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Min D, Kim D, Lee Y. Direct Care Nurses' Needlestick Injury Experiences: A Qualitative Descriptive Study. West J Nurs Res 2023; 45:1094-1103. [PMID: 37830483 DOI: 10.1177/01939459231204692] [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: 10/14/2023]
Abstract
BACKGROUND Even when education and the use of safety equipment are emphasized, nurses frequently experience needlestick injuries. Understanding the risk situations and coping mechanisms for needlestick injuries experienced by nurses facilitates their prevention. OBJECTIVES We aimed to explore and describe the phenomenon of needlestick injuries through the research questions: (1) What causes nurses to suffer from needlestick injuries? (2) How to cope after a needlestick injury? and (3) What are the recommendations for needlestick injury prevention? METHODS This qualitative descriptive study involved focus group interviews with 31 direct care nurses in 6 groups who had experienced needlestick injuries while working in different acute care hospitals across 3 regions in South Korea. Data were collected from January 29 to March 29, 2022, and analyzed using thematic analysis. RESULTS The average age of the participating nurses was 29.7 years. The following 3 themes were identified: various needlestick injury experiences, post-needlestick injury coping, and expectations regarding needlestick injuries. CONCLUSIONS Risk situations and coping mechanisms of nurses who experienced needlestick injuries were diverse. Emergency situations and novice nurses were the causes of most of the needlestick injuries. Often, personal protective equipment was found cumbersome. Reporting needlestick injuries depended on the work environment.
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Affiliation(s)
- Deulle Min
- Department of Nursing, College of Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Dahee Kim
- Graduate School, Wonkwang University, Iksan, Republic of Korea
| | - Yewon Lee
- Department of Nursing, Kangbuk Samsung Hospital, Seoul, Republic of Korea
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Tsuchiya A, Wada K, Morikane K, Yoshikawa T, Hosomi Y, Dhungel B, Kunishima H. Characteristics of needlestick and sharps injuries of the hands in the operating room among orthopedic surgeons in Japan. INDUSTRIAL HEALTH 2023; 61:151-157. [PMID: 35249893 PMCID: PMC10079498 DOI: 10.2486/indhealth.2021-0194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 02/15/2022] [Indexed: 06/14/2023]
Abstract
Among the reports on needlestick and sharps injuries (NSIs), many are orthopedic-related due to the frequent use of sharp devices such as pins and wires. This study aimed to identify high-risk instruments, the most common injury sites for each instrument, and the circumstances of NSIs of the hand during orthopedic surgeries in Japan. Incidents of exposure to blood or bodily fluids among physicians during orthopedic surgeries reported to the Japan-EPINet between 2000 and 2015 were included in this study. The four most common devices were identified and the associations among years of experience, equipment users, and injured sites were analyzed. We identified 666 cases of NSIs affecting orthopedic surgeons in the operating room. The instrument most frequently responsible for NSIs was suture needles, which were involved in 265 cases (39.7%). The second most common instrument was pins/wires, which was involved in 111 cases (16.6%). NSIs of the hands of orthopedic surgeons were frequently caused by suture needles used in all surgeries, but relatively often caused by orthopedic devices. Orthopedic surgeons must be aware that they are at risk of NSIs and must take appropriate measures and always be cautious when performing surgery, regardless of their years of experience.
