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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Alvear Fa B, Reid L, Radjaeipour G. Behavioural video to navigate predoctoral dental students toward safer practice (revision of EJE-21-4739). Eur J Dent Educ 2023; 27:841-848. [PMID: 36367346 DOI: 10.1111/eje.12874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Local anaesthesia is considered essential knowledge within the dental profession as it helps to address pain management. Operator percutaneous needlestick injuries associated with the delivery of dental anaesthesia are common for dental healthcare providers. The study proposes a supplemental technique to reduce self-inducing novice operator needlestick injury to complement existing pedagogies for the preclinical local anaesthesia curriculum. The purpose of the study is to evaluate whether a local anaesthesia behavioural video can navigate students to safer clinical practice. Further, a supplemental technique is proposed in whether assessing instrument retraction technique in clinical patient care leads to decreased self-inducing intraoral needle stick injury for novice predoctoral dental operator. MATERIALS AND METHODS Beginning in 2011, predoctoral dental students were asked to view a "what not to do" video within a summative assessment and identify at least five behaviours that were unacceptable errors for delivering local anaesthesia. Operator intraoral needlestick injury was also tracked per the bloodborne exposure reports within predoctoral patient clinics. RESULTS Data from the learners' responses identified progression in recognising unacceptable errors from behavioural video. Intraoral needlestick injury, 8 and 9 years prior and after the introduction of video showed significance with a low correlation coefficient. CONCLUSION More data need to be gathered and evaluated in other dental school settings to determine whether this supplemental educational video decreases needlestick injury in novice operators. Results suggest this behavioural video may guide novice operators to overall safer clinical practice.
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Affiliation(s)
- Bernadette Alvear Fa
- Department of Preventive and Restorative Dentistry, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, USA
| | - Laura Reid
- Department of Preventive and Restorative Dentistry, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, USA
| | - Gitta Radjaeipour
- Department of Preventive and Restorative Dentistry, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, USA
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Ravi A, Shetty PK, Singh P, Wakode D, Modica SF, Kodaganallur Pitchumani P, Thomas DC. Needlestick injuries in dentistry: Time to revisit. J Am Dent Assoc 2023; 154:783-794. [PMID: 37530693 DOI: 10.1016/j.adaj.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Blood-borne pathogens (BBPs) are infectious microorganisms that are found in human blood and can cause diseases in humans. Health care workers such as physicians, surgeons, nurses, dentists, dental students, dental assistants, laboratory technicians, personnel handling infectious waste, and other health care employees are at increased risk of exposure to these pathogens. Percutaneous injuries from needles or other sharp objects are the major sources of BBPs in the workplace. Needlestick injuries (NSIs) have the most potential to transmit and have the easiest mode of transmission of BBPs. TYPES OF STUDIES REVIEWED The authors searched electronic databases (PubMed, Web of Science, Google Scholar, Scopus, Embase, MEDLINE-Ovid) for studies and articles focused on the various aspects of NSIs, their possible causes, prevention, and management protocols. RESULTS There is a lack of literature on the global prevalence of NSIs among dental practitioners and underreporting of NSIs by clinicians. The authors also found that dental students and inexperienced practitioners were the most vulnerable. They found apparent inconsistencies in guidelines and recommendations from various regulatory and statutory agencies in charge of limiting and managing NSIs. CONCLUSION The most significant occupational risks for health care workers globally are NSIs. Dentists are recognized as one of the high-risk groups for exposure to NSIs. Although the reporting rate was noticeably low, the frequency of NSIs among dental students was alarmingly high. PRACTICAL IMPLICATIONS Appropriate and succinct training of dental health care workers is crucial for prevention and management of NSIs. It is recommended that dentists familiarize themselves with recommendations from such agencies and organizations as the Center for Disease Control and Prevention, Occupational Safety and Health Administration, and American Dental Association.
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Mohamed M, Tandon N, Kim Y, Kopp I, Tanaka N, Mikamo H, Friedman K, Bajpai S. Needlestick Injuries With Insulin Injections: Risk Factors, Concerns, and Implications of the Use of Safety Pen Needles in the Asia-Pacific Region. J Diabetes Sci Technol 2023:19322968231186402. [PMID: 37475682 DOI: 10.1177/19322968231186402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Globally, health care workers (HCWs) are at a high risk of occupational exposure to needlestick injuries (NSIs). Needlestick injuries not only are associated with an increased risk of infections caused by bloodborne pathogens but are also a primary source of emotional distress and job burnout for HCWs and patients. Insulin injection-related NSIs are common among HCWs working in hospitals in the Asia-Pacific (APAC) region and impose a significant burden. Insulin pen needles have a high risk of transmitting infections (at both the patient-end and cartridge end of the sharp) after use. Recapping a needle after administering an insulin injection poses a major risk to HCWs. Currently, several safety-engineered needle devices (SENDs) are available with active or passive safety mechanisms. Passive insulin safety pen needles with dual-ended protection and automatic recapping capabilities have resulted in a significant drop in accidental punctures to HCWs while administering insulin to patients with diabetes. In this article, we have reviewed the burden and common causes of NSIs with insulin injections among HCWs in the APAC region. We have discussed current approaches to address the issues associated with NSIs and the benefits of introducing SENDs in health care settings, including long-term care facilities, nursing homes, and home care settings where patients may require assisted insulin injections. This review also summarizes key strategies/recommendations to prevent NSIs in HCWs and patients with diabetes in the APAC region.
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Affiliation(s)
- Mafauzy Mohamed
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Youngsoon Kim
- Kangwon National University Hospital, Gangwon-do, South Korea
| | - Irene Kopp
- Nepean Diabetes Service, Nepean Hospital, Kingswood, NSW, Australia
| | - Nagaaki Tanaka
- Center for Diabetes, Endocrinology and Metabolism, Kansai Electric Power Hospital, Osaka, Japan
| | - Hiroshige Mikamo
- Department of Clinical Infectious Diseases, Aichi Medical University, Aichi, Japan
| | - Kevin Friedman
- embecta (formerly BD Diabetes Care), Parsippany, NJ, USA
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Kang MS, Park HB, Kim S, Kim I, Kim DH. Clinical, Electrophysiological, and Sonographic Findings in Patients With Nerve Injury After Vessel Puncture. J Clin Neurol 2023; 19:371-375. [PMID: 37417433 DOI: 10.3988/jcn.2022.0285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/03/2022] [Accepted: 11/09/2022] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND AND PURPOSE This study aimed to describe the clinical, electrophysiological, and ultrasonographic findings of patients with nerve injury after vessel puncture. METHODS Data on ten patients (three males and seven females) with nerve injury after vessel puncture were reviewed. Demographic and clinical data were analyzed retrospectively. Bilateral electrophysiological studies were performed based on clinical findings. Ultrasonographic examinations were performed on both the affected and unaffected sides of the injured nerve. RESULTS The nerves of nine patients were injured following vein puncture, and injury occurred following arterial sampling in one patient. Seven patients had superficial radial sensory nerve injury: five medial, one lateral, and one at both branches. One patient had injury to the dorsal ulnar cutaneous nerve, one to the lateral antebrachial cutaneous nerve, and one to the median nerve. Nerve conduction studies produced abnormal findings in 80% of patients, whereas ultrasonographic examinations produced abnormal findings in all of the patients. Spearman's coefficient for the correlation between the amplitude ratio and nerve cross-sectional area ratio was not significant, at -0.127 (95% confidence interval=-0.701 to 0.546, p=0.721). CONCLUSIONS Ultrasonography supported by electrodiagnosis was found to be a useful method for identifying the lesion location and structural abnormalities of vessel-puncture-related neuropathy.
