may experience a range of psychological issues following a sharps injury, including post-traumatic stress disorder, anxiety and depression. There was also evidence to suggest that the necessary psychological follow-up care is often inadequate, so improvements are required in this area. Further research is necessary to enhance understanding of the psychological effects of sharps injuries on healthcare workers and to ensure they receive appropriate support.
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Affiliation(s)
- Kevin Hambridge
- School of Nursing and Midwifery, University of Plymouth, Plymouth, England
| | - Ruth Endacott
- School of Nursing and Midwifery, University of Plymouth, Plymouth, England
| | - Andrew Nichols
- School of Nursing and Midwifery, University of Plymouth, Plymouth, England
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Hambridge K. The psychological impact of sharps injuries sustained by medical students. Br J Hosp Med (Lond) 2022; 83:1-7. [DOI: 10.12968/hmed.2021.0385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Much is known and reported about sharps injuries among healthcare workers, but there has been a lack of published evidence regarding the psychological impact of sharps injuries among medical students. The purpose of this narrative review was to discover the psychological impact of sharps injuries within the medical student population. Medical, health and psychology databases were searched for studies written in the English language and published between 1980 and 2021. The review identified six studies conducted in six countries which described the psychological impacts of sharps injuries among medical students as being fear, anxiety, depression and post-traumatic stress disorder. The findings highlight the potential psychological issues created by sharps injuries, and highlights that further research is needed into this topic to aid the education and prevention of this harmful problem.
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Affiliation(s)
- Kevin Hambridge
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Devon, UK
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Conover S, Koo H, Boynton-Jarrett R. Spatiotemporal trends in discarded needle reports near schools in Boston, Massachusetts, between 2016-2019. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2021; 47:737-745. [PMID: 34783625 DOI: 10.1080/00952990.2021.1978473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Childhood exposures to discarded needles pose a direct risk for infection with blood-borne pathogens and psychological trauma for caregivers and children. Little is known about environmental predictors of discarded needles relative to areas where children are frequent, such as schools. OBJECTIVE We investigated spatiotemporal trends in discarded needle reports and the density near schools in Boston, Massachusetts, between 2016 and 2019. METHODS We used the kernel density estimation (KDE) and a relative risk function (RRF) to explore their spatial distribution and temporal changes of discarded needles reported through the 311 service request system in Boston. The density of needle pick-up requests around schools was investigated by using Thiessen polygons. RESULTS Between January 2016 and December 2019, 18,272 discarded needle reports were made. Publicly reported discarded needles in Boston sharply increased over the 4 years and the highest density of needles was found in 2 central neighborhoods. The density of reports of discarded needles near schools increased among the majority of schools. About 30% of schools demonstrated an increase of 100% or more in reports of discarded needles. CONCLUSION This analysis provides insight into potential risk of exposure to needle stick injuries for children based on utilizing publicly available crowd-sourced data. Monitoring the density of discarded needles near schools may be a novel approach to improve public health efforts to distribute safe needle disposal locations and reduce injection drug use in public.
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Affiliation(s)
- Soojin Conover
- Division of General Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA
| | - Hyeongmo Koo
- Department of Geoinformatics, University of Seoul, Seoul, Republic of Korea
| | - Renée Boynton-Jarrett
- Division of General Pediatrics, Boston University School of Medicine, Boston Medical Center, Boston, MA, USA
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12
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Smith JL, Banerjee R, Linkin DR, Schwab EP, Saberi P, Lanzi M. 'Stat' workflow modifications to expedite care after needlestick injuries. Occup Med (Lond) 2021; 71:20-24. [PMID: 33399827 DOI: 10.1093/occmed/kqaa209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Post-exposure prophylaxis (PEP) for human immunodeficiency virus (HIV) is recommended to start within hours of needlestick injuries (NSIs) among healthcare workers (HCWs). Delays associated with awaiting the results of testing from the source patient (whose blood was involved in the NSI) can lead to psychological consequences for the exposed HCW as well as symptomatic toxicities from empiric PEP. AIMS After developing a 'stat' (immediate) workflow that prioritized phlebotomy and resulting of source patient bloodwork for immediate handling and processing, we retrospectively investigated whether our new workflow had (i) decreased HIV order-result interval times for source patient HIV bloodwork and (ii) decreased the frequency of HIV PEP prescriptions being dispensed to exposed HCWs. METHODS We retrospectively analysed NSI records to identify source patient HIV order-result intervals and PEP dispensing frequencies across a 6-year period (encompassing a 54-month pre-intervention period and 16-month post-intervention period). RESULTS We identified 251 NSIs, which occurred at similar frequencies before versus after our intervention (means 3.54 NSIs and 3.75 NSIs per month, respectively). Median HIV order-result intervals decreased significantly (P < 0.05) from 195 to 156 min after our intervention, while the proportion of HCWs who received one or more doses of PEP decreased significantly (P < 0.001) from 50% (96/191) to 23% (14/60). CONCLUSION Using a 'stat' workflow to prioritize source patient testing after NSIs, we achieved a modest decrease in order-result intervals and a dramatic decrease in HIV PEP dispensing rates. This simple intervention may improve HCWs' physical and psychological health during a traumatic time.
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Affiliation(s)
- J L Smith
- The University of Texas Health Science Center at Houston, McGovern Medical School, UT Health, Houston, TX, USA
| | - R Banerjee
- Division of Hematology/Oncology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - D R Linkin
- Division of Infectious Diseases, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,Department of Medicine, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - E P Schwab
- Department of Medicine, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA.,Division of Geriatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - P Saberi
- Division of Employee Occupational Health, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
| | - M Lanzi
- Division of Employee Occupational Health, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
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Hambridge K, Endacott R, Nichols A. The experience and psychological impact of a sharps injury on a nursing student population in the UK. ACTA ACUST UNITED AC 2021; 30:910-918. [PMID: 34379471 DOI: 10.12968/bjon.2021.30.15.910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIMS The aims of this study were to explore the experience and psychological impact of sustaining a sharps injury within a nursing student population in the UK. Design: A qualitative approach was taken, using two methods to gather data, namely a Twitter chat and interviews. METHODS A Twitter chat was orchestrated to investigate the experiences of sharps injury with nursing students and registered nurses nationwide (n=71). Interviews were conducted with nursing students from a university in the UK who had sustained a sharps injury (n=12) to discover their experiences and the impact of the injury. Findings were then synthesised and examined. RESULTS Some nursing students reported psychological impacts after sustaining the sharps injury, which affected both their professional and personal life. The qualitative findings were synthesised into eight themes. CONCLUSION Sharps injuries can have many psychological impacts on the individual nursing student and necessary support should be available.