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Affiliation(s)
- Akihiro Tsuchiya
- Department of Social Medical Sciences, Graduate School of Medicine, International University of Health and Welfare, Japan
- The Research Group of Occupational Infection Control and Prevention in Japan
| | - Koji Wada
- Department of Social Medical Sciences, Graduate School of Medicine, International University of Health and Welfare, Japan
- The Research Group of Occupational Infection Control and Prevention in Japan
| | - Keita Morikane
- Division of Clinical Laboratory and Infection Control, Yamagata University Hospital, Japan
- The Research Group of Occupational Infection Control and Prevention in Japan
| | - Toru Yoshikawa
- National Institute of Occupational Safety and Health, Japan
- The Research Group of Occupational Infection Control and Prevention in Japan
| | - Yumiko Hosomi
- International Safety Center, Inc., USA
- The Research Group of Occupational Infection Control and Prevention in Japan
| | - Bibha Dhungel
- Graduate School of Public Health, St. Luke's International University, Japan
- Department of Health Policy, National Center for Child Health and Development, Japan
| | - Hiroyuki Kunishima
- Department of Infectious Diseases. St. Marianna University School of Medicine, Japan
- The Research Group of Occupational Infection Control and Prevention in Japan
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Elisa N, Ssenyonga L, Iramiot JS, Nuwasiima D, Nekaka R. SHARP/NEEDLESTICK INJURIES AMONG CLINICAL STUDENTS AT A TERTIARY HOSPITAL IN EASTERN UGANDA. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.02.01.23285330. [PMID: 36778363 PMCID: PMC9915806 DOI: 10.1101/2023.02.01.23285330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background Clinical students, like health workers, are at risk of sharp/needle stick injuries and potential percutaneous exposure to blood and body fluids. They acquire infections like Human Immunodeficiency Virus (HIV) and Hepatitis B Virus (HBV) through injuries. This study determined the prevalence and factors associated with sharp injuries among clinical students at Mbale Regional Referral Hospital. Methods Across sectional study was carried out at Mbale Regional Referral Hospital, a teaching hospital located along Pallisa road, Mbale City, Eastern Uganda. Ethical approval was obtained, Printed and soft copy questionnaires eliciting demographics, injury occurrence and associated factors were randomly and conveniently distributed respectively to 322 clinical students. Data was entered in Microsoft excel, cleaned and exported to STATA version 14 for analysis. Results One hundred sixty (55.2%) clinical students had sustained a sharp injury in their clinical practice with a self-reported prevalence of 46.6% in the last year. The majority of the students 93(68.9%), sustained multiple sharp injuries. The common cause and site of injury were solid needles 72(45%) and finger (83.1%). Most students, 197(67.9%) reported ward procedures not being supervised and 124(42%) students worked on 15 and above patients daily. Final year clinical students were more likely to sustain sharp injuries than semi-finalists (P=0.000, OR 3.195% CI 1.7-5.5). Students who worked on ≥15 patients were more likely to sustain a sharp injury than those who attended to < 15 patients daily (P=0.000, OR 6.3 95% CI 3.7-10.8%). Students' knowledge about sharp/infection control was limited. Conclusion This study showed a high prevalence of needle stick injuries among clinical students. The associated factors were; the year of study, having not learned about infection control, the number of patients attended to daily. Students should attend to a manageable number of patients, carry out procedures not rushing while supervised. It is important to create awareness and train students on infection control before and during their deployment in clinical areas as their health and the future of the health sector depend on them.
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Affiliation(s)
- Ndyamuhakyi Elisa
- Department of Nursing, Faculty of Health Sciences, Busitema University
| | - Lydia Ssenyonga
- Department of Nursing, Faculty of Health Sciences, Busitema University
| | - Jacob Stanley Iramiot
- Department of Microbiology and Immunology, Faculty of Health Sciences, Busitema University
| | - Doreck Nuwasiima
- Department of Nursing, Faculty of Health Sciences, Busitema University
| | - Rebecca Nekaka
- Department of Community and Public Health, Faculty of Health Sciences, Busitema University
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Needlestick injuries among anesthesia providers from a large US academic center: A 10-year retrospective analysis. J Clin Anesth 2022; 80:110885. [PMID: 35644082 DOI: 10.1016/j.jclinane.2022.110885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 11/20/2022]
Abstract
STUDY OBJECTIVE Anesthesiologists are at high risk for needlestick injury. Such injuries pose a serious health threat from exposure to bloodborne pathogens. This retrospective analysis aimed to examine needlestick injury rate among anesthesia providers between 2010 and 2020 at the University of California Los Angeles, Department of Anesthesiology and Perioperative Medicine to determine specialty-specific factors associated with these injuries. DESIGN Retrospective analysis. SETTING Academic Anesthesiology Department. PATIENTS AND INTERVENTIONS None. MEASUREMENTS All reported incidents of needlestick injuries to employees are sent to the Injury and Illness Prevention Committee. We included all anesthesia residents, fellows, nurse anesthetists, solo anesthesiologists, and supervising anesthesiologists. MAIN RESULTS The overall rate of reported needlestick injuries was 5.3%. The rates for anesthesia residents were 2.1%, 13.5%, 7.9%, and 6.7% for post graduate year 1-4 (PGY 1-4) residents. The rates were 14.3%, 4.7%, 2.1%, and 6.9% for fellows, nurse anesthetists, supervising anesthesiologists, and solo anesthesiologists, respectively. We found that PGY2 residents had a higher injury rate than PGY1 residents (p-value<0.001). When grouping PGY2, PGY3, and PGY4 residents together, they had a collective rate of 9.4%. Furthermore, residents had a higher needlestick injury rate than supervising anesthesiologists (p-value <0.001). CONCLUSIONS PGY2 residents and fellows had the highest rate of needlestick injury. Our study highlights the trend of increasing sharps injuries after PGY1 while supervising anesthesiologists had the lowest rate. Proposed mechanisms for the increased sharps injuries include residents' transition from medicine-based internship to the operating room environment with increased exposure to potentially injurious equipment, overnight call, and increased work-related and cognitive stress. Improving understanding of institution-specific prevention programs, raising awareness during their initial high-intensity training period with one-to-one supervision when habits are formed, and reducing exposure to sharps using a needleless system are some steps toward reducing the incidence of sharps injuries in a field where the risk remains high.