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Affiliation(s)
- Min Seok Kang
- Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, Ansan Hospital, Ansan, Korea
| | - Hong Bum Park
- Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, Ansan Hospital, Ansan, Korea
| | - Seohyun Kim
- Korea University College of Medicine, Seoul, Korea
| | - Ihyun Kim
- Korea University College of Medicine, Seoul, Korea
| | - Dong Hwee Kim
- Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, Ansan Hospital, Ansan, Korea.
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Kumah A, Forkuo-Minka AO. Advancing Staff Safety: Assessment of Quality Improvement Interventions in Reducing Needlestick Injuries Among Staff at Nyaho Medical Centre. Glob J Qual Saf Healthc 2023; 6:55-61. [PMID: 37333756 PMCID: PMC10275633 DOI: 10.36401/jqsh-22-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 04/01/2023] [Accepted: 04/10/2023] [Indexed: 06/20/2023]
Abstract
Introduction Needlestick injury, which occurs when the skin is accidentally punctured, is linked to infection transmission of HIV, hepatitis B, and hepatitis C. Because of the associated risks, hospitals are keen to do everything necessary to prevent needlestick injuries to their staff. This is a quality improvement project aimed at reducing needlestick injuries among staff at Nyaho Medical Centre (NMC). Methods A facility-based assessment of the incidence of needlestick injury recorded and quality intervention employed was conducted between 2018 and 2021. Quality improvement tools such as the fishbone (cause and effect analysis) and the run chart were used to analyze and evaluate improvements made over time. Results NMC staff have greatly reduced the incidence of needlestick injuries from 2018 to 2021 (from 11 needlestick injuries in 2018 to 3 recorded needlestick injuries in 2021). Conclusion Using root cause analysis to investigate the possible cause of needlestick injury and use of the run chart to monitor the implemented improvement strategies (interventions) helped reduce the incidence of needlestick injuries among staff and thereby improved staff safety. The introduction of the incident reporting management systems saw an increase in the culture of incident reporting in general. Other incidents, such as medical errors and patient falls, were being reported using the incident reporting system. The inclusion of infection prevention and control training as part of NMC's onboarding for new employees helped in the knowledge and awareness creation of needlestick injuries and safety measures to prevent injury from needles and sharps. Policy changes and audit with feedback sharing key performance indicators with frontline team members were identified to have had the most effect.
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Moheimani R, Arastoo S, Lowder R, Reddy R, Kim H, Chen A, Pangarkar S. A survey of pain physicians: Needlesticks injuries. Pain Pract 2023. [PMID: 37067198 DOI: 10.1111/papr.13230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/19/2023] [Accepted: 03/24/2023] [Indexed: 04/18/2023]
Abstract
OBJECTIVE To investigate and characterize the incidence of needlestick injuries (NSI) in a sample of practicing pain medicine physicians, with the ultimate goal of aiding to prevent these injuries by raising awareness of their prevalence. DESIGN A cross-sectional research survey. SETTING A REDCap survey was emailed to physicians who had membership to the American Academy of Pain Medicine. SUBJECTS Eligibility criteria included physicians who were actively practicing and identified as pain physicians who participated in procedures with needlesticks or sharps. METHODS Basic demographics without identifiers were collected, including practice setting, years in practice, and training type. Respondents were asked to estimate the number of sharps-involved procedure days per week and per day. They were then asked to estimate the number of NSIs they sustained since completing training and in the past year. RESULTS A total of 430 surveys were opened by email by potential participants, of which 124 responded (response rate 29%). Data from a total of 109 respondents that met inclusion criteria were included. Roughly 60% of respondents reported at least one NSI since completing training and approximately one-third had sustained more than three NSIs. In the last year, roughly 19% of providers reported at least one needlestick injury. The number of NSIs reported by providers since completing training was not significantly associated with practice setting, the number of procedure days per week, or the number of sharps-involved procedures per day. There was a significant relationship between years post-training and number of NSIs since completing training, with providers with more years post-training reporting higher incidences of NSIs (p < 0.0005). The number of NSIs since completing training and the number of NSIs were also associated, with providers that had sustained a greater number of total NSIs reporting a higher incidence of NSIs within the last year (p < 0.0005). CONCLUSIONS This study characterizes NSIs in a population of pain medicine physicians. These data warrant caution and will hopefully raise awareness amongst providers.
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Affiliation(s)
- Roya Moheimani
- Department of Physical Medicine & Rehabilitation, VA Greater Los Angeles Healthcare System/UCLA, Los Angeles, California, USA
- Department of Anesthesiology and Pain Medicine, University of California San Diego Health Sciences, La Jolla, California, USA
| | - Sara Arastoo
- Department of Anesthesiology and Perioperative Medicine, University of California Los Angeles, Los Angeles, California, USA
- David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Ryan Lowder
- David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Rajiv Reddy
- Department of Anesthesiology and Pain Medicine, University of California San Diego Health Sciences, La Jolla, California, USA
| | - Hyung Kim
- David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Department of Physical Medicine & Rehabilitation and Pain Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Allen Chen
- David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Department of Orthopedic Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Sanjog Pangarkar
- David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Department of Physical Medicine & Rehabilitation and Pain Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
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Abstract
We report a case of monkeypox in a physician after an occupational needlestick injury from a pustule. This case highlights risk for occupational transmission and manifestations of the disease after percutaneous transmission: a short incubation period, followed by a solitary lesion at the injured site and later by systemic symptoms.