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Affiliation(s)
- Kevin Hambridge
- Lecturer in Adult Nursing, Associate Head of School (Marketing), University of Plymouth
| | - Ruth Endacott
- Professor in Clinical Nursing (Critical Care), University of Plymouth
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Lafferty L, Rance J, Dore GJ, Grebely J, Lloyd AR, Treloar C. Hepatitis C treatment as prevention in the prison setting: Assessments of acceptability of treatment scale up efforts by prison correctional and health personnel. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 98:103379. [PMID: 34311138 DOI: 10.1016/j.drugpo.2021.103379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Hepatitis C (HCV) infection is prevalent in the prison setting, with sharing of unsterile injecting equipment the most common mode of transmission in high income countries. Mathematical modelling suggests that HCV treatment scale-up could prevent onward transmission, known as treatment as prevention. Direct-acting antivirals have enabled rapid scale up of HCV treatment, underpinning the first clinical trial of treatment as prevention in the prison setting. The Surveillance and Treatment of Prisoners with hepatitis C (SToP-C) study was carried out in four correctional centres in New South Wales, Australia. This paper utilises Sekhon's Theoretical Framework of Acceptability to examine correctional, prison health, and study personnel's assessments of acceptability of HCV treatment as prevention in the prison setting. METHODS Correctional (n=24) and health personnel (n=17) including officers, nurses (including seven study nurses), and senior administrators across the four prisons where SToP-C was delivered, participated in interviews. This included two maximum security, one minimum security, and one women's medium/minimum security prison. Data analysis was informed by a seven-component theory of acceptability. RESULTS Participants reported broad acceptability of HCV treatment as prevention in the prison setting across five components of acceptability (affective attitude, burden, ethicality, perceived effectiveness, and self-efficacy). Attributes contributing to acceptability included reduced HCV prevalence within the prison, and public health benefits for the community when people are released without HCV (affective attitude). Elements which may negatively impact on acceptability included limited clinic space (burden) and lack of correctional officers' understanding of availability of equivalent healthcare in the community (ethicality). System-wide prison participation was viewed as necessary for treatment as prevention to be successful (perceived effectiveness), while nonjudgmental care was seen as instrumental to HCV treatment scale up efforts (self-efficacy). CONCLUSION Correctional and prison-based health personnel view HCV treatment as prevention as an acceptable health intervention. Overall, environmental issues relating to implementation (i.e., clinic space) were viewed as requiring a strategic approach to support prison-wide HCV treatment scale up.
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Affiliation(s)
- L Lafferty
- Centre for Social Research in Health, UNSW Sydney, Level 1, Goodsell Building, Sydney 2052 NSW, Australia; The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney 2052 NSW, Australia.
| | - J Rance
- Centre for Social Research in Health, UNSW Sydney, Level 1, Goodsell Building, Sydney 2052 NSW, Australia
| | - G J Dore
- The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney 2052 NSW, Australia
| | - J Grebely
- The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney 2052 NSW, Australia
| | - A R Lloyd
- The Kirby Institute, UNSW Sydney, Level 6, Wallace Wurth Building, Sydney 2052 NSW, Australia
| | - C Treloar
- Centre for Social Research in Health, UNSW Sydney, Level 1, Goodsell Building, Sydney 2052 NSW, Australia
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Investigation and Analysis of Sharp Injuries among Health Care Workers from 36 Hospitals in Shandong Province, China. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5698483. [PMID: 34195270 PMCID: PMC8214496 DOI: 10.1155/2021/5698483] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 06/05/2021] [Indexed: 12/04/2022]
Abstract
Background This study investigated and analyzed the current situation of sharp injuries among health care workers (HCWs) in China's Shandong Province. Methods By means of questionnaire survey, the incidence of sharp injuries among HCWs from 36 hospitals in China's Shandong Province in October 2019 was investigated, and the results of this survey were compared with those of October 2012. Results A total of 48165 HCWs were investigated. 549 cases of sharp injuries occurred. The incidence of sharp injuries was 1.14%, which was significantly lower than that in October 2012 (9.71%). In the occupational distribution of sharp injuries among HCWs, the proportion of nurses was 58.65%, doctors 23.32%, and interns 12.02%. Among the distribution of sharp injury departments, general wards, operating rooms, intensive care units, disinfection supply centers, and outpatient clinics were the high-incidence sites of occupational exposure among HCWs. The main instruments causing sharp injuries in HCWs were syringes, scalp steel needles, surgical suture needles, vacuum blood collection needles, and glass slides. Drug administration, double-handed loop needle cap, blood extraction, surgical suture needle, and arteriovenous needle extraction were high-risk operations causing sharp instrument injuries in HCWs. Conclusion The incidence of sharp injuries among HCWs from 36 hospitals in Shandong Province in October 2019 was significantly lower than that in October 2012. Sharp injuries were a common type of occupational exposure for HCWs. The occurrence of sharp injuries should be effectively reduced by changing wrong habitual behavior and implementing standard protective measures.
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Asfour HI, Tayyib NAG, Lindsay G, Alsolami FJ, Alshmemri MS. Sharp injuries and their relationship with stress among nurses working in acute care settings. Nurs Crit Care 2021; 26:274-281. [PMID: 33498094 DOI: 10.1111/nicc.12595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 12/04/2020] [Accepted: 01/08/2021] [Indexed: 12/12/2022]
Abstract
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.
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Affiliation(s)
- Hayam Ibrahim Asfour
- Faculty of Nursing, Umm Al-Qura University, Mecca, Kingdom of Saudi Arabia.,Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | | | - Grace Lindsay
- Faculty of Nursing, Umm Al-Qura University, Mecca, Kingdom of Saudi Arabia
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Matsubara C, Sakisaka K, Sychareun V, Phensavanh A, Ali M. Anxiety and perceived psychological impact associated with needle stick and sharp device injury among tertiary hospital workers, Vientiane, Lao PDR. INDUSTRIAL HEALTH 2020; 58:388-396. [PMID: 32074514 PMCID: PMC7417503 DOI: 10.2486/indhealth.2019-0088] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 02/13/2020] [Indexed: 06/10/2023]
Abstract
Occupational needle stick and sharp injuries (NSSIs) affect healthcare workers' (HCWs') mental health, however, limited evidence is available on the psychological impact of NSSIs, especially in developing countries where most of NSSIs have been reported. A cross-sectional study was conducted to evaluate the anxiety and psychological impact regarding NSSIs among HCWs at tertiary hospitals in Lao PDR. In this study, four among seven items of anxiety scale in Hospital Anxiety and Depression Scale (HADS) (Cronbach's α=0.80) was applied. Participants who experienced NSSIs in the past 6 months showed significantly higher anxiety scores than those who did not experienced (p=0.004) and the average anxiety scores was high shortly after the NSSI. The 42.7% of them were more afraid of needles and sharp devices in the 2 wk after the NSSI than the time of the interview. The results encourage developing countries to adapt a comprehensive NSSI management policy including not only to take adequate precaution measures but psychological support and treatment for HCWs from immediately after NSSIs to improve safety for HCWs and patients. Further studies are needed to develop normative psychiatric scales with cultural adaptation in developing countries which provide convenient mental disorder assessment after NSSIs.