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Workplace Hazards in Orthopaedic Surgery Training: A Nationwide Resident Survey Involving Sharps-related Injuries. J Am Acad Orthop Surg 2022; 30:428-436. [PMID: 35171846 DOI: 10.5435/jaaos-d-21-00941] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/07/2022] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Surgical specialties are at an increased risk for occupational hazards, including sharps-related injuries. The objective of this study was to report the frequency of sharps injuries and evaluate which characteristics influence the number of injuries and reporting behaviors. METHODS A web-based, anonymous survey was available for 10 weeks to 46 US orthopaedic surgery residency programs (1,207 potential residents) participating in an education research collaborative. The survey was divided into the following areas: demographics, training and attitudes concerning occupational hazards, and sharps injuries and reporting. Logistic regression was used to evaluate the association between the above variables on experiencing sharps injuries with significance threshold set at P < 0.05. RESULTS In this study, 518 surveys were included yielding a response rate of 42.9% (518/1,207). Nearly 80% of the residents recalled some form of safety training during intern orientation and 62% of the respondents felt that they received adequate occupation safety training specifically related to orthopaedic surgery. Four hundred seventeen residents (80.5%) experienced a sharps injury (mean 2.8). Nearly 20% of the respondents experienced ≥5 sharps injuries. Needle sticks (38.8%) were responsible for the greatest percentage of injuries, followed by Kirschner wires (33.6%), scalpel (22.5%), and bone (17.3%). Only 42% of the residents consistently reported all injuries. Reasons included feelings of no risk (63.1%), too much hassle (58.9%), embarrassment (14.5%), other (8.7%), forgot (5.8%), and unclear what to do (3.3%). Inadequate safety training specific to orthopaedic surgery (odds ratio, 2.32 [95% confidence interval, 1.20 to 4.46]; P = 0.012) and greater training seniority (odds ratio, 2.04 [95% confidence interval, 1.64 to 2.52]; P < 0.0001) were associated with acquiring five or more sharps injuries. DISCUSSION Sharps injuries are a prevalent and concerning reality for orthopaedic surgical trainees. Despite this common occurrence, only 42% of the residents always reported their injuries. Inadequate training specific to orthopaedic surgery and each subsequent year of postgraduate training are associated with increased sharps injuries. STUDY TYPE Level III, retrospective observational survey.
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Korkmaz N, Çiçek Şentürk G, Tekin A, Gürbüz Y, Sevinç G, Tütüncü EE, Şencan İ. Rates of Underreported Needlestick and Sharps Injuries among Healthcare Workers in Turkey; in the Light of Infection Control Committee Data. Int J Qual Health Care 2022; 34:6548206. [PMID: 35285914 DOI: 10.1093/intqhc/mzac012] [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: 08/19/2021] [Revised: 12/03/2021] [Accepted: 03/12/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Doctors and nurses are frequently exposed to needlestick and sharps injuries (NSIs) because of their work. It is estimated that NSIs are more common than the reported rates to Infection Control Committee. The purpose of this study was to determine the incidence and reporting rates of NSIs in our hospital. METHODS After their consent forms were obtained for the questionnaire, 670 doctors and nurses were interviewed face-to-face by the Infection Control Committee nurse. The questionnaire consisted of 22 questions, and the answers were recorded. The questions were on demographic data and injuries. The data of NSIs, whose active surveillance was made in our hospital since 2005 and in the last 1 year were also analyzed retrospectively. RESULTS A total of 119 (17%) out of 670 people who participated in the study had at least one NSIs; 43 (36%) of the 119 people were doctors, and 76 (63.9%) were nurses. The most common injuries among doctors were found in assistant doctors (60%). No statistically significant differences were detected between the doctors and nurses in terms of injury status (p=0.398). The most common injuries were found in surgical clinics, and a significant difference was detected here when compared to other clinics. The data that 20 (17%) of the 118 people who were injured by the NSIs reported the injury were obtained from the Infection Control Committee database. CONCLUSION It is seen that injuries are high in surgical clinics and assistant doctors who have high work stress and workload. There were more injuries with sharp objects than the expected rates in our hospital although the reports were made very rarely. First of all, we should determine strategies, especially education, to reduce injuries, and then remove the obstacles to unreported injuries. Activities of clinics with high reporting rates needs to be search and adapt them to our clinic.