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Friel BA, Sieradzan R, Jones C, Katz RA, Smith CM, Trenery A, Gee J. Leveraging Partnerships to Reduce Insulin Needlestick Injuries: Nurse-Led System-Wide Quality Improvement Project. J Nurs Care Qual 2022; 37:14-20. [PMID: 34446664 PMCID: PMC8608009 DOI: 10.1097/ncq.0000000000000592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Percutaneous injuries from needlesticks are a major occupational hazard for nurses. LOCAL PROBLEM Reducing subcutaneous insulin-related needlestick injuries was part of a nurse-led comprehensive sharps injury-reduction program at an integrated, not-for-profit health system. METHODS The incident rate of needlestick injuries was compared between 1 year before and 1 year after introducing this quality improvement project. INTERVENTIONS A system-wide educational program instituting changes in subcutaneous insulin administration practices was combined with supply chain standardization using a single type of safety-engineered insulin syringe. RESULTS The average monthly incidence of needlestick injuries per 10 000 subcutaneous insulin injections fell significantly from year to year (incidence rate ratio, 0.49; 95% CI, 0.30-0.80; Poisson regression P = .004). One-year cost savings for supplies totaled $3500; additional annual median savings were $24 875 (2019 US dollars) in estimated costs of needlestick injuries averted. CONCLUSIONS The effectiveness of this multifaceted project provides a practical template to reduce subcutaneous insulin-related needlestick injuries.
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Affiliation(s)
- Beth Ann Friel
- Intermountain Healthcare, Salt Lake City, Utah (Mss Friel and Katz, Messrs Jones and Smith, and Dr Gee); and Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey (Drs Sieradzan and Trenery). Dr Gee is now with the University of Utah College of Nursing, Salt Lake City
| | - Ray Sieradzan
- Intermountain Healthcare, Salt Lake City, Utah (Mss Friel and Katz, Messrs Jones and Smith, and Dr Gee); and Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey (Drs Sieradzan and Trenery). Dr Gee is now with the University of Utah College of Nursing, Salt Lake City
| | - Chris Jones
- Intermountain Healthcare, Salt Lake City, Utah (Mss Friel and Katz, Messrs Jones and Smith, and Dr Gee); and Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey (Drs Sieradzan and Trenery). Dr Gee is now with the University of Utah College of Nursing, Salt Lake City
| | - Rachael A. Katz
- Intermountain Healthcare, Salt Lake City, Utah (Mss Friel and Katz, Messrs Jones and Smith, and Dr Gee); and Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey (Drs Sieradzan and Trenery). Dr Gee is now with the University of Utah College of Nursing, Salt Lake City
| | - Cole M. Smith
- Intermountain Healthcare, Salt Lake City, Utah (Mss Friel and Katz, Messrs Jones and Smith, and Dr Gee); and Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey (Drs Sieradzan and Trenery). Dr Gee is now with the University of Utah College of Nursing, Salt Lake City
| | - Alyssa Trenery
- Intermountain Healthcare, Salt Lake City, Utah (Mss Friel and Katz, Messrs Jones and Smith, and Dr Gee); and Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey (Drs Sieradzan and Trenery). Dr Gee is now with the University of Utah College of Nursing, Salt Lake City
| | - Julie Gee
- Intermountain Healthcare, Salt Lake City, Utah (Mss Friel and Katz, Messrs Jones and Smith, and Dr Gee); and Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey (Drs Sieradzan and Trenery). Dr Gee is now with the University of Utah College of Nursing, Salt Lake City
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Makeen AM, Alharbi AA, Mahfouz MS, Alqassim AY, Ismail AA, Arishi HM, El-Setouhi MA, Horner RD, Muaddi MA. Needlestick and sharps injuries among secondary and tertiary healthcare workers, Saudi Arabia. Nurs Open 2021; 9:816-823. [PMID: 34806326 PMCID: PMC8685775 DOI: 10.1002/nop2.1136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 09/03/2021] [Accepted: 11/07/2021] [Indexed: 01/24/2023] Open
Abstract
Aim The study aimed to assess the incidence of needlestick and sharps injuries among healthcare workers (HCWs) in the Jazan region of Saudi Arabia, as well as to determine whether there exists an association between hospital level and needlestick and sharps injuries rate. Design A cross‐sectional survey was conducted among 609 randomly selected HCWs from nine general hospitals. Methods A self‐administered questionnaire, which covered the structure and process of injection safety, was used for data collection. Results The overall needlestick and sharps injuries incidence rate was 24%. The needlestick and sharps injuries rates were 30% and 14% in secondary and tertiary hospitals, respectively. HCWs working in tertiary hospitals were 61% less likely to have needlestick and sharps injuries than those employed in secondary hospitals. This was mainly the impact of better and continuous training. High safety level maintenance and health education provision are vital in such settings.
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Affiliation(s)
- Anwar M Makeen
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan City, Jazan, Saudi Arabia
| | - Abdullah A Alharbi
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan City, Jazan, Saudi Arabia
| | - Mohammed S Mahfouz
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan City, Jazan, Saudi Arabia
| | - Ahmad Y Alqassim
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan City, Jazan, Saudi Arabia
| | - Ahmed A Ismail
- Kansas Department of Health and Environment, Topeka City, Kansas, USA
| | - Haider M Arishi
- King Fahad Central Hospital, Jazan Health Department, Jazan City, Jazan, Saudi Arabia
| | - Maged A El-Setouhi
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan City, Jazan, Saudi Arabia
| | - Ronnie D Horner
- Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia City, South Carolina, USA
| | - Mohammed A Muaddi
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan City, Jazan, Saudi Arabia
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Ou YS, Wu HC, Guo YL, Shiao JSC. Comparing risk changes of needlestick injuries between countries adopted and not adopted the needlestick safety and prevention act: A meta-analysis. Infect Control Hosp Epidemiol 2021;:1-7. [PMID: 34674781 DOI: 10.1017/ice.2021.372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To determine whether countries that adopted the Needlestick Safety and Prevention Act (NSPA) achieved a reduced risk of needlestick injuries (NSIs). METHOD In this meta-analysis, 3 international databases (Embase, PubMed, and MEDLINE EBSCO) and 1 Chinese database (Airiti Library) were searched using appropriate keywords to retrieve relevant articles, including multiyear NSI incidences that were published after 2010. The Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies was used to evaluate article prevalence. A binary random-effects model was used to estimate risk ratio as summary effect. A log scale was used to evaluate differences in risk ratios of NSIs between countries that adopted versus those that did not adopt the NSPA. RESULTS In total, 11 articles were included in the meta-analysis from 9 countries, and NSI incidence rates were surveyed between 1993 and 2016. The risk ratios of NSIs in countries with and without the NSPA were 0.78 (95% CI, 0.67-0.91) and 0.98 (95% CI, 0.85-1.12), respectively, and the ratio of risk ratios was 0.79 (95% CI, 0.65-0.98). Reduction in NSI incidence was more prominent in nurses than in physicians. CONCLUSIONS Our findings suggest that the mandatory use of safety-engineered medical devices in countries that adopted the NSPA had lower NSI incidence in healthcare workers compared with countries without needlestick safety and prevention regulatory policies. Further studies are needed to develop preventive strategies to protect against NSIs in physicians, which should be incorporated into the standards of care established by national regulatory agencies.