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Affiliation(s)
- Chieko Matsubara
- National Center for Global Health and Medicine, Japan
- Graduate School of Medicine, The University of Tokyo, Japan
| | - Kayako Sakisaka
- Graduate School of Medicine, The University of Tokyo, Japan
- Teikyo University Graduate School of Public Health, Japan
- National Center of Neurology and Psychiatry, National Institute of Mental Health, Japan Support Center for Suicide Countermeasures, Japan
| | | | | | - Moazzam Ali
- Reproductive Health and Research, World Health Organization, Switzerland
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Jackson AP, Almerol LA, Campbell J, Hamilton L. Needlestick injuries: the role of safety-engineered devices in prevention. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2020; 29:S22-S30. [PMID: 32697642 DOI: 10.12968/bjon.2020.29.14.s22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The first documented mention of a needlestick injury (NSI) in the medical literature appeared in 1906. Despite growth in academic and clinical interest for NSI prevention, a global report identified that approximately 3 million healthcare workers have suffered percutaneous exposure to blood-borne pathogens. Legislation is an important component of NSI prevention. Unfortunately, the impact of legislation may not always reduce the incidence of NSI as much as expected. Safety-engineered device (SED) implementation has demonstrated a substantial reduction in NSI rates compared with non-SEDs. More importantly, passive SEDs are 10 times less likely to be connected with an NSI incident.
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Affiliation(s)
- Andrew Paul Jackson
- IV Nurse Consultant, The Rotherham NHS Foundation Trust, and Director, IVTEAM.com
| | - Leo Andrew Almerol
- Vascular Access Clinical Nurse Specialist, Bedfordshire Hospitals NHS Foundation Trust
| | | | - Louise Hamilton
- IV Clinical Nurse Specialist, Ashford and St Peter's NHS Foundation Trust
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Aljabri D, Vaughn A, Austin M, White L, Li Z, Naessens J, Spaulding A. An Investigation of Healthcare Worker Perception of Their Workplace Safety and Incidence of Injury. Workplace Health Saf 2020; 68:214-225. [PMID: 31983297 DOI: 10.1177/2165079919883293] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Managing the safety climate in health care is a promising tool for improving employee and patient safety in the health care work environment. Gaps in the theoretical and conceptual underpinnings of safety climate, as well as the evidence base for its practical application in health care remain. The purpose of this study was to evaluate the number of work injuries occurring in health care work units and associated safety climate beliefs. Methods: A retrospective analysis was conducted utilizing organizational staff survey data collected by a large medical hospital in the Midwest in 2015. Employees (n = 32,327) were invited to identify safety climate perceptions via survey. Injuries, days restricted, and days absent were identified through the Hospital's Occupational Safety and Health Administration (OSHA) log. Zero inflated negative binomial regressions used injuries as dependent variables and safety climate perceptions as independent variables. Findings: In all, 23,599 employees completed the survey (73% response rate) across 1,805 employee work units which were defined as groupings of employees reporting to a single supervisor. We found that there was an association between fewer injuries and health care workers indicating that they share responsibility for compliance with safety rules and procedures (relative risk [RR] = 0.98, 95% confidence interval [CI] = [0.98, 0.99]). Conclusion/Application to Practice: This study supports the use of a safety climate measure to assess working units' perceptions of employee safety. A continued focus on the health and safety of employees who interact directly with patients is warranted, as well as employees who do not provide direct patient care.
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Aziz AM. Do training and needle-safety devices prevent needlestick injuries? A systematised review of the literature. ACTA ACUST UNITED AC 2019; 27:944-952. [PMID: 30187800 DOI: 10.12968/bjon.2018.27.16.944] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This systematised review was undertaken to appraise research on the effects of training and the use of needle-safety devices (NSDs) on the prevention of needlestick injuries (NSIs) among health workers, focusing on a European perspective. A literature search from 2007 to 2017 was performed, which identified six studies that investigated the introduction of training and NSDs and their affect on NSIs. The six chosen studies identified that training, as well as the adoption of NSDs, has an impact on preventing NSIs. However, further information is required on the content and mode of delivery of training and on which types of NSDs are most effective at preventing injuries. This will help healthcare workers to understand and implement the most effective strategies to prevent injuries. This article provides a critique of the research approaches used in the six studies.
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Affiliation(s)
- Ann-Marie Aziz
- Clinical Lead: Infection Control and Prevention, Pennine Care NHS Foundation Trust, Manchester
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21
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Silowati T, Handiyani H, Rachmi SF. Prevention behavior for NSI among nursing students and nurses in Indonesia: A comparative study. ENFERMERIA CLINICA 2019. [DOI: 10.1016/j.enfcli.2019.04.120] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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22
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Fanikos J, Burger M, Canada T, Ebright P, Fleming J, Harder KA, Pham JC, Sawyer MD, Stevenson JG. An assessment of currently available i.v. push medication delivery systems. Am J Health Syst Pharm 2019; 74:e230-e235. [PMID: 28438828 DOI: 10.2146/ajhp150830] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
| | | | - Todd Canada
- MD Anderson Cancer Center, Houston, TX, and University of Texas at Austin College of Pharmacy, Austin, TX
| | | | - Joshua Fleming
- Leesburg Regional Medical Center, Central Florida Health, Leesburg, FL
| | - Kathleen A Harder
- Center for Design in Health, University of Minnesota, Minneapolis, MN
| | - Julius Cuong Pham
- Department of Anesthesia and Critical Care Medicine, Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Melinda D Sawyer
- Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD
| | - James G Stevenson
- Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI, and Visante, St. Paul, MN.
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Akbari H, Ghasemi F, Akbari H, Adibzadeh A. Predicting needlestick and sharps injuries and determining preventive strategies using a Bayesian network approach in Tehran, Iran. Epidemiol Health 2018; 40:e2018042. [PMID: 30130955 PMCID: PMC6232661 DOI: 10.4178/epih.e2018042] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Accepted: 08/20/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Recent studies have shown that the rate of needlestick and sharps injuries (NSIs) is unacceptably high in Iranian hospitals. The aim of the present study was to use a systematic approach to predict and reduce these injuries. METHODS This cross-sectional study was conducted in 5 hospitals in Tehran, Iran. Eleven variables thought to affect NSIs were categorized based on the Human Factors Analysis and Classification System (HFACS) framework and modeled using a Bayesian network. A self-administered validated questionnaire was used to collect the required data. In total, 343 cases were used to train the model and 50 cases were used to test the model. Model performance was assessed using various indices. Finally, using predictive reasoning, several intervention strategies for reducing NSIs were recommended. RESULTS The Bayesian network HFACS model was able to predict 86% of new cases correctly. The analyses showed that safety motivation and fatigue were the most important contributors to NSIs. Supervisors' attitude toward safety and working hours per week were the most important factors in the unsafe supervision category. Management commitment and staffing were the most important organizational-level factors affecting NSIs. Finally, promising intervention strategies for reducing NSIs were identified and discussed. CONCLUSIONS To reduce NSIs, both management commitment and sufficient staffing are necessary. Supervisors should encourage nurses to engage in safe behavior. Excessive working hours result in fatigue and increase the risk of NSIs.