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Affiliation(s)
- Nesibe Korkmaz
- Department of Infectious and Clinical Microbiology Diseases, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Gönül Çiçek Şentürk
- Department of Infectious and Clinical Microbiology Diseases, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Asiye Tekin
- Hospital Infection Control Committee Nursing, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Yunus Gürbüz
- Department of Infectious and Clinical Microbiology Diseases, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ganime Sevinç
- Hospital Infection Control Committee Nursing, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Emin Ediz Tütüncü
- Department of Infectious and Clinical Microbiology Diseases, Kafkas University, Kars, Turkey
| | - İrfan Şencan
- Department of Infectious and Clinical Microbiology Diseases, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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Sabaa MA, Hassan AM, Abd-Alla AK, Hegazy EE, Amer WH. Needle-stick and sharps injuries: awareness, prevalence and risk factors of a global problem in healthcare workers at Tanta University Hospitals, Egypt. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:1419-1429. [PMID: 33704007 DOI: 10.1080/10803548.2021.1901445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objectives. This study aimed to assess the level of awareness, prevalence and risk factors of needle-stick and sharps injuries (NSSIs) in Tanta University Hospitals, Egypt to develop a well-established preventive strategy. Methods. A total of 662 healthcare workers (HCWs), including nurses and physicians, who attended work during the last 6 months of 2019 were included. Data were collected on a structured questionnaire distributed during their working time. Results. Of 662 participating HCWs, 486 were nurses and 176 were physicians. Good awareness (86.1 and 83.1%) of the participants about safe injection policy and sharp disposal after use was observed. Nurses showed a significantly higher percentage of poor awareness score (79.1%) than physicians (20.9%). NSSIs in our hospitals reached 60.4%. Nurses (67.9%) had higher risk of NSSIs than physicians (39.8%; p < 0.001). NSSIs were significantly less likely to occur for HCWs who were aware of safe injection and sharp disposal policies. NSSIs were frequent with specimen collection (16.4%), injections (15.5%) and sharp disposal (14.6%). Only 110 (27.5%) have reported their injuries. Conclusion. A comprehensive program that addresses institutional, behavioral and device-related factors that contribute to the occurrence of NSSIs and reporting systems is needed.
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Affiliation(s)
| | - Azza M Hassan
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Tanta University
| | - Amany Kamal Abd-Alla
- Department of Medical Surgical Nursing, Faculty of Nursing, Tanta University, Egypt
| | - Eman E Hegazy
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Tanta University
| | - Wesam Hatem Amer
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Tanta University
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Franchi M, Garzon S, Laganà AS, Baggio S, Cromi A, Ghezzi F, Scambia G, Raffaelli R. Needlestick injuries among obstetrics and gynecology trainees: A survey study. Eur J Obstet Gynecol Reprod Biol 2021; 259:67-74. [PMID: 33601315 DOI: 10.1016/j.ejogrb.2021.02.005] [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: 12/31/2020] [Revised: 02/05/2021] [Accepted: 02/07/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To assess characteristics, incidence, risk factors, and reporting rate of needlestick injuries (NSIs) among Obstetrics and Gynecology trainees. STUDY DESIGN We performed a nationwide cross-sectional survey study. The 40-items survey Obstetrics Needlestick Injury Questionnaire (ONSI-Q) was used to investigate the prevalence of NSIs, participant attitudes, associated factors, and the NSI reporting rate among trainees in Obstetrics and Gynecology. The target responders were all trainees of Obstetrics and Gynecology training programs in Italy. The trainees were invited between September 2018 and December 2018 via a web-based platform. RESULTS Among 1049 trainees, 1041 (99.2%) completed the survey. Out of 1041 trainees, 639 (61.4%) had at least one NSI, and 90.9% (581/639) experienced at least one during obstetric surgery. The number of NSIs increased with the year of training, with 2.48 NSIs per trainee in the fifth year. 90.6% (579/639) reported details about the most recent NSI, which was during obstetric surgery in 95.3% (552/579) of cases. 57.1% (315/552) experienced the most recent NSI during cesarean section, which was mainly inflicted by someone else (72.4%; 228/315). 42.9% (237/552) of NSIs were during perineal suture, and 84% (199/237) of them were self-inflicted. 77.9% (417/535) of trainees did not report the NSI. Associated factors were non-high-risk patients, self-inflicted NSI, and the first NSI. CONCLUSIONS NSIs are frequent among Obstetrics and Gynecology trainees but not reported, and obstetric surgery is the primary source. These data support the European efforts to improve working practices' safety. The education about protective strategies and reporting should be a priority.