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Gębska-Kuczerowska A, Kucharska I, Segiet-Święcicka A, Kuczerowski M, Gajda R. Assessment of Epidemiological Safety in the Cosmetic Service Industry in Poland: A Cross-Sectional Questionnaire Study. Int J Environ Res Public Health 2021; 18:ijerph18115661. [PMID: 34070627 PMCID: PMC8199086 DOI: 10.3390/ijerph18115661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/07/2021] [Accepted: 05/20/2021] [Indexed: 12/22/2022]
Abstract
The variety of current cosmetic procedures has increased the potential risks of adverse events and infections. In a nationwide cross-sectional study (2013-2015), we assessed the aspects of infection risk in cosmetic services. An anonymous voluntary questionnaire survey was conducted among 813 employees of cosmetic establishments in Poland. The establishments were selected from a register of service providers. The survey was conducted by employees of the State Sanitary Inspectorate during an audit, and the results showed that cosmetic providers were not fully prepared for risk assessment in terms of occupational exposure or infection transmission. The majority of the respondents (84%) reportedly washed the salon tools. Some establishments did not perform any decontamination (2%) or sterilization (~13%) procedures. Occupational punctures or lacerations occurred from needles, ampoules-syringes, or razors. Most respondents had attended professional training or studied medical textbooks. Approximately 1.7% of the respondents had not updated their knowledge, and 5% gained knowledge from unauthorized sources.The project's results impacted a variety of innovations and improvements in the field of public health. The results were used to update the national education program (2012-2017); more attention has been directed toward effective education in infection prevention, general hygiene, and post-exposure procedures. Moreover, the study's results were grounds for the introduction of legislative modifications in the field of epidemiological safety standards for cosmetic services in Poland.
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Affiliation(s)
- Anita Gębska-Kuczerowska
- Collegium Medicum, Cardinal Stefan Wyszynski University, KazimierzaWóycickiego 1/3, 01-938 Warsaw, Poland
- Correspondence: ; Tel.: +48-507-037-736
| | | | - Agnieszka Segiet-Święcicka
- Faculty and Department of Experimental Physiology, Medical University of Warsaw, ŻwirkiiWigury 61, 02-091 Warsaw, Poland;
| | - Marcin Kuczerowski
- Clinical Department of Oncological Gynecology and Obstetrics, prof. Witlold Orłowski Hospital, Czerniakowska, 231, 00-416 Warsaw, Poland;
| | - Robert Gajda
- Gajda-Med Medical Center, ul. PiotraSkargi 23/29, 06-100 Pułtusk, Poland;
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Malek AE, Fife CE, Rasmussen JC, Karni RJ, Morrow JR, Wanger A, Sevick-Muraca EM, Ostrosky-Zeichner L. Lymphatic Dissemination and Axillary Web Syndrome in Primary Cutaneous Tuberculosis Secondary to Needlestick Injury. Open Forum Infect Dis 2021; 8:ofab160. [PMID: 34322561 PMCID: PMC8312518 DOI: 10.1093/ofid/ofab160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/25/2021] [Indexed: 11/14/2022] Open
Abstract
Cutaneous tuberculosis secondary to skin inoculation of Mycobacterium tuberculosis is uncommon but it can occur in the health care settings. Herein, we report an unusual case of primary cutaneous tuberculosis of the thumb following a needlestick injury. The infection progressed with a necrotic granuloma, lymphatic dysfunction as visualized by near-infrared fluorescence lymphatic imaging, and the development of an axillary web syndrome.
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Affiliation(s)
- Alexandre E Malek
- Department of Internal Medicine, Division of Infectious Diseases, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA.,Department of Infectious Diseases, Infection Control and Employee Health, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Caroline E Fife
- Department of Geriatrics, Baylor College of Medicine, Houston, Texas, USA.,CHI St Luke's Hospital, The Woodlands, Texas, USA
| | - John C Rasmussen
- Center for Molecular Imaging, Brown Foundation Institute for Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Ron J Karni
- Department of Otorhinolaryngology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - John R Morrow
- Center for Molecular Imaging, Brown Foundation Institute for Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Audrey Wanger
- Department of Microbiology and Molecular Genetics, McGovern School of Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Eva M Sevick-Muraca
- Center for Molecular Imaging, Brown Foundation Institute for Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Luis Ostrosky-Zeichner
- Department of Internal Medicine, Division of Infectious Diseases, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
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Ahadizadeh EN, Quintanilla-Dieck L, Pfeifer H, Wax MK. Needlestick Injury in Otolaryngology-Head and Neck Surgery Resident Programs. Laryngoscope 2020; 131:E1076-E1080. [PMID: 33141429 DOI: 10.1002/lary.29234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 10/13/2020] [Accepted: 10/17/2020] [Indexed: 01/27/2023]
Abstract
OBJECTIVES/HYPOTHESIS Up to 800,000 percutaneous injuries involving healthcare workers occur each year. The morbidity of needlestick injuries (NSIs) ranges from nothing to death. The incidence of NSI in otolaryngology residency is deemed to be high based on prior studies. This study aimed at defining the trends in otolaryngology residents regarding sharps exposure. STUDY DESIGN Cross-sectional study using survey/questionnaire. METHODS Otolaryngology accredited residency programs in North America were surveyed in 2013 and 2017 regarding their experience with NSI and perceived risk of acquiring a blood-borne infection. RESULTS Surveys were received from 314 residents (31 programs). There was a total of 509 needlesticks, primarily occurring during junior years (post-graduate year 1-3, 81%). Sixty-eight percent of residents had experienced an NSI. Of the residents that had an injury, the mean number of sticks was 2.37 sticks/resident. Junior residents were less likely to report their injury compared to senior residents (50% vs. 30%). The primary reason for not reporting was the time commitment. Residents underestimated their risk of acquiring human immunodeficiency virus (51% of residents) and overestimated their risk of acquiring hepatitis C virus (90% of residents). CONCLUSIONS Occupational exposure is high in healthcare and particularly high in surgical trainees. The majority of otolaryngology trainees undergo a needlestick injury in their junior years. There continues to be underreporting of these injuries by residents, who report that the process is too time-consuming. Most residents do not have an accurate understanding of their actual risk of acquiring a blood-borne disease. These findings emphasize the need for education regarding risks and development of strategies to encourage reporting of injuries. LEVEL OF EVIDENCE VI Laryngoscope, 131:E1076-E1080, 2021.
