Frequency and barriers of underreported needlestick injuries amongst Iranian nurses, a questionnaire survey

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

OBJECTIVES

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

CONTENT

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

SUMMARY AND OUTLOOK

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

Needlestick injuries among healthcare personnel in Qatar: A retrospective study

Background: A needlestick injury (NSI) is a serious occupational hazard among healthcare personnel (HCP), as it can cause transmission of blood-borne pathogens such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). This study aimed to determine the frequency and distribution of reported NSIs, associated factors, use of post-exposure prophylaxis (PEP), and percentage of seroconversion among HCP in a major tertiary care hospital in Qatar.

Methods: This retrospective study analyzed NSIs among HCP reported in Hamad Medical Corporation facilities in Doha between May 01, 2017, and May 01, 2018. A surveillance follow-up period of 6 months commenced after the 1-year study period.

Results: A total of 130 NSIs were reported during the study period, with an overall incidence of eight injuries per 1000 HCP. The mean age was 34.6 ± 7.9 years. Among the reported cases, the proportion of female HCP (n = 72, 55.4%) was greater than that of male HCP (n = 58, 44.6%). Of 130 NSIs, 79 (60.8%) occurred in nurses, followed by 35 (26.9%) cases in doctors and 16 (12.3%) in other HCP. The total healthcare population comprised 49.6% of nurses and 18% of doctors. NSIs occurred in 10.1 per 1000 nurses and in 12.4 per 1000 doctors. Exposures mainly occurred in the operating theater, 35 (31.5%); inpatient wards, 24 (21.6%); and emergency department, 20 (18%). Common modes of injury were after use or before disposal of the device in 44 (44.4%) cases and during surgical interventions in 35 (35.4%) cases. Hollow-bore needles (64/98, 65.3%) were the most common devices involved. Source serology was documented in 71 (54.6%) cases of which 52 (73.2%) were normal, 9 (12.7%) were abnormal, and 10 (14.1%) were incomplete. Among the exposed HCP, 124 (95.4%) had adequate immunity to HBV. PEP for HBV was indicated in 6 (4.6%) and received by 4 (3.1%) HCP. NSI cases were followed up for 6 months post-exposure, and during this surveillance period, no seroconversion to HBV, HCV, or HIV was detected.

Conclusion: NSIs are common among HCP. In this study, most of the exposed HCP had adequate immunity to HBV. There was no hepatitis B, hepatitis C, or HIV transmission among the study cohort. Adherence to proper needle/sharps disposal techniques and safe practices during procedures will help prevent NSIs.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Barriers to Incident Reporting among Nurses: A Qualitative Systematic Review

Incident reporting in health care prevents error recurrence, ultimately improving patient safety. A qualitative systematic review was conducted, aiming to identify barriers to incident reporting among nurses. Joanna Briggs Institute methodology for qualitative systematic reviews was followed, with data extracted using JBI QARI tools, and selected studies assessed for methodological quality using Critical Appraisal Skills Program (CASP). A meta-aggregation synthesis was carried out, and confidence in findings was assessed using GRADE ConQual. A total of 921 records were identified, but only five studies were included. The overall methodological quality of these studies was good and GRADE ConQual assessment score was "moderate." Fear of negative consequences was the most cited barrier to nursing incident reporting. Barriers also included inadequate incident reporting systems and lack of interdisciplinary and interdepartmental cooperation. Lack of nurses' necessary training made it more difficult to understand the importance of incident reporting and the definition of error. Lack of effective feedback and motivation and a pervasive blame culture were also identified.

Needlestick and sharps injuries in an Indonesian tertiary teaching hospital from 2014 to 2017: a cohort study

OBJECTIVE

Needlestick and sharps injuries among healthcare workers (HCWs) pose significant occupational health problems. We aim to provide incidence and other epidemiological aspects of needlestick and sharp injuries (NSSIs) among HCWs in a tertiary teaching hospital in Indonesia, to inform the evaluation of NSSIs prevention programme.