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Affiliation(s)
- Massimo Franchi
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Simone Garzon
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy.
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Silvia Baggio
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Antonella Cromi
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Fabio Ghezzi
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Giovanni Scambia
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Rome, Italy
| | - Ricciarda Raffaelli
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
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Bagnasco A, Zanini M, Catania G, Watson R, Hayter M, Dasso N, Dini G, Agodi A, Pasquarella C, Zotti CM, Durando P, Sasso L. Predicting needlestick and sharps injuries in nursing students: Development of the SNNIP scale. Nurs Open 2020; 7:1578-1587. [PMID: 32802379 PMCID: PMC7424443 DOI: 10.1002/nop2.540] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/21/2020] [Indexed: 12/19/2022] Open
Abstract
Aim To develop an instrument to investigate knowledge and predictive factors of needlestick and sharps injuries (NSIs) in nursing students during clinical placements. Design Instrument development and cross-sectional study for psychometric testing. Methods A self-administered instrument including demographic data, injury epidemiology and predictive factors of NSIs was developed between October 2018-January 2019. Content validity was assessed by a panel of experts. The instrument's factor structure and discriminant validity were explored using principal components analysis. The STROBE guidelines were followed. Results Evidence of content validity was found (S-CVI 0.75; I-CVI 0.50-1.00). A three-factor structure was shown by exploratory factor analysis. Of the 238 participants, 39% had been injured at least once, of which 67.3% in the second year. Higher perceptions of "personal exposure" (4.06, SD 3.78) were reported by third-year students. Higher scores for "perceived benefits" of preventive behaviours (13.6, SD 1.46) were reported by second-year students.
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Affiliation(s)
| | - Milko Zanini
- Department of Health SciencesUniversity of GenoaGenoaItaly
| | | | - Roger Watson
- Faculty of Health and Social CareUniversity of HullHullUK
| | - Mark Hayter
- Faculty of Health and Social CareUniversity of HullHullUK
| | | | - Guglielmo Dini
- Occupational Medicine UnitDepartment of Health SciencesPoliclinico San Martino HospitalUniversity of GenoaGenoaItaly
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia"University of CataniaCataniaItaly
| | | | - Carla Maria Zotti
- Department of Public Health and PediatricsUniversity of TurinTurinItaly
| | - Paolo Durando
- Occupational Medicine UnitDepartment of Health SciencesPoliclinico San Martino HospitalUniversity of GenoaGenoaItaly
| | - Loredana Sasso
- Department of Health SciencesUniversity of GenoaGenoaItaly
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La-Rotta EIG, Garcia CS, Pertuz CM, Miquilin IDOC, Camisão AR, Trevisan DD, Aoki FH, Correa-Filho HR. Conhecimento e adesão como fatores associados a acidentes com agulhas contaminadas com material biológico: Brasil e Colômbia. CIENCIA & SAUDE COLETIVA 2020; 25:715-727. [DOI: 10.1590/1413-81232020252.04812018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 07/03/2018] [Indexed: 11/21/2022] Open
Abstract
Resumo Fizemos estudo transversal para iniciar coorte em dois Hospitais Universitários de dois países - Brasil e Colômbia - para avaliar a prevalência de acidentes com material biológico (AT-MB), o nível de adesão às Precauções Padrão (PP) e o conhecimento sobre patógenos transmissíveis pelo sangue e fatores associados entre trabalhadores e estudantes da saúde, no marco da implementação da norma NR-32. Criamos escalas para estimar conhecimento e adesão baseadas em 12 e 11 perguntas respectivamente. Utilizamos Regressão de Poisson-Tweedie para avaliar a associação do conhecimento e da adesão às PP com sofrer AT-MB. Avaliamos 965 indivíduos (348 estudantes e 617 profissionais). O conhecimento teve média de 10,98 com mediana de 11 (10, 12) e α-Cr de 0,625. A média de adesão foi de 30,74 com mediana de 31 (28, 34) e α-Cr de 0,745, associando-se a País, grupo (estudantes) e percepção de risco. Entre os fatores associadas ao relato de AT-MB encontraram-se o conhecimento, a adesão às PP, País de origem e ter tomado o esquema completo de vacinação contra Hepatites B. Concluímos que o nível de conhecimento e adesão foram adequados, ainda melhores entre os participantes do Brasil e associaram-se ao relato AT-MB.
