Causes of Needlestick and Sharps Injuries When Using Devices with and without Safety Features

Analysis of factors associated with needlestick injuries of clinical nurses by applying a human factor analysis and classification system: A nationwide cross-sectional survey

AIMS

This study aims to investigate the current situation of needlestick injuries (NSIs) of clinical nurses and identify associated factors by using the theoretical framework of the human factors analysis and classification system (HFACS).

DESIGN

A nationwide cross-sectional survey was conducted.

METHODS

Multi-stage sampling was used to investigate 3336 nurses in 14 Chinese hospitals. Descriptive statistics and univariate and multivariate logistic regression were employed to reveal the rate of NSIs and their associated factors.

RESULTS

A total of 970 nurses (29.1%) reported having experienced at least one NSI in the past year. The multivariate logistic regression analysis showed that good hospital safety climate and clinical nurses in intensive care unit (ICU) and emergency department had protective effects against NSIs compared with nurses in internal medicine department. The nurse, senior nurse, and nurse in charge have significantly increased the risk for NSIs compared with the associate chief nurse or above. Patients with poor vision but wearing glasses and poor vision but not wearing glasses were more prone to have NSIs. Working in the operating room compared with internal medicine, average weekly working time of >45 h compared with ≤40 h and poor general health led to increased risk of NSIs.

CONCLUSION

The rate of NSIs in clinical nurses was high in China. Individual factors including professional title, department, visual acuity and general mental health and organisational factors including weekly working hours and hospital safety atmosphere were significantly correlated with the occurrence of NSIs.

RELEVANCE TO CLINICAL PRACTICE

Nursing managers should focused on physical and psychological conditions of clinical nurses, and organisational support is required to enhance the hospital safety atmosphere.

NO PATIENT OR PUBLIC CONTRIBUTION

Contributions from patients or the public are irrelevant because this study aims to explore current situation and factors associated with NSIs in clinical nurses.

Did safety-engineered device implementation contribute to reducing the risk of needlestick and sharps injuries? Retrospective investigation of 20 years of observation in a specialist tertiary referral hospital

OBJECTIVES

In Poland, there are numerous cases of injuries caused by sharp instruments annually, still significantly more than in other European Union countries. The aim of this study was to analyze work-related injuries among healthcare workers in a selected hospital before and after the implementation of safety-engineered devices (SED).

MATERIAL AND METHODS

Retrospective analysis of medical documentation regarding occupational needlestick and sharps injuries (NSSI) in a tertiary referral surgical hospital in 1998-2018. The study group consisted of nurses and doctors who had been injured and reported the incident. The frequency of injury reports, injury rate, and characterization of circumstances surrounding NSSI are presented.

RESULTS

Over the period of 20 years, a total of 257 NSSI incidents were reported. The average injury rate was statistically significant for nurses (p = 0.004) and was higher before the introduction of SED. Moreover, the number of injuries among nurses showed a downward trend during the study period. However, for doctors, there was no statistically significant difference in the median puncture rate (p = 0.099), and the number of injuries showed an increasing trend.

CONCLUSIONS

In this study, the authors' have demonstrated not only the occurrence of injuries and punctures in the daily work of medical personnel but also the potential for their reduction through the use of safety equipment at every workstation where healthcare services are provided using sharp medical instruments. Int J Occup Med Environ Health. 2024;37(2):234-43.

Determination and prioritization of factors affecting the occurrence of needle stick injuries among healthcare workers using techniques of Delphi and fuzzy analytical hierarchy process (FAHP)

INTRODUCTION

Needlestick injuries (NSIs) are a major hazard in the workplace for healthcare workers. To prevent these injuries, it is essential to determine the important factors affecting the occurrence of them. This study aimed to identify, classify and prioritize these factors using techniques of Delphi and fuzzy analytical hierarchy process (FAHP).

METHODS

This descriptive-analytical study was conducted in 2022. Firstly, the factors affecting the occurrence of needlestick injuries were identified by the literature review. Moreover, the Delphi technique was used to identify the factors. 20 experts (physicians, nurses, and occupational health experts) participated in the steps of the Delphi method. Then, these factors were grouped into six groups. In the next step, the fuzzy analytical hierarchy process (FAHP) was applied to prioritize the factors. For this purpose, the pairwise comparison questionnaire was designed and filled out by 20 experts. Finally, data were analyzed using MATLAB software (version 2018a).