METHODS

A cohort study was conducted at Cipto Mangunkusumo Hospital in Jakarta. We analysed data of the sharps injury programme at the hospital between January 2014 and December 2017. Incidence of NSSIs was calculated per 1000 person-years (1000-PY).

RESULTS

Over the 4-year period, a total of 286 NSSIs were reported. The mean NSSIs incidence rate for 4 years was 13.3/1000-PY, peaking in 2015 (15.5/1000-PY) then decreasing afterward. Most NSSIs were experienced by nurses (42.7%), but the highest incidence was among midwives (18.9/1000-PY), followed by nurses, medical students and medical doctors (15.2/1000-PY, 12.6/1000-PY and 11.8/1000-PY, respectively). The devices causing the highest proportion of NSSIs were hollow-bore needles (66.8%), followed by suture needles (14.3%) and solid needles (10.8%). 9.4% of NSSIs were related to insulin pen injection. Of all the incidents, 31.3% occurred during surgical procedures, 25.9% during blood collections, 14.3% during administering injection of drugs and 13.3% during waste cleaning.

CONCLUSION

In conclusion, this study showed varied incidences of NSSI among different occupations, with the highest among midwives and nurses. Many unsafe work practices still continue, which is of utmost concern. We suggest opportunities for prevention including training and cultivating safer workplace practices.

Needlestick injuries among Malaysian healthcare workers

BACKGROUND

Needlestick injury (NSI) is a significant occupational health issue among healthcare workers (HCWs).

AIMS

To determine the national self-reported incidence and risk factors for NSI among Malaysian Ministry of Health (MOH) HCWs.

METHODS

Using data from the MOH national sharps injury surveillance programme, information on reported NSIs over a 1-year period (2016) for different HCW subgroups were extracted and analysed.

RESULTS

A total of 1234 NSI cases were reported in 2016, giving an overall incidence of 6 injuries per 1000 HCWs. Medical doctors recorded the highest incidence (21.1 per 1000 HCWs) followed by dental staff (7.5), pharmacy staff (4.2), nurses (3.7), medical assistants (3.4) and allied and auxiliary staff (1.0). Doctors had significantly increased risk of NSI compared with allied and auxiliary staff (relative risk [RR] = 20.7, 95% confidence interval [CI] 15.5-27.5), medical assistants (RR = 6.1, 95% CI 4.5-8.2), nurses (RR = 5.7, 95% CI 5.0-6.6), pharmacy staff (RR = 5.0, 95% CI 3.7-6.6) and dental staff (RR = 2.8, 95% CI 2.2-3.5). Significant differences were found in age and sharps- handling experience between occupational subgroups (P < 0.001 for both variables). Male employees had higher risk than females (RR = 1.33, 95% CI 1.18-1.50), with a significant difference seen in their sharps-handling experience (P < 0.01). Important risk factors included unsafe practices such as recapping of needles and their improper disposal.

CONCLUSIONS

The national incidence of NSI amongst Malaysian HCWs was lower compared with other countries, but unsafe practices remain an important concern. There is a need to formulate, implement and monitor safe and consistent practices for the different healthcare professionals.

Occupational exposure to blood and body fluids and use of human immunodeficiency virus post-exposure prophylaxis amongst nurses in a Gauteng province hospital

Background

Healthcare facilities in South Africa are confronted by several challenges arising from Human immunodeficiency virus (HIV) and acquired immune diseases syndrome infection pandemic. All categories of nurses continue to experience accidental occupational exposure to blood and body fluids (BBFs) of patients who are HIV-positive. Studies conducted revealed that nurses fail to report the occurrence of the exposures. This represents a serious challenge because they contract HIV infections whilst in the process of helping others.

Objectives

The purpose of this study was to determine the occupational exposures and use of HIV post-exposure prophylaxis (PEP) amongst nurses at the selected tertiary academic hospital, Tshwane district, Gauteng province, South Africa.