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Affiliation(s)
- Emily N Ahadizadeh
- Department of Otolaryngology Head and Neck Surgery, Oregon Health and Sciences University, Portland, Oregon, U.S.A
| | - Lourdes Quintanilla-Dieck
- Department of Otolaryngology Head and Neck Surgery, Oregon Health and Sciences University, Portland, Oregon, U.S.A
| | - Hailey Pfeifer
- School of Medicine, Oregon Health and Sciences University, Portland, Oregon, U.S.A
| | - Mark K Wax
- Department of Otolaryngology Head and Neck Surgery, Oregon Health and Sciences University, Portland, Oregon, U.S.A.,Department of Oral and Maxillofacial Surgery, Oregon Health and Sciences University, Portland, Oregon, U.S.A
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15
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Getie A, Wondmieneh A, Tesfaw G. The Prevalence of Needlesticks and Sharp Injuries, and the Associated Factors Among Midwives and Nurses in North Wollo Zone Public Hospitals, North East Ethiopia: An Institution-based Cross-sectional Study. Drug Healthc Patient Saf 2020; 12:187-193. [PMID: 33116914 PMCID: PMC7573301 DOI: 10.2147/dhps.s273669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 09/17/2020] [Indexed: 02/05/2023]
Abstract
Background Health professionals are at high risk of exposure for needlestick or sharp injury due to repeated exposure in clinical areas. This exposure leads to the acquiring of different infectious diseases like human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and other infectious diseases. Nurses and midwives having repeated exposure due to long working time, not wearing personal protective equipment, less work experience, and who are unable to apply infection prevention utilization guidelines are at high risk of needlestick and sharp injuries. Methods An institutional-based, cross-sectional study design was conducted in North Wollo Zone public hospitals. A simple random sampling technique was applied to select study subjects. The method of data collection was self-administered questionnaires that are structured and pretested from February to March 2019. The data were analyzed using both descriptive and analytical statistics. Binary logistic regressions were used to test the association between variables. Then, P-value <0.05 was considered as statistically significant in this study. Results Of the 147 respondents who participated in the study, 50.3% were female and 49.7% were male. The prevalence of needlestick and the sharp injuries was 75.5%. Recap practice of needle (AOR: 3.880; 95%CI: 1.666–9.036), working room (maternal care room) (AOR: 2.968; 95%CI: 1.012–8.703), and contagious room like emergency room (AOR: 3.587; 95%CI: 1.383–9.301) are significantly associated with needlestick and sharp injuries. Conclusion This study showed that three-quarters of the study subjects were exposed to needlestick injury at least once in the past year. Needle recapping practice and working room were associated with needlestick and sharp injuries. Then, health personnel should avoid the practice of recapping a needle and tale care themself to avoid needle and sharp injuries in the workplace.
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Affiliation(s)
- Addisu Getie
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Adam Wondmieneh
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Getachew Tesfaw
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
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16
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Gębska-Kuczerowska A, Kucharska I, Segiet-Swiecicka A, Kuczerowski M, Gajda R. Assessing Infection Risks among Clients and Staff Who Use Tattooing Services in Poland: An Observational Study. Int J Environ Res Public Health 2020; 17:E6620. [PMID: 32932896 DOI: 10.3390/ijerph17186620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 12/16/2022]
Abstract
Across cultures and generations, people have tattooed their bodies. Although blood-borne infections from tattooing have been reduced, certain service aspects remain improperly managed. We assessed the infection risks associated with tattooing by conducting a cross-sectional study (2013–2014) in Poland using an anonymous questionnaire survey. Scoring procedures for blood-borne infection risks for tattooists and their clients were used. Overall, 255 tattooists were interviewed. A quasi-random selection of tattoo parlors was based on a service register. Knowledge, attitudes, and behavior regarding blood-borne infection risks were assessed using a questionnaire. Simultaneously, tattoo centers were audited. Tattooing had a higher infection risk for tattooists than for clients. Approximately 50% of respondents underwent training on postexposure procedures, which constituted almost one in five of the reported needlestick/cut injuries sustained while working. Furthermore, 25.8% had no knowledge regarding risk from reliable sources, and 2.1% had not broadened their knowledge. Tattooists and their clients are at a risk of infection, and knowledge concerning infection risks remains an underestimated preventative factor. Service quality surveillance and creation of a register for tattoo-related complications may help assess the scale of this public health issue. However, a lack of these records implies the challenges in developing effective organizational and legal protections.
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17
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Shintani T, Iwata T, Okada M, Nakaoka M, Yamasaki N, Fujii T, Shiba H. Clinical Outcomes of Post-exposure Prophylaxis following Occupational Exposure to Human Immunodeficiency Virus at Dental Departments of Hiroshima University Hospital. Curr HIV Res 2020; 18:475-479. [PMID: 32753017 PMCID: PMC8388063 DOI: 10.2174/1570162x18666200804151118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 11/22/2022]
Abstract
Background Dental professionals have so many opportunities to use injection needles and sharp instruments during dental treatment that they face an increased risk of needlestick injuries. This retrospective study reports the utilization and clinical outcomes of occupational post-exposure prophylaxis (PEP) with anti-retroviral agents after being potentially exposed to HIV at the dental departments of Hiroshima University Hospital. Objective This study reports the utilization and clinical outcomes of occupational post-exposure prophylaxis (PEP) with antiretroviral agents after being potentially exposed to HIV at dental departments of Hiroshima University Hospital. Methods Data on the clinical status of HIV-infected source patients and information on HIV-exposed dental professionals from 2007 to 2018 were collected. Results Five dentists with an average experience of 5.6 years (1-15 years) were exposed. The averaged CD4-positive cell number and HIV-RNA load were 1176 (768-1898) /μl and less than 20 copies/ml, respectively, in all the patients. Two of the five HIV exposed dentists received PEP. Three months after the exposures, all of their results were negative in HIV antibody/antigen tests. Conclusion These data might support the concept of “undetectable equals untransmittable”, although HIV exposure in this study was not through sexual transmission.
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Affiliation(s)
- T Shintani
- Center of Oral Clinical Examination, Hiroshima University Hospital, Japan
| | - T Iwata
- Department of Periodontal Medicine, Graduate School of Biomedical & Sciences, Hiroshima University, Japan
| | - M Okada
- Division of Dental Hygiene, Department of Clinical Practice and Support, Hiroshima University Hospital, Japan
| | - M Nakaoka
- Division of Dental Hygiene, Department of Clinical Practice and Support, Hiroshima University Hospital, Japan
| | - N Yamasaki
- Division of Blood Transfusion, Hiroshima University Hospital, Japan,AIDS Care Unit, Hiroshima University Hospital, Japan
| | - T Fujii
- Division of Blood Transfusion, Hiroshima University Hospital, Japan,AIDS Care Unit, Hiroshima University Hospital, Japan
| | - H Shiba
- Center of Oral Clinical Examination, Hiroshima University Hospital, Japan,Department of Biological Endodontics, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
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18
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Abstract
BACKGROUND Needlestick injuries (NSIs) are common healthcare-related injuries and possible consequences include blood-borne infections. Despite that, a large proportion of NSIs are not reported. AIMS To estimate the prevalence of under-reporting of NSIs and to evaluate the knowledge, attitude and behaviour towards NSIs among junior doctors in a tertiary hospital in Singapore. METHODS An explanatory sequential mixed-methods design was employed. Quantitative data were collected through questionnaires completed by 99 junior doctors. Descriptive statistics and bivariate analysis were performed to evaluate socio-demographic characteristics, NSI history and NSI reporting practices. Qualitative data were collected through 12 in-depth interviews. Participants were purposively recruited, and semi-structured topic guides were developed. Data were analysed using a thematic approach. RESULTS Fifty-two per cent of respondents had history of NSI. Of those with history of NSI, 31% did not report injury. NSI reporters were 1.52 times as likely to be aware of how to report injury (P < 0.05), and 1.63 times as likely to feel that reporting benefits their health (P < 0.01) compared with non-reporters. NSI reporters were 83% more likely to report a clean NSI (P = 0.05). For non-reporters, the main reasons for not reporting were perceived low risk of transmission (41%) and lack of time to report (35%). Themes identified in the qualitative data include perceived benefits, perceived barriers, perceived threats, cues to action and organizational culture. CONCLUSION Under-reporting of NSIs may have significant implications for patients and healthcare workers. Addressing identified factors and instituting targeted interventions will help to improve reporting rates.