RESULTS

42 factors (31 factors extracted from the literature review and 11 factors obtained from the Delphi technique) were identified in this study. These factors were categorized into six groups. Based on the results, the relative weight of non-demographic personal factors, tool and technology factors, job factors, organizational factors, demographic personal factors, and environmental factors were computed by 0.200, 0.185, 0.184, 0.157, 0.142, and 0.133, respectively.

CONCLUSION

These results determined the importance of the factors affecting the occurrence of needlestick injuries. These findings can be useful for planning preventive measures.

Sleep and Safety among Healthcare Workers: The Effect of Obstructive Sleep Apnea and Sleep Deprivation on Safety

Almost one billion people worldwide are affected by Obstructive Sleep Apnea (OSA). Affected individuals experience disordered breathing patterns during sleep, which results in fatigue, daytime drowsiness, and/or sleep deprivation. Working under the influence of these symptoms significantly impairs work productivity and leads to occupational accidents and errors. This impact is seen in healthcare workers (HCWs) who are not immune to these conditions. However, poorly controlled OSA in this subset of individuals takes a heavy toll on patient care due to the increased risk of medical errors and can also alter the mental and physical well-being of the affected HCW in various ways. OSA and safety issues have been recognized and mitigated among the airline and transport industries; however, the healthcare industry lags in addressing these concerns. This article reviews hypersomnolence and sleep disorder as key clinical features of OSA and their effect on HCW safety.

Biohazard Accidents, Harmful Elements to the Wellness of Healthcare Workers, and Their Risk Factors

BACKGROUND

For healthcare personnel, biohazard accidents pose a significant risk to their health. These exposures can enable the transmission of pathogens such as Hepatitis B, Hepatitis C, and human immunodeficiency virus (HIV).

OBJECTIVE

To indicate and quantify the risk associated with higher threatening situations, such as biohazard accidents on repeated occasions or incorrect notifications to injured healthcare professionals.

METHODS

A cross-sectional study was conducted at the Poniente Hospital in Almeria (Spain). In total, 592 participants reported 1062 accidents and their characteristics and notifications were analyzed.

RESULTS

It was found that women (OR = 1.29) working in the surgical area (OR = 2.92), those on indefinite contracts (OR = 1.67), and those with high work experience (OR = 1.14) were the main risk factors for multiple biohazard accidents. Concerning the incorrect notification of these accidents, the main risk factors were work performance during the afternoon shift (OR = 1.72) and the fact that the accident was caused by the injured worker himself (OR = 1.53).

CONCLUSIONS

This study outlined the main factors that can contribute to healthcare professionals suffering these accidents. As a result, corrective measures must be taken against these risk factors to improve safety for healthcare workers in the future.

Prevention from Sharp Injuries in the Hospital Sector: An Italian National Observatory on the Implementation of the Council Directive 2010/32/EU before and during the COVID-19 Pandemic

Sharp injuries, determining the risk of bloodborne infections and psychological distress in healthcare workers, may be prevented by a set of strategies, legally enforced in Europe through the Directive 2010/32/EU. To assess its level of implementation in Italy, a national survey was conducted in 2017 and again in 2021, evaluating the progress and possible drawbacks of the COVID-19 pandemic. Altogether, 285 safety managers and 330 nurses from a representative sample of 97 and 117 public hospitals were interviewed using a standardized questionnaire. Knowledge of the Directive requirements decreased significantly, with <60% of participants answering correctly in 2021, and nurses' attendance in specific courses dropped to 25% in 2021 compared to 54% in 2017. Over 75% of hospitals introduced multiple safety-engineered devices (SED), though total replacement occurred in <50% of cases; routine SED availability increased for blood collection (89%) and venous access devices (83%). Incorrect behaviors in handling sharps decreased significantly over time. Nurses' HBV vaccination coverage was high (89% in both surveys); in the last year, 97% were vaccinated against COVID, and 47% against influenza. Average annual injuries per hospital did not increase significantly (32 in 2021 vs. 26 in 2017). In 2017, nurses' perceived safety barriers were working in emergency situations (49%) and lack of resources (40%); in 2021, understaffing (73%), physical fatigue (62%), and handling difficulties while wearing full protective equipment (59%). Safety measures were implemented in Italian hospitals, and although the average injuries per hospital did not show a decrease, these measures could have helped protect healthcare workers during the pandemic, mitigating its potential impact on the increase in situations at risk of injury.