Methods

A quantitative descriptive study was conducted with 94 male and female clinical nurses, using a self-administered questionnaire that facilitated collection of biographical data, occupational exposures to BBFs and use of HIV PEP. The data analysis included univariate and bivariate descriptive analyses.

Results

Of the 94 nurses, n = 40 (43%) had been exposed to BBFs, either through sharp or needle prick injuries or splashes but only 16 (46%) of them reported the incident. Nurses were not keen to report accidental occupational exposures to BBFs in their own facility and rather sought HIV PEP outside their workplace. They gave different reasons for their behaviour. For example, ‘I did not know where to report’.

Conclusion

Our study highlights the gaps that exist in reporting occupational exposure to BBFs and obtaining HIV PEP. Therefore, we recommend evaluation of these occupational exposures to BBFs and the management thereof, as well as to address the identified problems.

The impact of occupational splash, sharps and needlestick injuries (SSNIs) on the quality of life of healthcare workers in a Kenyan university hospital

BACKGROUND

Infection as a consequence of splash sharps and needlestick injuries (SSNIs) is a hazard faced by healthcare workers. Little is known about the impact this has on quality of life particularly in countries where the risk of infection is high.

OBJECTIVE

This study aims to describe the impact SSNIs have on the quality of life of healthcare workers in Kenya, where blood borne illness prevalence is high.

METHODS

A hospital-wide survey of a facility in Nairobi was conducted. Data was collected online from at risk healthcare workers using Burckhardt and Anderson's Quality of Life Scale (QOLS) and a 10-item symptoms questionnaire.

RESULTS

Of the 416 participants, 192 (46.2%) had experienced SSNIs. Their mean QOLS scores were considerably lower than that predicted for a healthy population. The relationship between symptoms and QOLS scores showed a strong positive correlation (Pearson's r = 0.753). Tests of association between QOLS scores and SSNI type, anti-retroviral (ARV) drug use, educational level and staff cadre revealed significant association (p < 0.05). However, on key demographic variables, the association was non-dependent, indicating that the impact was felt similarly by many staff.

CONCLUSIONS

SSNIs clearly impact on healthcare workers quality of life. Hospital management should ensure measures are taken to reduce SSNIs and provide appropriate personal protection equipment. For staff experiencing an SSNI, psychological wellbeing should be assessed and appropriate expert help provided.

Prevalence of needlestick and sharps injuries in the healthcare workers of Iranian hospitals: an updated meta-analysis

BACKGROUND

Needlestick and sharps injuries (NSIs) are critical occupational risk among health care workers (HCWs), which is extremely worrying due to the potential risk of transmitting bloodborn pathogens (BBPs). This study was carried out to evaluate the prevalence of NSIs among Iranian HCWs.

METHODS

In this systematic review and meta-analysis, the key terms percu* injur*, needle* stick injur*, needlestick* injur*, or sharp* injur* were searched in the Scientific Information Database (SID), MagIran, IranMedex, Google Scholar, Science Direct, PubMed, and Scopus. A prefabricated checklist, including variables: first author, publication year, study population, sample size, gender, total prevalence of needlestick in each gender, type of questionnaire, region, and type of hospitals, was used to extract data from the selected articles included which were published between 2003 and 2016.

RESULTS

The analysis showed that the prevalence of NSIs in the Iranian HCWs was 42.5% (95% CI 37-48). Moreover, the prevalence of NSIs was more in women (47%; 95% CI 36-58) compared to men (42%; 95% CI 26-58).

CONCLUSION

Given the high prevalence of NSIs, it is necessary to supply safe needles and instruments, hold training programs focused on new methods of using sharp objects safely, observe safety principles and standards, reinforce the practical skills of personnel, and pay more attention to reporting and improving occupational behaviors like avoiding needle recapping in order to reduce the prevalence of NSIs and consequently reduce potential risk of transmission of BBPs.