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Affiliation(s)
- M W Ong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - J Hwang
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - S M Lim
- Occupational Health Clinic, National University Health Systems, Singapore, Singapore
| | - J Sng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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19
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Lee JT, Gaertner WB. Workplace Exposures. Clin Colon Rectal Surg 2019; 32:435-441. [PMID: 31686995 DOI: 10.1055/s-0039-1693010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Workplace exposure in colorectal surgery is unique compared with other surgical specialties and generally underreported. Although the most common device-associated exposure in surgery is suture needle injury, colorectal surgeons are increasingly exposed to gastrointestinal-related infectious agents, radiation, and other hazards in multiple different clinical settings. Highlighting the unique workplace exposures in colorectal surgery may help increase awareness, improve education, and identify possible targets for early intervention in order to minimize these risks.
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Affiliation(s)
- Janet T Lee
- Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Wolfgang B Gaertner
- Division of Colon and Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, Minnesota
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20
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Hakeem A, Alsaigh S, Alasmari A, Aloushan A, Bin Saleh F, Yousef Z. Awareness, Concerns, and Protection Strategies Against Bloodborne Viruses Among Surgeons. Cureus 2019; 11:e4242. [PMID: 31131165 PMCID: PMC6516613 DOI: 10.7759/cureus.4242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Surgeons are at high risk of contracting infectious viruses such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) through exposure to patients' blood. The purpose of this study was to assess the surgeons' awareness of contracting bloodborne viruses. Methods: A cross-sectional study with a questionnaire distributed to 241 surgeons at King Abdulaziz Medical City - Riyadh (KAMC-R) during the period June 2017 through January 2018. Descriptive statistics were used to analyze data collected using Stata®, v14 (StataCorp LLC, College Station, Texas, USA). Categorical variables were analyzed using Pearson chi-square test. P-value of < 0.05 was considered significant. RESULTS A total of 241 surgeons answered the questionnaire, 179 (74.3%) surgeons were male and 62 (25.7%) were female. The mean age ± standard deviation (SD) of male surgeons was 35.8 ± 11.0 years while for females was 33.3 ± 9.1 years. The majority of our cohort were vaccinated for HBV (96% in males and 97% in females). Two-thirds of the study cohort did not know the conversion rate post-needlestick injury by HIV, HBV, and HCV. Two-thirds of the study cohort think there is a need for HIV screening before surgery. Mixed answers were received from the cohort when asked about their concern regarding contracting HIV infection from their patients; only one-third of the surgeons were extremely concerned. When asked about the risk of needlestick injury during treating patients positive for HBV, the majority of the surgeons said no. However, a significant difference between the female and male surgeons was found in which 12 of the 62 female surgeons answered yes (19.4%) compared to 11 of the 179 male surgeons (6.1%) (p = 0.002). CONCLUSION The majority of our surgeons are vaccinated for HBV. However, female surgeons appear to be at higher risk of needlestick injury from HBV patients. This requires further investigation into the reasons for such high incidents. More education is needed about bloodborne viruses.
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Affiliation(s)
- Anadel Hakeem
- Internal Medicine, King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, SAU
| | - Shahad Alsaigh
- Surgery, King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, SAU
| | - Amal Alasmari
- Dermatology, King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, SAU
| | - Amairah Aloushan
- Emergency Medicine, King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, SAU
| | - Fatemah Bin Saleh
- Pediatrics, King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, SAU
| | - Zeyad Yousef
- Surgery, King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, SAU
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21
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Joukar F, Mansour-Ghanaei F, Naghipour M, Asgharnezhad M. Needlestick Injuries among Healthcare Workers: Why They Do Not Report their Incidence? Iran J Nurs Midwifery Res 2018; 23:382-387. [PMID: 30186344 PMCID: PMC6111658 DOI: 10.4103/ijnmr.ijnmr_74_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
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.
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Affiliation(s)
- Farahnaz Joukar
- Caspian Digestive Diseases Research Center (CDDRC), Guilan University of Medical Sciences (GUMS), Rasht, Iran
| | - Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences (GUMS), Rasht, Iran
| | - MohammadReza Naghipour
- Gastrointestinal and Liver Diseases Research Center (GLDRC), Guilan University of Medical Sciences (GUMS), Rasht, Iran
| | - Mehrnaz Asgharnezhad
- Caspian Digestive Diseases Research Center (CDDRC), Guilan University of Medical Sciences (GUMS), Rasht, Iran
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22
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Dulon M, Wendeler D, Nienhaus A. Seroconversion after needlestick injuries - analyses of statutory accident insurance claims in Germany. GMS Hyg Infect Control 2018; 13:Doc05. [PMID: 30046511 PMCID: PMC6047420 DOI: 10.3205/dgkh000311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Objective: After a needlestick injury (NSI) with contaminated blood, there is a risk of seroconversion. Statutory accident insurance (SAI) claims data were used to determine the numbers of seroconversions for hepatitis B and C viruses (HBV, HCV) and for HIV. Materials and methods: Cases of HBV, HCV or HIV infection recognised as occupational diseases between 2006 and 2015 were selected from the BGW (Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege) database. Cases where an NSI was reported to the accident insurer before the diagnosis of the infectious disease was made were included in the analysis. The causal link between the infection and the NSI identified was estimated based on diagnostic findings in medical case files. Results: In total, 566 cases with an occupation-related HBV, HCV or HIV infection were identified, including 44 cases where an NSI had been reported before diagnosis. Data on file indicated a possible causal link in 34 cases. In 16 of the 34 cases, seroconversion after the NSI was proven by diagnostic findings; in 13 of the 34 cases, seroconversion was possible but not proven because of the lack of initial findings. The index case was known in 23 of the 34 cases. The injuries occurred most often during waste disposal and high-risk procedures such as taking blood samples. The injuries were most often caused by cannulas for intravenous puncture. Subcutaneous devices were involved in two NSIs but there was no information on the initial serology or known index case. Conclusions: It is possible to identify seroconversion in SAI claims data. However, data on the injured person’s initial infection status is often incomplete and this makes it difficult to assess any causal link. The incidence of seroconversions resulting from injuries from subcutaneously applied devices is apparently low; this is consistent with the literature.