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Maina AN, Bii LC. Factors affecting HBV vaccination in a Medical training College in Kenya: A mixed methods Study. BMC Public Health 2020; 20:48. [PMID: 31931751 PMCID: PMC6958794 DOI: 10.1186/s12889-020-8158-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 01/03/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Hepatitis B Virus (HBV) is highly endemic in Sub-Saharan Africa with 70 to 90% of the population becoming infected before the age of 40 years. Healthcare workers (HCWs) including healthcare students (HCSs) are at an increased risk of contracting HBV due to occupational exposure. HCSs are especially at a high risk because of their inexperience with infection control procedures and insufficient knowledge about the level of risk when dealing with patients. Despite the availability of an effective vaccine, and its recommendation by Kenya's Ministry of Health, few HCW and students are vaccinated. The aim of this study was to evaluate the influence of awareness, attitude, practices, and access factors on hepatitis B vaccination uptake by HCSs at Kenya Medical Training College (KMTC). METHODS This was a concurrent mixed methods study. For the quantitative arm, a structured questionnaire was used to assess the awareness, knowledge, attitudes and practices towards HBV disease and vaccination. Accessibility of the HBV vaccine in the participating campuses was also assessed. Two FGDs were carried out: one comprised of student representatives of the participating campuses while the second comprised of members of staff. Quantitative data was analysed using STATA (version 15) while NVIVO (version 11) was used for qualitative data. RESULTS Out of 634 students invited to participate in the study, 487 participated (response rate 76.8%). Majority of the respondents were from Nairobi Campus (44.2%) and from the Department of Nursing (31.2%). HBV vaccine uptake rate was 85.8% while the non-vaccination rate was 14.3%. Full vaccination was reported by only 20.2% of respondents. The major reason for not receiving the recommended doses was the unavailability of the vaccine when students went for it. The qualitative study revealed challenges in the implementation of the vaccination program at KMTC. CONCLUSIONS Full vaccination rates remained low despite good knowledge of HBV infection and positive attitude towards vaccination. There is therefore need to streamline vaccination programs in medical colleges to ensure availability and accessibility of the vaccine to healthcare students.
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Affiliation(s)
- Anne Njeri Maina
- Department of Medical Microbiology, University of Nairobi, P.O Box 19676-00202, Nairobi, Kenya.
| | - Leah Chebet Bii
- Kenya Medical Training College, Nairobi, P. O BOX, Nairobi, 30195-00100, Kenya
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Yang AD, Quinn CM, Hewitt DB, Chung JW, Zembower TR, Jones A, Buyske J, Hoyt DB, Nasca TJ, Bilimoria KY. National Evaluation of Needlestick Events and Reporting Among Surgical Residents. J Am Coll Surg 2019; 229:609-620. [PMID: 31541698 DOI: 10.1016/j.jamcollsurg.2019.09.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 09/03/2019] [Accepted: 09/03/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND Needlestick injuries pose significant health hazards; however, the nationwide frequency of needlesticks and reporting practices among surgical residents are unknown. The objectives of this study were to examine the rate and circumstances of self-reported needlestick events in US surgery residents, assess factors associated with needlestick injuries, evaluate reporting practices, and identify reporting barriers. STUDY DESIGN A survey administered after the American Board of Surgery In-Training Examination (January 2017) asked surgical residents how many times they experienced a needlestick during the last 6 months, circumstances of the most recent event, and reporting practices and barriers. Factors associated with needlestick events were examined using multivariable hierarchical regression models. RESULTS Among 7,395 resident survey respondents from all 260 US general surgery residency programs (99.3% response rate), 27.7% (n = 2,051) noted experiencing a needlestick event in the last 6 months. Most events occurred in the operating room (77.5%) and involved residents sticking themselves (76.2%), mostly with solid needles (84.7%). Self-reported factors underlying needlestick events included residents' own carelessness (48.8%) and feeling rushed (31.3%). Resident-level factors associated with self-reported needlestick events included senior residents (PGY5 29.9% vs PGY1 22.4%; odds ratio 1.66; 95% CI 1.41 to 1.96), female sex (31.9% vs male 25.2%; odds ratio 1.31; 95% CI 1.18 to 1.46), or frequently working more than 80 hours per week (odds ratio 1.42; 95% CI 1.20 to 1.68). More than one-fourth (28.7%) of residents did not report the needlestick event to employee health. CONCLUSIONS In this comprehensive national survey of surgical residents, needlesticks occurred frequently. Many needlestick events were not reported and numerous reporting barriers exist. These findings offer guidance in identifying opportunities to reduce needlesticks and encourage reporting of these potentially preventable injuries among trainees.