Needlestick Injuries among Healthcare Workers: Why They Do Not Report their Incidence?

Background

Needlestick injuries (NSIs) among healthcare workers (HCWs) pose an important health challenge and several pieces of evidence show that in many cases HCWs do not report the injury.

Materials and Methods

This multicenter descriptive cross-sectional study was performed in eight teaching hospitals of Rasht, Iran. Using consecutive sampling methods, 1010 nurses were enrolled from October 2014 to January 2015. A three-part self-administered questionnaire was used. It included questions on demographic features, NSI-related questions, and questions on the knowledge of hepatitis B and C viruses (HCV, HBV).

Results

Among the 1010 participants, 580 (57.42%) showed a positive history of NSI; the total number of occurrences of NSI was 914. The major item causing NSI was the syringe with needle (315; 34.47%). In this way, NSIs occurred most frequently during recapping and injection [339 (37.10%) and 147 (16.10%), respectively]. Only 92 (10.07%) of all NSI positive participations had referred to the infection control units of their hospitals. The others mostly answered the question of "Why did you not report the incident?" with being too busy at work at the time of injury (140; 27.58%). The results showed that among participants with <5 years elapsed since their vaccination, the risk of NSI reduced to 60% [p < 0.02, odds ratio (OR) = 0.40, 95% confidence interval (CI) = 0.20-0.80].

Conclusions

It seems that NSI is still a major problem among nurses. Correspondingly, HCWs do not take the reporting system seriously and training them requires an ongoing activity in all hospitals.

Stress and Fear of Exposure to Sharps in Nurses

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.

Needle-Stick Injuries Among Healthcare Workers in a Teaching Hospital

Background:

Needle-Stick Injuries (NSIs) are among the hazards and problems that can expose health workers to infections.

Objectives:

This study aimed to determine the rate of NSIs in a teaching hospital in Tehran, Iran.

Materials and Methods:

This cross-sectional, analytical and descriptive study was conducted at one of the teaching hospitals in Tehran, Iran, in 2013. The study population was 344 employees in various occupational groups selected via census. Data were collected using a researcher-made questionnaire. The collected data were analyzed using some statistical tests, including independent-samples t-test with SPSS software version 21.0.

Results:

The results showed that only 50.2% of injuries had been reported; 67.8% of all participants (n = 211) had at least one NSI. Most NSIs had been reported in the emergency department (33.5%). Most participants mentioned the injection syringe needles as the main cause of their injuries (71.1% of all NSIs). Among NSIs, those caused by insulin syringe needles (6.2%) were the second cause. In this study, females had NSIs more than males. There was a statistically significant relationship between sex and the rate of NSIs (P < 0.05).

Conclusions:

Considering the high rate of occupational injuries, further preventive measures should be implemented to prevent these injuries from occurring. Providing initial and continuing training for employees is very important. Directing special attention to emergency department employees may be effective in reducing occupational injuries.

Effect of Education on Stress of Exposure to Sharps Among Nurses in Emergency and Trauma Care Wards

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.

Knowledge, attitude, and performance of medical staff of teaching healthcare settings about hepatitis B and C in Isfahan, Iran

Background:

hospital personnel are at high risk of exposure, infection, and transmission of viral hepatitis. The present study aimed at investigating the knowledge, attitude, and performance of health service providers to provide them with the information required for their educational promotion on viral hepatitis.

Materials and Methods:

This cross-sectional study was conducted on 400 staff of the forenamed healthcare settings such as on nurses, midwives, licensed practical nurses, and lab officials in Isfahan, Iran, in 2012. A checklist including demographic data and questions associated with the knowledge (18 questions), attitude (4 questions), and performance (15 questions) on hepatitis B and C was completed by the participants.