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Affiliation(s)
- Hamed Akbari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Fakhradin Ghasemi
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hesam Akbari
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Amir Adibzadeh
- Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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An HS, Ko S, Bang JH, Park SW. Elimination of Lancet-Related Needlestick Injuries Using a Safety-Engineered Lancet: Experience in a Hospital. Infect Chemother 2018; 50:319-327. [PMID: 30600655 PMCID: PMC6312902 DOI: 10.3947/ic.2018.50.4.319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 09/28/2018] [Indexed: 12/25/2022] Open
Abstract
Background Lancet-related needlestick injuries (NSIs) occur steadily in clinical practices. Safety-engineered devices (SEDs) can systematically reduce NSIs. However, the use of SEDs is not active and no study to guide the implementation of SEDs was known in South Korea. The lancet-related NSIs may be eliminated to zero incidence using a SED lancet with effective sharp injury protection and reuse prevention features. Materials and Methods We implemented a SED lancet by replacing a conventional prick lancet in a tertiary hospital in a sequential approach. A spot test of the new SED was conducted for 1 month to check the acceptability in practice and a questionnaire survey was obtained from the healthcare workers (HCWs). A pilot implementation of the SED lancet in 2 wards was made for 1 year. Based on these preliminary interventions, a hospital-wide full implementation of the SED lancet was launched. The incidence of NSIs and cost expenditure before and after the intervention were compared. Results There were 29 cases of conventional prick lancet-related NSIs for 3 years before the full implementation of SED lancet. The proportion of prick lancet-related NSIs among yearly all kinds of NSIs during two years before the pilot study was average 11.7% (22/188). Pre-interventional baseline incidence of all kinds of NSIs was 7.01 per 100 HCW-years. After the full implementation of SED lancet, the lancet-related NSIs became zero in the 2nd year (P = 0.001). The average direct cost of 18,393 US dollars (USD) per year from device and post-exposure medical care before the intervention rose to 20,701 USD in the 2nd year of the intervention. The incremental cost-effectiveness ratio was 210 USD per injury avoided. Conclusion The implementation of a SED lancet could eliminate the lancet-related NSIs to zero incidence. The cost increase incurred by the use of SED lancet was tolerable.
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Affiliation(s)
- Hye Sun An
- Infection Control Office, Boramae Medical Center, Seoul, Korea
| | - Suhui Ko
- Infection Control Office, Boramae Medical Center, Seoul, Korea
| | - Ji Hwan Bang
- Infection Control Office, Boramae Medical Center, Seoul, Korea.,Department of Internal Medicine, Boramae Medical Center and Seoul National University College of Medicine, Seoul, Korea
| | - Sang Won Park
- Infection Control Office, Boramae Medical Center, Seoul, Korea.,Department of Internal Medicine, Boramae Medical Center and Seoul National University College of Medicine, Seoul, Korea.
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Suliman M, Al Qadire M, Alazzam M, Aloush S, Alsaraireh A, Alsaraireh FA. Students nurses' knowledge and prevalence of Needle Stick Injury in Jordan. NURSE EDUCATION TODAY 2018; 60:23-27. [PMID: 28987894 DOI: 10.1016/j.nedt.2017.09.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 05/30/2017] [Accepted: 09/26/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Student nurses are at high risk of blood-borne pathogens transmitted via Needle Stick Injury (NSI). Understanding various aspects of NSI is essential if they are to avoid the risks associated with it. OBJECTIVES The study was conducted to measure student nurses' level of knowledge about NSI and to examine its prevalence and post-exposure measures in Jordan. DESIGN A cross-sectional and descriptive design was used. SAMPLE AND SETTING A sample of 279 student nurses studying at one private and four government universities distributed throughout Jordan. METHOD The study used an online survey composed of 22 questions developed from NSI literature. The questionnaire was divided into three parts: background, to measure students' demographics; knowledge, to measure nurses' understanding of NSI; and prevalence, to measure exposure to NSI and the follow-up measures. Student nurses were recruited through Facebook. The survey was available online for one full semester in 2016/2017. RESULTS The total number of completed surveys was 279 (response rate=61%). Most of the students were female (n=198; 71%), in their fourth year (n=114; 40.9%). Their mean age was 21years (SD=2.5). The mean score for the knowledge part was 7 out of 10 (SD=1.7). Almost a third of the students had at least one incident of exposure to NSI (n=73; 26.2%). Most of the students who had suffered NSI did not inform their clinical instructors (67.1%) or write an incident report (86.3%). The results showed that there was no significant difference in the knowledge total scores between males and females or between students across different universities. However, a significant difference was found between students in different years of study (F (276, 2)=6.77, p=0.001). CONCLUSION Student nurses in Jordan have a moderate understanding of issues regarding NSI. This knowledge improved with seniority. However, exposure to NSI and its under-reporting is a prevalent problem. This study recommends focusing on NSI in the nursing curriculum, and providing more protection and post-exposure intervention for students during their clinical practice.
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Affiliation(s)
- Mohammad Suliman
- Department of Community and Mental Health Nursing, Princess Salma Faculty of Nursing, Al-alBayt University, Mafraq, Jordan.
| | - Mohammad Al Qadire
- Department of Adult Health Nursing, Princess Salma Faculty of Nursing, Al-alBayt University, Mafraq, Jordan.
| | - Manar Alazzam
- Department of Community and Mental Health Nursing, Princess Salma Faculty of Nursing, Al-alBayt University, Mafraq, Jordan.
| | - Sami Aloush
- Department of Community and Mental Health Nursing, Princess Salma Faculty of Nursing, Al-alBayt University, Mafraq, Jordan
| | - Arwa Alsaraireh
- Department of Maternity and Child Health Nursing, School of Nursing, Mutah University, AL-Karak, Jordan
| | - Faris A Alsaraireh
- Community and Mental Health Nursing, School of Nursing, Mutah University, AL-Karak, Jordan.
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Januário GDC, Carvalho PDCFD, Moraes JT, Santos MAD, Gir E, Toffano SEM. Symptoms of posttraumatic stress disorder after exposure to biological material. ESCOLA ANNA NERY 2017. [DOI: 10.1590/2177-9465-ean-2017-0129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
Abstract Objective: To track symptoms of posttraumatic stress disorder (PTSD) according to scores of the Impact of Event Scale-Revised (IES-R) in nursing staff exposed to accidents with biological material, from October 2014 to May 2016, in a philanthropic hospital in the state of Minas Gerais. Methods: Retrospective, descriptive study with a quantitative approach. Inferential analysis was performed using a 95% confidence interval, p ≤ 0.05. The data were collected considering all the ethical aspects described in resolution 466/2012. Results: The majority of workers were nursing technicians (52.5%), female (91.8%), with a mean age of 31.4 years (SD 7.5), the majority of exposures being percutaneous (60.7%). Of all individuals, 19.6% presented scores above 5.6, showing signs of PTSD. Individuals who had suffered accidents more than six months previously (p = 0.025) had significantly higher scores than those who had been exposure for less than three months. Conclusion: The study highlights the need for the use of validated instruments for the evaluation of fear, anxiety, stress, and other psychological reactions that characterize PTSD, as well as the provision of psychological care for workers exposed to biological material.