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Affiliation(s)
- Anthony D Yang
- Surgical Outcomes and Quality Improvement Center, Department of Surgery and Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL; Northwestern Medicine, Chicago, IL.
| | - Christopher M Quinn
- Surgical Outcomes and Quality Improvement Center, Department of Surgery and Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL; Northwestern Medicine, Chicago, IL
| | - D Brock Hewitt
- Surgical Outcomes and Quality Improvement Center, Department of Surgery and Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL; Northwestern Medicine, Chicago, IL; Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, PA
| | - Jeanette W Chung
- Surgical Outcomes and Quality Improvement Center, Department of Surgery and Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL; Northwestern Medicine, Chicago, IL
| | - Teresa R Zembower
- Division of Infectious Diseases, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | - Jo Buyske
- American Board of Surgery, Philadelphia, PA
| | | | - Thomas J Nasca
- Accreditation Council for Graduate Medical Education, Chicago, IL
| | - Karl Y Bilimoria
- Surgical Outcomes and Quality Improvement Center, Department of Surgery and Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL; Northwestern Medicine, Chicago, IL
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Aigbodion SJ, Motara F, Laher AE. Occupational blood and body fluid exposures and human immunodeficiency virus post-exposure prophylaxis amongst intern doctors. South Afr J HIV Med 2019. [DOI: 10.4102/sajhivmed.v20i1.958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Aigbodion SJ, Motara F, Laher AE. Occupational blood and body fluid exposures and human immunodeficiency virus post-exposure prophylaxis amongst intern doctors. South Afr J HIV Med 2019; 20:958. [PMID: 31205779 PMCID: PMC6561641 DOI: 10.4102/hivmed.v20i1.958] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 03/22/2019] [Indexed: 12/31/2022] Open
Abstract
Background Healthcare workers (HCWs) are constantly vulnerable to occupational blood and body fluid exposures (OBBFEs). Exposed HCWs experience emotional, physical and psychological trauma. Less experienced HCWs, such as intern doctors, are more prone to OBBFEs. Objectives The aim of this study was to investigate the prevalence and practices pertaining to OBBFEs amongst a select group of intern doctors in the Gauteng province of South Africa. Methods A quantitative cross-sectional descriptive study using a questionnaire based on a practical model was used. Intern doctors were recruited from four major hospitals in Gauteng. Results A total of 175 intern doctors participated in the study. There was a total of 182 (mean = 1.04, standard deviation [s.d] 0.88) reported OBBFEs amongst 136 (77.7%) subjects. The exposures occurred predominantly whilst subjects were working in surgery (n = 50, 27.5%), obstetrics and gynaecology (n = 49, 26.9%) and internal medicine (n = 48, 26.4%) departments; were superficial wounds (n = 69, 37.9%); were acquired during vascular puncture or intravenous line insertion (n = 69, 37.9%); and occurred when subjects were working >12 h shifts (n = 101, 55.5%). Human immunodeficiency virus (HIV) post-exposure prophylaxis (PEP) was initiated in 141 (77.5%) out of the 182 exposures. Only 90 (63.8%) subjects completed the recommended 28-day course of PEP. Two (1.1%) subjects reported that they had acquired HIV infection as a consequence of the OBBFE. Conclusion Occupational blood and body fluid exposures are common amongst intern doctors. It is recommended that regular training, health education and monitoring compliance should be incorporated during the induction of medical intern doctors in hospitals. The availability of PEP regimens with better tolerability will encourage compliance.