Results:

A total of 388 participants completed the checklist. Participants’ knowledge on the ways of transmission, prevalence, vaccination, and prevention methods was moderate (total score = 58.56 ± 10.1 percent) and the attitude was generally positive. Proper vaccination was carried out by 81.4% of the participants. Accidental injury by a needle was reported in 47.7% of the participants, but only 37.6% of them reported it to higher authorities and of them only 13.7% received appropriate treatment. Only 44.3% and 11.6% of participants reported always using gloves and masks, respectively, and 58.8% of the staff covered the needle cap before transferring it to the safety box.

Conclusions:

Due to excessive contact with patients, a paramedic-educated society is expected to have an optimal level of knowledge, attitude, and performance related to viral hepatitis. Our results from the checklists showed that medical personnel are not appropriately aware of viral hepatitis and their performance, too, is not satisfactory. Further continuous training is required and there needs to be more emphasis on actions regarding behaviors with high risk of infection transmission.

Epidemiology of exposure to HIV/AIDS risky conditions in healthcare settings: the case of health facilities in Gondar City, North West Ethiopia

BACKGROUND

It has been estimated that every year more than quarter a million health care workers exposed to HIV risky conditions in health care settings, more so in developing countries, with high incidence of HIV/AIDS and unsafe practices. Particularly, Sub-Saharan African countries share at least half of these occupational exposures to HIV risky conditions among health care workers. The aim of this study was to determine the epidemiology of health care workers' exposure to HIV/AIDS risky conditions and associated factors in the healthcare settings in Gondar city.

METHODS

Institution based quantitative cross sectional study was conducted from April 1-20, 2014. The study included 401 health care workers who were selected from the source population by simple random sampling technique. Data were collected by interviewing health care workers using structured and pretested questionnaire. After the collected data entered to EPI INFO version 3.5.3 statistical software and exported to SPSS version 20.0 for analysis, both binary and multivariable logistic regressions were done to identify factors associated with exposure to HIV/AIDS risky conditions.

RESULTS

From a total of 401 health care workers involved in this study, 162(40.4%) reported at least one history of occupational exposure to HIV/AIDS risky conditions in the last one year. More than half (52.31%) of physicians and 47.62% of anesthetists were exposed to HIV/AIDS risky conditions within one year. Lack of training on infection prevention, 5-10 years work experience, long working hours per week, absence of work guidelines, and dissatisfaction with current job were significantly associated with accidental occupational exposure to HIV/AIDS risky conditions.

CONCLUSION

This study found quite high prevalence of health care workers exposure to HIV/AIDS risky conditions in the health care settings in Gondar city. Therefore, effective and goal oriented educational programmes targeting at health care workers and establishment of surveillance systems for registering, reporting and management of occupational exposures in health care settings are quite important.

Anesthesia Personnel's Knowledge of, Attitudes Toward, and Practice to Prevent Needlestick Injuries

Anesthesia personnel are at risk for needlestick injuries (NSIs). This study evaluated the knowledge of, attitudes toward, and practice of preventing NSIs among anesthesia personnel in four Iranian university hospitals. A self-administered anonymous questionnaire was distributed to 104 anesthesia personnel. In addition, hospital infection control center records were reviewed. The prevalence of NSI among anesthesia personnel was 56.8%. Only 32.2% reported their NSI. Men were more knowledgeable about the risks associated with NSI and the application of standard precautions than women, but were also more likely to experience NSI. Standard precautions were often not followed. In contrast with other hospital staff, most reported NSIs among anesthesia personnel produced high-risk exposures. The knowledge and prevention practices of anesthesia personnel related to needles and other sharps were not satisfactory. These health care providers need appropriate training on standard precautions and administrative oversight to improve their practices. Anesthesia personnel's gender and position should also be considered to improve compliance.