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Cooke CE, Stephens JM. Clinical, economic, and humanistic burden of needlestick injuries in healthcare workers. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2017; 10:225-235. [PMID: 29033615 PMCID: PMC5628664 DOI: 10.2147/mder.s140846] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Introduction Needlestick injuries (NSIs) from a contaminated needle put healthcare workers (HCWs) at risk of becoming infected with a blood-borne virus and suffering serious short- and long-term medical consequences. Hypodermic injections using disposable syringes and needles are the most frequent cause of NSIs. Objective To perform a systematic literature review on NSI and active safety-engineered devices for hypodermic injection. Methods MEDLINE, EMBASE, and COCHRANE databases were searched for studies that evaluated the clinical, economic, or humanistic outcomes of NSI or active safety-engineered devices. Results NSIs have been reported by 14.9%–69.4% of HCWs with the wide range due to differences in countries, settings, and methodologies used to determine rates. Exposure to contaminated sharps is responsible for 37%–39% of the worldwide cases of hepatitis B and C infections in HCWs. HCWs may experience serious emotional effects and mental health disorders after a NSI, resulting in work loss and post-traumatic stress disorder. In 2015 International US$ (IntUS$), the average cost of a NSI was IntUS$747 (range IntUS$199–1,691). Hypodermic injections, the most frequent cause of NSI, are responsible for 32%–36% of NSIs. The use of safety devices that cover the needle-tip after hypodermic injection lowers the risk of NSI per HCW by 43.4%–100% compared to conventional devices. The economic value of converting to safety injective devices shows net savings, favorable budget impact, and overall cost-effectiveness. Conclusion The clinical, economic, and humanistic burden is substantial for HCWs who experience a NSI. Safety-engineered devices for hypodermic injection demonstrate value by reducing NSI risk, and the associated direct and indirect costs, psychological stress on HCWs, and occupational blood-borne viral infection risk.
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Affiliation(s)
- Catherine E Cooke
- Department of Pharmacy Practice & Science, University of Maryland School of Pharmacy, Baltimore, MD
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Linzer PB, Clarke SP. An Integrative Review of the Hands-Free Technique in the OR. AORN J 2017; 106:211-218.e6. [PMID: 28865631 DOI: 10.1016/j.aorn.2017.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 01/17/2017] [Accepted: 07/07/2017] [Indexed: 10/18/2022]
Abstract
Sharps injury rates are proportionally higher in perioperative areas than in other practice settings. The hands-free technique (HFT) has been shown to decrease the hazards of sharps injuries when passing sharps during surgery. We reviewed and synthesized research studies regarding compliance with the HFT and factors facilitating its use using a key word search of online databases and a secondary search of references. We reviewed English language studies published since 2001 regarding HFT compliance rates or related factors using the Johns Hopkins Nursing Evidence-Based Practice Model and Guidelines. We found 14 articles reporting a wide range of HFT compliance rates (ie, 5% to 84%), which identified that a number of organizational factors and health care workers' perceptions of infection risks influenced the use of the HFT.
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Deipolyi AR, Prabhakar AM, Naidu S, Oklu R. Needlestick Injuries in Interventional Radiology Are Common and Underreported. Radiology 2017. [PMID: 28631962 DOI: 10.1148/radiol.2017170103] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To determine the prevalence of and risk factors for needlesticks in interventional radiology physicians, as well as the attitudes, behaviors, and conditions that promote or interfere with reporting of these injuries. Materials and Methods A total of 3889 interventional radiologists from academic and private practice in the United States were surveyed by emailing all interventional radiologist members of the Society of Interventional Radiology, including attending-level physicians and trainees (April-August 2016). The institutional review board waived the need for consent. Questions inquired about the nature, frequency, and type of needlestick and sharps injuries and whether and to whom these incidents were reported. Stepwise regression was used to determine variables predicting whether injuries were reported. Results In total, 908 (23%) interventional radiologists completed at least a portion of the survey. Eight hundred fourteen (91%) of 895 respondents reported a prior needlestick injury, 583 (35%) of 895 reported at least one injury while treating an HIV-positive patient, and 626 (71%) of 884 reported prior training regarding needlestick injury. There was, on average, one needlestick for every 5 years of practice. Most needlestick or sharps injuries were self inflicted (711 [87%] of 817) and involved a hollow-bore device (464 [56%] of 824). Only 566 (66%) of 850 injuries were reported. The most common reasons for not reporting included perceived lack of utility of reporting (79 [28%] of 282), perceived low risk for injury (56 [20%] of 282), noncontaminated needle (53 [19%] of 282), too-lengthy reporting process (37 [13%] of 282), and associated stigma (23 [8%] of 282). Only 156 (25%) of 624 respondents informed their significant other. Stepwise regression assessing variables affecting the likelihood of reporting showed that male sex (P = .009), low-risk patient (P < .0001), self injury (P = .010), trainee status (P < .0001), and the total number of prior injuries (P = .019) were independent predictors of not reporting. Conclusion Needlestick injuries are ubiquitous among interventional radiologists and are often not reported. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Amy R Deipolyi
- From the Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, New York, NY (A.R.D.); Division of Cardiovascular Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (A.M.P.); and Division of Interventional Radiology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.N., R.O.)
| | - Anand M Prabhakar
- From the Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, New York, NY (A.R.D.); Division of Cardiovascular Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (A.M.P.); and Division of Interventional Radiology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.N., R.O.)
| | - Sailendra Naidu
- From the Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, New York, NY (A.R.D.); Division of Cardiovascular Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (A.M.P.); and Division of Interventional Radiology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.N., R.O.)
| | - Rahmi Oklu
- From the Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, New York, NY (A.R.D.); Division of Cardiovascular Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, Mass (A.M.P.); and Division of Interventional Radiology, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ 85054 (S.N., R.O.)
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Ouyang B, Li LD, Mount J, Jamal AJ, Berry L, Simone C, Law M, Tai RM. Incidence and characteristics of needlestick injuries among medical trainees at a community teaching hospital: A cross-sectional study. J Occup Health 2016; 59:63-73. [PMID: 27885240 PMCID: PMC5388614 DOI: 10.1539/joh.15-0253-fs] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objectives: This field study aimed to determine the incidence and distribution of needlestick injuries among medical trainees at a community teaching hospital in Toronto, Canada. Methods: The study was performed during the 2013-2015 academic years at Toronto East General Hospital (TEGH), a University of Toronto-affiliated community-teaching hospital during the 2013-2015 academic years. Eight-hundred and forty trainees, including medical students, residents, and post-graduate fellows, were identified and invited via email to participate in an anonymous online fluidsurveys.com survey of 16 qualitative and quantitative questions. Results: Three-hundred and fifty trainees responded (42% response rate). Eighty-eight (25%) respondents reported experiencing at least one injury at TEGH. In total, our survey identified 195 total injuries. Surgical trainees were significantly more likely to incur injuries than non-surgical trainees (IRR = 3.03, 95% CI 1.80-5.10). Orthopaedic surgery trainees had the highest risk of a needlestick injury, being over 12 times more likely to be injured than emergency medicine trainees (IRR = 12.4, 95% CI 2.11-72.32). Only 28 of the 88 most recent needlestick injuries were reported to occupational health. Trainees reported a perception of insignificant risk, lack of resources and support for reporting, and injury stigmatization as reasons for not reporting needlestick injuries. Conclusions: Needlestick injuries were a common underreported risk to medical trainees at TEGH. Future research should investigate strategies to reduce injury and improve reporting among the high-risk and reporting-averse trainees.