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Affiliation(s)
- Sunday J Aigbodion
- Department of Emergency Medicine, Far East Rand Hospital, Johannesburg, South Africa
| | - Feroza Motara
- Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Abdullah E Laher
- Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Don't Get Stuck: A Quality Improvement Project to Reduce Perioperative Blood-Borne Pathogen Exposure. Jt Comm J Qual Patient Saf 2019; 45:329-336. [PMID: 30733139 DOI: 10.1016/j.jcjq.2018.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 11/30/2018] [Accepted: 12/03/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Blood-borne pathogen exposure (BBPE) represents a significant safety and resource burden, with more than 380,000 events reported annually across hospitals in the United States. The perioperative environment is a high-risk area for BBPE, and efforts to reduce exposures are not well defined. A multidisciplinary group of nurses, surgical technologists, surgeons, and employee health specialists created a BBPE prevention bundle to reduce Occupational Safety and Health Administration (OSHA) recordable cases. METHODS Mandatory double gloving, a safety zone, engineered-sharps injury prevention devices, and clear communication when passing sharps were implemented in an evidence-based fashion at one institution. Days between exposures and total number of exposures were monitored. Analysis by specialty, role, location, type of injury, and timing was performed. RESULTS During fiscal year (FY) 2015, 45 cases were reported. During the first year of implementation, cases decreased to 38 (a 15.6% decrease; p < 0.65). In the postimplementation period (FY 2017), only 21 cases were reported (an additional 44.7% decrease; p < 0.12), for a total decrease of 53.3% (p < 0.01). The mean number of days between injuries significantly increased (2.5 to 16.3) over the study period. For FY 2017, the main cause of BBPE was needlestick while suturing (47.6%); fellows and attendings combined had the most injuries (52.4%); among divisions, pediatric surgery (19.0%), operating room staff (19.0%), and orthopedics (19.0%) had the most events. CONCLUSION A comprehensive and multidisciplinary approach to employee safety, focused on reduction of BBPE resulted in a significant progressive annual decrease of injuries among perioperative staff.
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The State of Needlestick Training for Undergraduate Medical Students at Canadian Universities. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019; 41:210-213. [DOI: 10.1016/j.jogc.2018.09.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/20/2018] [Accepted: 09/24/2018] [Indexed: 11/23/2022]
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Vilar-Compte D, de-la-Rosa-Martinez D, Ponce de León S. Vaccination Status and Other Preventive Measures in Medical Schools. Big Needs and Opportunities. Arch Med Res 2018; 49:255-260. [PMID: 30195701 DOI: 10.1016/j.arcmed.2018.08.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 08/24/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Proper immunization and knowledge in infection prevention are key factors in protecting medical students. AIM OF THE STUDY To describe the status on vaccination recommended for healthcare workers (HCW) and infection prevention knowledge. METHODS We conducted a cross-sectional study on medical students at clinical years of medical school from a public University in Mexico. RESULTS A total of 1,824 medical students responded the survey. One thousand ninety (59.8%) were women. Median age was 22 years. One thousand six hundred twenty-two (88.9%) knew their childhood immunization status. One thousand seventy-one (58.7%) were vaccinated against influenza for the 2016-2017 season; 1667 (91.4%) had been vaccinated at least once against hepatitis B, only 315 (18.9%) of vaccinated had received a full course with 3 doses. Most students were vaccinated against measles, mumps and rubella during childhood, 542 (29.7%) received an additional dosage during or after adolescence. Six hundred ninety-seven (38.2%) were concerned about vaccine's safety. A total of 1,431 (78.5%) properly identified situations were standard precautions are recommended, and 1540 (84.4%) had received some training on safe care delivery and personal protective equipment. Regarding needle-stick injuries, 1165 (63.9%) had been informed on the protocols to follow if an injury occurred. Three hundred forty-nine (19.1%) had suffered needle-stick injuries, only 125 (35.8%) received immediate medical attention at the point of care. CONCLUSIONS Most medical students were not vaccinated as recommended, and they were not adequately instructed on safe practices for medical attention, nor advised or followed when a health-care related accident occurs. The results may be useful for implementation strategies on vaccination compliance and training on infection prevention.
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Affiliation(s)
- Diana Vilar-Compte
- Departmento de Enfermedades Infecciosas, Hospital de Epidemiología, Instituto Nacional de Cancerología, Ciudad de México, México; Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México.
| | - Daniel de-la-Rosa-Martinez
- Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México; Programa de Estudios Combinados en Medicina, Ciudad de México, México
| | - Samuel Ponce de León
- Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México; Programa Universitario de Investigación en Salud, Universidad Nacional Autónoma de México, Ciudad de México, México
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CORR Insights®: Surgeon Personal Protection: An Underappreciated Benefit of Positive-pressure Exhaust Suits. Clin Orthop Relat Res 2018; 476:1349-1351. [PMID: 29698309 PMCID: PMC6263587 DOI: 10.1097/01.blo.0000533609.68604.07] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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