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Affiliation(s)
- Madeleine Dulon
- Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW)
| | - Dana Wendeler
- Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW)
| | - Albert Nienhaus
- Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW).,University Medical Center Hamburg-Eppendorf (UKE), Institute for Health Services Research in Dermatology and Nursing (CVcare)
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23
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Ottenhoff JSE, Voorn GP, Vlaminckx BJM, Juten PG, Wagenvoort GHJ. An operating room employee with a necrotic fingertip. JMM Case Rep 2018; 5:e005138. [PMID: 29568535 PMCID: PMC5857364 DOI: 10.1099/jmmcr.0.005138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 01/09/2018] [Indexed: 11/18/2022] Open
Affiliation(s)
- Janna S E Ottenhoff
- Department of Plastic Surgery, St. Antonius Hospital, P.O. Box 2500, 3430 EM Nieuwegein, The Netherlands
| | - Geert P Voorn
- Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Bart J M Vlaminckx
- Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Philip G Juten
- Department of Plastic Surgery, St. Antonius Hospital, P.O. Box 2500, 3430 EM Nieuwegein, The Netherlands
| | - Gertjan H J Wagenvoort
- Department of Medical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, The Netherlands
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Hada V, Saurabh K, Sharma A, Nag VL, Gadepalli RS, Maurya AK. Nursing students: A vulnerable health-care worker for needlesticks injuries in teaching hospitals. J Family Med Prim Care 2018; 7:717-720. [PMID: 30234043 PMCID: PMC6132020 DOI: 10.4103/jfmpc.jfmpc_265_17] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Occupational exposure to bloodborne pathogen is a significant risk to health-care workers. In any teaching hospital apart from regular health-care workers and employees, there are significant population of students and trainee. It is important to assess the health-care worker in hospital which has maximum chances of exposure to these pathogens. The aim of this study is to determine the most susceptible job group for needlestick injury (NSI) reported in a newly established teaching medical institute in the Western part of Rajasthan, India. Methods: This is a retrospective analysis of data of NSI occurred during September 2014 to January 2017. Results: Sixty three NSIs were reported during the study. Nursing students were the most vulnerable group who reported maximum number of NSI. Among the nursing students, 72% were completely vaccinated against hepatitis B virus. Conclusions: Nursing students are at utmost risk for NSIs, the prevention of which requires regular training and education.
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Affiliation(s)
- Vivek Hada
- Department of Microbiology, ESIC Medical College and Hospital, Hyderabad, Telangana, India
| | - Kumar Saurabh
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Anuradha Sharma
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Vijaya Lakshmi Nag
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Ravi Sekhar Gadepalli
- Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Anand Kumar Maurya
- Department of Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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25
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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] [What about the content of this article? (0)] [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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Abstract
Undertaking peripheral intravenous (IV) cannulations and the management of cannulae are associated with the risk of blood leakage or spillage and blood exposure. Open cannulae are the most common type of peripheral IV cannulae used in the UK. However, closed cannulae, also known as blood-control cannulae, have the potential to reduce the risk of needlestick injury, blood leakage and blood exposure during cannulation, as well as to increase dwell time and patient comfort. Closed cannulae may also reduce the time taken to perform cannulation. This article explains the differences between open cannulae and closed cannulae. It reviews the current use of open cannulae and the risks of blood exposure and how these can be reduced. The benefits of using closed cannulae are also described.
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Affiliation(s)
- Sally Jane Shaw
- VIP Venepuncture and Cannulation Training, Warwickshire, England
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Rymer W, Gładysz A, Filipowski H, Zubkiewicz-Zarębska A, Tumińska A, Knysz B. Risk of occupational exposure to the HBV infection in non-clinical healthcare personnel. Med Pr 2017; 67:301-10. [PMID: 27364104 DOI: 10.13075/mp.5893.00272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Occupational risk of blood-borne infections is investigated mostly among nurses and doctors, studies concerning non-clinical health personnel (nCHP) being rare. The analysis of the occupational exposure to the hepatitis B virus (HBV) infection and the history of vaccination against the HBV in the nCHP group has been the aim of the study. MATERIAL AND METHODS A retrospective analysis of 458 cases of the occupational exposure to biological agents was conducted: group I - doctors (N = 121, 28%), group II - nursing staff (N = 251, 55%), group III - nCHP (N = 86, 19%). RESULTS In the group III the source was usually unknown (group: I - 0.83%, II - 11.16%, III - 86.05%, p < 0.001), and the proportion of individuals vaccinated against hepatitis B before the exposure was the lowest (group: I - 98.35%, II - 97.19%, III - 77.91%, p < 0.001). In this group most exposures resulted from injuries caused by needles/sharps deposited in waste sacks (60%) or anywhere outside of the medical waste container (5%). The possibility of the HBV infection risk during the exposure was found in 25 cases and was significantly more frequent in the group III. The qualification for the HBV post-exposure prophylaxis was also significantly more frequent in the group III. CONCLUSIONS The exposure to the occupational risk of the HBV infection also concerns the non-clinical healthcare personnel. The non-clinical healthcare personnel comprises one of the main groups of the HBV post-exposure recipients. It is essential to determine the causes of the low hepatitis B vaccination coverage in the nCHP and consider introduction of mandatory vaccination in this group in Poland. Med Pr 2016;67(3):301-310.
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Affiliation(s)
- Weronika Rymer
- Wroclaw Medical University / Uniwersytet Medyczny we Wrocławiu, Wrocław, Poland (Department of Infectious Diseases, Hepatology and Acquired Immune Deficiencies / Katedra i Klinika Chorób Zakaźnych, Chorób Wątroby i Nabytych Niedoborów Odpornościowych).
| | - Andrzej Gładysz
- Wroclaw Medical University / Uniwersytet Medyczny we Wrocławiu, Wrocław, Poland (Department of Infectious Diseases, Hepatology and Acquired Immune Deficiencies / Katedra i Klinika Chorób Zakaźnych, Chorób Wątroby i Nabytych Niedoborów Odpornościowych).
| | - Henryk Filipowski
- Wroclaw Medical University / Uniwersytet Medyczny we Wrocławiu, Wrocław, Poland (Department of Patophysiology / Katedra i Zakład Patofizjologii).
| | - Anna Zubkiewicz-Zarębska
- Wroclaw Medical University / Uniwersytet Medyczny we Wrocławiu, Wrocław, Poland (Department of Infectious Diseases, Hepatology and Acquired Immune Deficiencies / Katedra i Klinika Chorób Zakaźnych, Chorób Wątroby i Nabytych Niedoborów Odpornościowych).
| | - Anna Tumińska
- Wroclaw Medical University / Uniwersytet Medyczny we Wrocławiu, Wrocław, Poland (Department of Physiology / Katedra i Zakład Fizjologii).
| | - Brygida Knysz
- Wroclaw Medical University / Uniwersytet Medyczny we Wrocławiu, Wrocław, Poland (Department of Infectious Diseases, Hepatology and Acquired Immune Deficiencies / Katedra i Klinika Chorób Zakaźnych, Chorób Wątroby i Nabytych Niedoborów Odpornościowych).