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Affiliation(s)
- Ben Ouyang
- Faculty of Medicine, University of Toronto
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Moayed MS, Mahmoudi H, Ebadi A, Sharif Nia H. Stress and Fear of Exposure to Sharps in Nurses. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2016; 10:e3813. [PMID: 27822279 PMCID: PMC5097827 DOI: 10.17795/ijpbs-3813] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Revised: 03/13/2016] [Accepted: 07/18/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND Injuries caused by sharp objects, which involve biological hazards are considered as one of the most important factors that lead to stress among the nursing staff. Contact with sharp objects is a major concern among healthcare workers, especially nurses. OBJECTIVES This study was done to determine the amount of stress caused by exposure to sharp medical instruments among nurses. MATERIALS AND METHODS This was a cross-sectional research on 527 nurses, working at different medical centers across Iran, with a cluster-sampling method. The relevant data was collected with a valid and reliable questionnaire. The Cronbach's alpha coefficient of internal consistency of this instrument was 0.92 and interclass correlation coefficient was 0.94. RESULTS The results showed that ward satisfaction, having master of science, age, and number of contacts were significantly able to predict variance in stress scores. The adjusted line regression model explained 36% of the overall variance in stress score (R2 = 0.60). CONCLUSIONS The results of this study showed that exposure to sharp objects may cause high stress in the nursing staff. Considering higher levels of stress in the area of contact care, the provisions on how to deal with patients and safe care can help reduce stress.
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Affiliation(s)
- Malihe Sadat Moayed
- Students' Research Committee, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Hosein Mahmoudi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Abbas Ebadi
- Behavioral Science Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Hamid Sharif Nia
- School of Nursing and Midwifery of Amol, Mazandaran University of Medical Sciences, Sari, IR Iran
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Jeong JS, Son HM, Jeong IS, Son JS, Shin KS, Yoonchang SW, Jin HY, Han SH, Han SH. Qualitative content analysis of psychologic discomfort and coping process after needlestick injuries among health care workers. Am J Infect Control 2016; 44:183-8. [PMID: 26526142 DOI: 10.1016/j.ajic.2015.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 09/01/2015] [Accepted: 09/02/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND This study was designed to survey psychologic discomfort and coping processes of health care workers that suffered needlestick injuries (NSIs). METHODS This qualitative analysis was performed with 15 health care workers who experienced NSIs. Data were collected using face-to-face interviews. The study subjects were asked the following: please describe the psychologic discomfort that you experienced after the NSI incidence. Data were evaluated by qualitative content analysis. RESULTS Types of psychologic discomfort after NSI among health care workers included anxiety, anger, and feelings of guilt. Some personnel adopted active coping strategies, such as seeking first aid or reporting the incident to a monitoring system, whereas others used passive coping methods, such as avoidance of reporting the incident, vague expectancy to have no problems, and reliance on religious beliefs. Recommended support strategies to improve the prevention of NSIs were augmenting employee education and increasing recognition of techniques for avoiding NSIs. CONCLUSION Medical institutions need to provide employees with repeated education so that they are familiar with guidelines for preventing NSIs and to stimulate their alertness to the risk of injuries at any time, in any place, and to anybody.
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Affiliation(s)
- Jae Sim Jeong
- Department of Nursing, University of Ulsan, Ulsan, Republic of Korea
| | - Haeng Mi Son
- Department of Nursing, University of Ulsan, Ulsan, Republic of Korea
| | - Ihn Sook Jeong
- College of Nursing, Pusan National University, Busan, Republic of Korea.
| | - Jun Seok Son
- Department of Occupational and Environmental Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | | | - Sung Won Yoonchang
- Department of Nursing, Chungwoon University, Chungnam, Republic of Korea
| | - Hye Young Jin
- Department of Infection Control Office, Ajou University Hospital, Suwon, Republic of Korea
| | - Si Hyeon Han
- Infection Prevention and Control Team, Dankook University Hospital, Cheon-An, Republic of Korea
| | - Su Ha Han
- Infection Prevention and Control Team, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
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Fukuda H, Yamanaka N. Reducing needlestick injuries through safety-engineered devices: results of a Japanese multi-centre study. J Hosp Infect 2015; 92:147-53. [PMID: 26601603 DOI: 10.1016/j.jhin.2015.09.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 09/28/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Quantitative information on the effectiveness of safety-engineered devices (SEDs) is needed to support decisions regarding their implementation. AIM To elucidate the effects of SED use in winged steel needles, intravenous (IV) catheter stylets and suture needles on needlestick injury (NSI) incidence rates in Japan. METHODS Japan EPINet survey data and device utilization data for conventional devices and SEDs were collected from 26 participating hospitals between 1 April 2009 and 31 March 2014. The NSI incidence rate for every 100,000 devices was calculated according to hospital, year and SED use for winged steel needles, IV catheter stylets and suture needles. Weighted means and 95% confidence intervals (CI) were used to calculate overall NSI incidence rates. FINDINGS In total, there were 236 NSIs for winged steel needles, 152 NSIs for IV catheter stylets and 180 NSIs for suture needles. The weighted NSI incidence rates per 100,000 devices for SEDs and non-SEDs were as follows: winged steel needles, 2.10 (95% CI 1.66-2.54) and 14.95 (95% CI 2.46-27.43), respectively; IV catheter stylets, 0.95 (95% CI 0.60-1.29) and 6.39 (95% CI 3.56-9.23), respectively; and suture needles, 1.47 (95% CI -1.14-4.09) and 16.50 (95% CI 4.15-28.86), respectively. All devices showed a significant reduction in the NSI incidence rate with SED use (P < 0.001 for winged steel needles, P = 0.035 for IV catheter stylets and P = 0.044 for suture needles). CONCLUSION SED use substantially reduces the incidence of NSIs, and is therefore recommended as a means to prevent occupational infections in healthcare workers and improve healthcare safety.
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Affiliation(s)
- H Fukuda
- Kyushu University Graduate School of Medical Sciences, Maidashi, Higashi-Ku, Fukuoka, Japan.
| | - N Yamanaka
- Kyushu University Graduate School of Medical Sciences, Maidashi, Higashi-Ku, Fukuoka, Japan; Kitakyushu General Hospital, Kitakyushu, Fukuoka, Japan
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Risk factors for and circumstances of needlestick and sharps injuries of doctors in operating rooms: A study focusing on surgeries using general anesthesia at Kurume University Hospital, Japan. J Infect Chemother 2015; 21:837-41. [PMID: 26462957 DOI: 10.1016/j.jiac.2015.08.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 08/13/2015] [Accepted: 08/19/2015] [Indexed: 11/21/2022]
Abstract
Healthcare workers are exposed to serious infectious diseases via needlestick and sharps injuries. The operating room is a particularly important environment in which the risk for needlestick injuries is increased for surgical doctors. According to national surveillance studies, the proportion of needlestick and sharps injuries in operating rooms has been increasing for unknown reasons. In this study, we examined risk factors for and circumstances of injuries in operating rooms by combining and analyzing incidence reports and electronic records of every surgery in Kurume University Hospital (Kurume, Japan). The annual injury rate (reflecting the reporting rate) rose continuously from fiscal years 2007-2012. We conducted analyses focusing on surgeries that used general anesthesia, which accounted for 88.1% of the injuries. An analysis of the time of injury found that the number of injuries increased toward the end of the surgical procedure. A comparative analysis of surgeries by doctors who had experienced injury revealed risk for the injury increased when a procedure ended after 20:00. In addition, a comparative analysis of doctors with and without injury experience who had similar level of operating time per year revealed that the number of working years was not lower in the injured doctors. Although the data analyzed in this study were confined to one university hospital, our approach and these results will form a basis on which to consider more effective measures to prevent injury in operating rooms.