Incidence of ambulatory care visits after needlestick and sharps injuries among healthcare workers in Taiwan: a nationwide population-based study

Healthcare professionals have a high risk of needlestick and sharps injuries (NSIs), which have a high potential for disease transmission. Ambulatory care follow up is essential, but is usually overlooked. This study aimed to investigate the annual and cumulative (age-, sex-, and subtype-specific) incidences of ambulatory care visits after NSIs. This study was also designed to evaluate the incidences of blood-borne diseases associated with NSIs among Taiwanese health professionals in Taiwan between 2004 and 2010. Data were obtained from the National Health Insurance Research Database, which contains anonymized records representing approximately 99% of the Taiwan population. A total of 4443 nurse healthcare workers (NHCWs) and 3138 non-nurse healthcare workers (NNHCWs), including physicians, medical technologists, and other health professionals were included in this longitudinal study. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. The Mantel-Haenszel method was used to adjust for sex, age, and type of affiliation. Results showed that the annual incidence of ambulatory care visits of NHCWs increased from 0.7% in 2004 to 1.9% in 2010; this incidence was significantly higher than that of NNHCWs (from 0.3% in 2004 to 0.5% in 2010) in any yearly comparison (p < 0.05). The sex-adjusted 7-year cumulative incidence rate was 3.23 (95% CI = 1.23-8.45) in males and 3.92 (95% CI = 2.70-5.69) in females (p < 0.05). The age-adjusted 7-year cumulative incidence rate was 2.74 (95% CI = 1.99-3.77) and 2.14 (95% CI = 1.49-3.07) in subjects ≤ 30 and ≥31 years old, respectively (p < 0.0005). The affiliation-adjusted 7-year cumulative incidence rate was 1.89 (95% CI = 1.21-2.94) in medical centers and 3.33 (95% CI = 2.51-4.41) in nonmedical centers (p < 0.01). In conclusion, NSIs increased steadily from 2004 to 2010 in Taiwan with NHCWs having higher NSIs incidences than NNHCWs. A routine ambulatory care visit after NSIs can prevent blood-borne transmission, especially for NHCWs. Educational programs may be helpful for reducing the incidence of NSIs and increasing ambulatory care visit ratios after NSIs.

Sharps injuries: the risks and relevance to plastic surgeons

Surgeons are at risk for injury in the operating room daily. Because of the ubiquity of occupational hazards, injuries remain prevalent and expensive. Although occupational hazards can include musculoskeletal conditions, psychosocial stress, radiation exposure, and the risk of communicable diseases, sharps injuries remain the most common among surgeons in practice and the most frequent route of transmission of blood-borne pathogens. Therefore, increased attention to the health, economic, personal, and social implications of these injuries is essential for appropriate management and future prevention.

Needlestick and sharps injuries among housekeeping workers in hospitals of Shiraz, Iran

BACKGROUND

Needlestick and sharps injuries (NSSIs) are one of the major risk factors for blood-borne infections (BBPs) at healthcare facilities. This study examines the current prevalence of NSSIs among housekeeping workers engaged in the handling and disposal of biomedical waste (BMW) at government and private hospitals in Shiraz, Iran, and furthermore, explores strategies for preventing these injuries.

FINDINGS

Using a cross-sectional study design, NSSI's and associated protective measures for housekeeping workers throughout hospitals in Shiraz were evaluated from 2009 onwards. Using a questionnaire, data was collected for 92 workers who had engaged directly with BMW. Data was analyzed using Chi-square, student t-test and where appropriate, SPSS version 12. 90.2 % of housekeeping workers were warned of the dangers associated with waste, 87.5 % in government and 93.2 % in private hospitals (P = 0.0444). 83.7 % had attended educational programs on biomedical waste (BMW) management and injury prevention at their hospital in the preceding year. 16.3 % had not been trained in biomedical waste management (P = 0.0379) and 88.9 % had a sufficient supply of safety wear.

CONCLUSIONS

NSSIs are a common risk factor for infection among health care workers within hospitals in Iran. For the effective prevention of these injuries, health boards and hospital trusts need to formulate strategies to improve the working conditions of health care workers, discourage the excessive use of injections, and increase their adherence to universal precautions.

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

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