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Goel V, Kumar D, Lingaiah R, Singh S. Occurrence of Needlestick and Injuries among Health-care Workers of a Tertiary Care Teaching Hospital in North India. J Lab Physicians 2017; 9:20-25. [PMID: 28042212 PMCID: PMC5015493 DOI: 10.4103/0974-2727.187917] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Occupational hazards such as accidental exposure to sharp, cuts, and splashes are common among health-care workers (HCWs). AIMS AND OBJECTIVES To determine the occurrence of self-reported occupational exposures to these hazards and to know the prevalent practices following the exposure. The second aim was to know the baseline antibody levels against hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) immediately after these accidents. METHODS An observational prospective study was done in the HCWs of a tertiary care academic health organization of North India from January 2011 to December 2013. At the time of self-reporting of injury, a questionnaire was administered. Blood sample of HCWs and of the source, if identified, was collected for baseline HBV, HCV, and HIV serum markers. The exposed HCWs were followed up and repeat testing was done after 3-4 weeks for seroconversion up to 6 months. RESULTS A total of 476 injuries were reported. Needlestick injury of fingers was the most common. Doctors were found to have the highest exposure rate (73.7%) distantly followed by nurses (19.1%). A significant number of the HCWs (125, 26.3%) vaccinated in past had hepatitis B surface antibody (anti-HBs) titers <10 mIU/mL (protection defined as anti-HBs level ≥10 mIU/ml). Only 44 sources were found to be seropositive (11 for HIV, 9 for HCV, and 24 for HBV). No seroconversion was seen in any of the exposed HCWs after 6 months. CONCLUSIONS The incidence of needlestick and sharp injuries is most often encountered in emergency wards. Anti-HBs titers were suboptimal in many of the HCWs requiring a booster dose of HBV vaccination.
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Affiliation(s)
- Varun Goel
- Division of Clinical Microbiology and Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Dinesh Kumar
- Division of Clinical Microbiology and Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Raghavendra Lingaiah
- Division of Clinical Microbiology and Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sarman Singh
- Division of Clinical Microbiology and Molecular Medicine, Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
- Address for correspondence: Prof. Sarman Singh, E-mail:
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Duflou J, McNamara B, Cluney R. A safer method for body restoration following autopsy. J Forensic Sci 2013; 59:224-5. [PMID: 24117624 DOI: 10.1111/1556-4029.12273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Accepted: 12/01/2012] [Indexed: 11/29/2022]
Abstract
Restoration of autopsy incisions can result in inadvertent needle stick injury to the prosector, which can be difficult to prevent even with the use of personal protective equipment such as Kevlar cut resistant gloves. We present a new technique for closure of autopsy incisions using a commonly available commercial hardware tool, a hole punch with a lever enhanced action, combined with blunt probe sewing, which results in an esthetic and leak-proof means of restoring cadavers. This technique is especially useful in cases which may pose blood-borne infection risks to the prosector.
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Affiliation(s)
- Johan Duflou
- Department of Forensic Medicine Sydney, PO Box 90, Glebe, NSW, 2037, Australia; Sydney Medical School, University of Sydney, Sydney, NSW, 2006, Australia
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Lee LK, Hassim IN. Implication of the prevalence of needlestick injuries in a general hospital in Malaysia and its risk in clinical practice. Environ Health Prev Med 2012; 10:33-41. [PMID: 21432161 DOI: 10.1265/ehpm.10.33] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2004] [Accepted: 10/18/2004] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To determine the prevalence of cases and episodes of needlestick injury among three groups of health care workers in the past one-year, the level of knowledge on blood-borne diseases and universal precautions and the practice of universal precautions. Other factors associated with the occurrence of needlestick injuries and the reporting of needlestick injuries were also analysed. METHODS A cross-sectional study was conducted in May 2003 to study the needlestick injuries among 285 health care workers (doctors, nurses, medical students) in a public teaching hospital in Negeri Sembilan, Malaysia. RESULTS The prevalence of needlestick injuries among the respondents was 24.6% involving 71 cases i.e. 48.0% among doctors, 22.4% among medical students, and 18.7% among nurses and the difference was statistically significant (p<0.001). There were a total of 174 episodes of needlestick injury. Prevalence of episode of needlestick injuries was highest among doctors (146%), followed by nurses (50.7%) and medical students (29.4%). Cases of needlestick injuries attained lower scores on practice of universal precautions compared to non-cases (p<0.001). About 59% of cases of needlestick injury did not report their injuries. CONCLUSIONS The study showed that needlestick injuries pose a high risk to health care workers and it is underreported most of the time. Many needlestick injuries can be prevented by strictly following the practice of universal precautions.
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Affiliation(s)
- Lai Kah Lee
- Sesama Centre Plaza Komanwel, International Medical University, Bukit Jalil, 57000, Kuala Lumpur, Malaysia,
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Guruprasad Y, Chauhan DS. Knowledge, attitude and practice regarding risk of HIV infection through accidental needlestick injuries among dental students of Raichur, India. Natl J Maxillofac Surg 2012; 2:152-5. [PMID: 22639503 PMCID: PMC3343388 DOI: 10.4103/0975-5950.94470] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Injuries from occupational accidents are associ-ated with agents of biological risk, as they are the gateway to serious and potentially lethal infectious diseases that can be spread by contact between people. Several studies have demonstrated that dental students are among the most vulnerable to blood-borne exposure. OBJECTIVES To assess the knowledge, attitude and practice regarding risk of HIV transmission through accidental needlestick injury amongst dental students and providing supportive and proper guidelines regarding needlestick injuries and HIV infection. STUDY DESIGN This was a cross-sectional study done at a dental college attached to a tertiary care hospital, which included third, fourth year students and interns. The results obtained were subjected to statistical analysis using Chi-square test. RESULTS Of the 120 students, 13 (11%) were not even aware that virus could be transmitted through infected needle. A significant proportion of the third year students i.e. 27 (67.5%) were not aware of correct method of disposal of disposable needles and syringes as against interns 17 (42.5%). Around 31 (26%) said that they would promote active bleeding at the site of injury and 37 (30%) said they would take post-exposure prophylaxis. CONCLUSION Dental professionals are at a risk of occupational acquisition of HIV primarily due to accidental exposure to infected blood and body fluids. There is a need of correcting the existing misconceptions through education programs early in the course and providing supportive and proper guidelines regarding needlestick injuries and HIV infection.
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Affiliation(s)
- Yadavalli Guruprasad
- Department of Oral and Maxillofacial Surgery, AME's Dental College Hospital and Research Centre, Raichur, Karnataka, India
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