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Moayed MS, Mahmoudi H, Ebadi A, Salary MM, Danial Z. Effect of Education on Stress of Exposure to Sharps Among Nurses in Emergency and Trauma Care Wards. Trauma Mon 2015; 20:e17709. [PMID: 26290853 PMCID: PMC4538726 DOI: 10.5812/traumamon.20(2)2015.17709] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 03/11/2014] [Accepted: 06/18/2014] [Indexed: 12/20/2022] Open
Abstract
Background: Health care services can cause injuries to medical staff. One of these injuries is exposure to needle-sticks. This can result in the transmission of blood-borne diseases, such as HIV and hepatitis B; the staff undergo continuous stress. Thus, it is necessary to use some method to reduce this stress. Objectives: The purpose of this study was to examine the effect of education based on the stabilization model on stress induced exposure to needle sticks among nurses working in emergency and trauma wards. Patients and Methods: This Quast- Experiental Study was performed on 35 nurses working in emergency and trauma wards of our hospital in October-December 2013. Data were collected using a two-part questionnaire; Reliability and validity of the questionnaire were confirmed (α = 0. 92 and ICC = 0.94).Data were analyzed using SPSS version 20. The one-sample Kolmogorov-Smirnov test, independent t-test and paired sample t-test were also used. Results: The mean and standard deviation of stress experienced by nurses before and after the intervention were 64.94 ± 15.67 and 43.91 ± 10.73, respectively. Findings indicated that education decrease needle stick stress in nurses significantly (P < 0.001). Conclusions: According to the results of this study, the stress level induced due to needle-stick exposure and its complications is high and interventions for reduction are essential.
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Affiliation(s)
- Malihe Sadat Moayed
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Hosein Mahmoudi
- Nursing Department, Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Hosein Mahmoudi, Nursing Department, Trauma Research Center, Baqiyatallah University of Medical Sciences, P. O. Box: 26127294, Tehran, IR Iran. Tel: +98-912 3313719, E-mail:
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Nursing Department, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Mehdi Salary
- Nursing Department, Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Zahra Danial
- Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
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Thomas AN, Horner D, Taylor RJ. An analysis of patient safety incident reports describing injuries to staff working in critical care in the North West of England between 2009 and 2013. J Intensive Care Soc 2015; 16:208-214. [PMID: 28979412 DOI: 10.1177/1751143715574510] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Critical care environments are potentially high-risk areas for staff harm due to procedural demand and increased incidence of delirium/dependence. The principal types of harm and temporal trends have not yet been quantified. METHODS Retrospective analysis of a multicentre dataset prospectively collected over a five-year period. All patient safety incidents reported to a regional network project were analysed; those recorded as staff harm were extracted, quantified and assessed by thematic analysis to identify key areas of harm, temporal trends and incident rates. RESULTS Staff harm accounted for 7% of all reported patient safety incidents over the study period. Incident rates remained static, ranging annually from 2.6 to 3.7 episodes/1000 patient days. Assaults on staff accounted for the highest proportional contribution on thematic analysis, which was a consistent annual finding. Sharps injuries and manual handling incidents were also notable contributions. Temporal trends for each theme remained static over the study period implying limited reduction in staff harm despite implementation of national guidance and local initiatives. CONCLUSION Staff harm is a consistent issue for those working in critical care. Assaults on staff appear to be the highest contributor on thematic analysis. These data imply significant reduction in harm can still be achieved and can be used to design and implement interventional measures.
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Affiliation(s)
- Antony N Thomas
- Critical Care Department, Salford Royal Hospitals NHS Foundation Trust, Salford, UK
| | - Daniel Horner
- Critical Care Department, Salford Royal Hospitals NHS Foundation Trust, Salford, UK.,North West Deanery, UK
| | - Robert J Taylor
- Department of Medical Physics, Salford Royal Hospitals NHS Foundation Trust, Salford, UK
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Rice BD, Tomkins SE, Ncube FM. Sharp truth: health care workers remain at risk of bloodborne infection. Occup Med (Lond) 2015; 65:210-4. [PMID: 25663385 DOI: 10.1093/occmed/kqu206] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND In 2013, new regulations for the prevention of sharps injuries were introduced in the UK. All health care employers are required to provide the safest possible working environment by preventing or controlling the risk of sharps injuries. AIMS To analyse data on significant occupational sharps injuries among health care workers in England, Wales and Northern Ireland before the introduction of the 2013 regulations and to assess bloodborne virus seroconversions among health care workers sustaining a blood or body fluid exposure. METHODS Analysis of 10 years of information on percutaneous and mucocutaneous exposures to blood or other body fluids from source patients infected with a bloodborne virus, collected in England, Wales and Northern Ireland through routine surveillance of health care workers reported for the period 2002-11. RESULTS A total of 2947 sharps injuries involving a source patient infected with a bloodborne virus were reported by health care workers. Significant sharps injuries were 67% higher in 2011 compared with 2002. Sharps injuries involving an HIV-, hepatitis B virus- or hepatitis C virus (HCV)-infected source patient increased by 107, 69 and 60%, respectively, between 2002 and 2011. During the study period, 14 health care workers acquired HCV following a sharps injury. CONCLUSIONS Our data show that during a 10-year period prior to the introduction of new regulations in 2013, health care workers were at risk of occupationally acquired bloodborne virus infection. To prevent sharps injuries, health care service employers should adopt safety-engineered devices, institute safe systems of work and promote adherence to standard infection control procedures.
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Affiliation(s)
- B D Rice
- Department of HIV and STI, Centre for Infectious Disease Surveillance and Control, Public Health England, 61 Colindale Avenue, Colindale, London NW9 5EQ, UK.
| | - S E Tomkins
- Department of HIV and STI, Centre for Infectious Disease Surveillance and Control, Public Health England, 61 Colindale Avenue, Colindale, London NW9 5EQ, UK
| | - F M Ncube
- Department of HIV and STI, Centre for Infectious Disease Surveillance and Control, Public Health England, 61 Colindale Avenue, Colindale, London NW9 5EQ, UK
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Psychosocial work characteristics and needle stick and sharps injuries among nurses in China: a prospective study. Int Arch Occup Environ Health 2015; 88:925-32. [PMID: 25605612 DOI: 10.1007/s00420-015-1021-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 01/13/2015] [Indexed: 12/14/2022]
Abstract
PURPOSE Psychosocial work characteristics may be associated with needle stick and sharps injuries (NSIs) among nurses. The current evidence is, however, sparse, inconclusive, and mainly limited to cross-sectional investigations. We aimed to contribute prospective data. METHODS We conducted a prospective study among 1,791 female hospital nurses from China. At baseline and at a 1-year follow-up, fourteen psychosocial work characteristics were assessed by the short Copenhagen Psychosocial Questionnaire. At follow-up, any NSI in the workplace during the previous year was measured by participants' self-reports. We quantified associations between (1) psychosocial work characteristics at baseline and NSIs at follow-up by multivariate relative risks (Poisson regression) and (2) NSIs reported at follow-up with psychosocial work characteristics at follow-up (multivariate linear regression, among others, adjusted for psychosocial work characteristics at baseline). RESULTS The only psychosocial work characteristic associated with a slightly increased risk of subsequent NSIs was quantitative demands. Examining the opposite direction of effect, we found that NSIs during the year preceding the follow-up were associated with slightly worse ratings of seven psychosocial work characteristics at follow-up (i.e., influence at work, meaning of work, commitment to the workplace, quality of leadership, social support, social community at work, and job insecurity). CONCLUSIONS Overall, our study does not provide compelling evidence for an association of psychosocial work characteristics and subsequent occurrence of NSIs. By contrast, experience of NSIs may predict less favorable perceptions of psychosocial work characteristics.
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Stress and Fear of Exposure to Sharps in Nurses. Trauma Mon 2014. [DOI: 10.5812/traumamon.17082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Bhardwaj A, Sivapathasundaram N, Yusof M, Minghat A, Swe K, Sinha N. The Prevalence of Accidental Needle Stick Injury and their Reporting among Healthcare Workers in Orthopaedic Wards in General Hospital Melaka, Malaysia. Malays Orthop J 2014; 8:6-13. [PMID: 25279086 PMCID: PMC4181076 DOI: 10.5704/moj.1407.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
ABSTRACT Background :Accidental needle-stick injuries (NSIs) are a hazard for health-care workers and general public health. Orthopaedic surgeons may be more prone to NSIs due to the prevalence of bone spikes in the operative field and the use of sharp orthopaedic instruments such as drills, saws and wires. A hospital-based cross sectional study was conducted in the orthopedic wards of Melaka General Hospital. The prevalence of NSIs was 32 (20.9%) and majority of it occurred during assisting in operation theatre 13(37.4%). Among them six (18.8%) were specialist, 12(37.5%) medical officer, 10 (31.2%) house officer and four staff nurses (12.5%). Among the respondents 142 (92.8%) had been immunized against Hepatitis B and 148 (96.7%) participants had knowledge regarding universal precaution. The incidence of NSI among health care workers at orthopaedics ward was not any higher in comparison with the similar studies and it was found out that the prevalence was more in junior doctors compared with specialist and staff nurses and it was statistically significant. KEY WORDS Needle sticks injury, health care workers, and standard precaution.
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Affiliation(s)
- A Bhardwaj
- Department of Orthopaedics, Newcastle University Medicine Malaysia, Johor, Malaysia
| | | | - Mf Yusof
- Department of Orthopaedics, Melaka General Hospital, Melaka, Malaysia
| | - Ah Minghat
- Department of Orthopaedics, Melaka Manipal Medical College, Malaysia
| | - Kmm Swe
- Department of Orthopaedics, Newcastle University Medicine Malaysia, Johor, Malaysia
| | - Nk Sinha
- Department of Orthopaedics, Melaka Manipal Medical College, Malaysia
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Wicker S, Walcher F, Wutzler S, Stephan C, Marzi I. Best practice for needlestick injuries. Eur J Trauma Emerg Surg 2014; 40:151-8. [PMID: 26815895 DOI: 10.1007/s00068-014-0376-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 01/09/2014] [Indexed: 01/04/2023]
Abstract
PURPOSE Needlestick injuries (NSIs) are a significant health hazard. Occupational transmission of bloodborne pathogens among healthcare workers (HCWs) is rare but has been repeatedly reported in the literature. METHODS In October 2010, new regulations were introduced for medical aftercare of HCWs following NSIs at the University Hospital Frankfurt. In June 2013, a university hospital-wide early intervention program was introduced that gives HCWs immediate 24/7/365 access to an HIV postexposure prophylaxis kit after confirmed or probable occupational HIV exposure. RESULTS Interdisciplinary collaboration between the attending surgeon and occupational health as well as infectious disease specialists facilitates optimal postexposure medical treatment of HCWs who suffer NSIs. Complete reporting of NSIs is a prerequisite for achieving optimal treatment of the affected HCWs. CONCLUSION An NSI is an emergency and needs to be evaluated immediately and, if necessary, treated as soon as possible. A standardized algorithm for initial diagnostic and treatment has proven to be helpful.
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Affiliation(s)
- S Wicker
- Occupational Health Service, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany.
| | - F Walcher
- Department of Trauma, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - S Wutzler
- Department of Trauma, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - C Stephan
- Department of Medicine II, Infectiology, HIV Therapy, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - I Marzi
- Department of Trauma, Hand- and Reconstructive Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
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Needlestick injuries: causes, preventability and psychological impact. Infection 2014; 42:549-52. [PMID: 24526576 DOI: 10.1007/s15010-014-0598-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 01/29/2014] [Indexed: 10/25/2022]
Abstract
Needlestick injuries (NSI) pose a significant health hazard among healthcare personnel (HCP). The aim of our prospective observational study was to evaluate the psychological impact of NSI and assess measures to prevent NSI. The target group was the medical staff and students of Frankfurt University Hospital who had experienced a NSI (n = 370) during the 12-month study period. Data were retrieved from accident insurance reports, occupational follow-up examinations and a standardized anonymous questionnaire sent to the affected HCP. Analysis of the completed questionnaires (232/370) revealed that stress (48.3 %) and tiredness (36.6 %) were common factors contributing to the NSI and that >80 % of the respondents were concerned about the consequences of the NSI. Higher levels of anxiety were reported when the patient was known to have a chronic virus infection. Stressful working conditions, lack of adequate protective medical/technical equipment and poor work routines were suggested as factors contributing to NSI.
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Wicker S, Marzi I. In reply. DEUTSCHES ARZTEBLATT INTERNATIONAL 2013; 110:420. [PMID: 23837088 PMCID: PMC3702028 DOI: 10.3238/arztebl.2013.0420b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Sabine Wicker
- *Betriebsärztlicher Dienst, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt,
| | - Ingo Marzi
- **Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Klinikum der Johann Wolfgang Goethe-Universität Frankfurt
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Sharps injuries cause psychiatric trauma. Br Dent J 2013. [DOI: 10.1038/sj.bdj.2013.496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Grime P. In this issue of Occupational Medicine. Occup Med (Lond) 2013. [DOI: 10.1093/occmed/kqt039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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