Sharps injuries within the healthcare student population: a narrative review

BACKGROUND

Studies have reported evidence on sharps injuries among nursing, medical and dental students but little is known about the amount, type and causes of sharps injuries affecting other healthcare students.

AIM

The aim of the narrative review was to identify the extent, type and causes of sharps injuries sustained by healthcare students, especially those not in those fields.

METHOD

Eight databases were searched using keywords to identify studies published between 1980 and March 2023.

FINDINGS

This narrative review highlights that some groups of healthcare students, including those studying pharmacy, physiotherapy and radiography, sustain sharps injuries from similar devices as reported in research on such injuries in nursing, medical and nursing students. Sharps injuries happen in a range of healthcare environments, and many were not reported by students. The main cause of a sharps injury identified was a lack of knowledge.

CONCLUSION

More research is needed on the extent of sharps injuries in healthcare students in European countries and the UK as well as on their physical and psychological effects. Education and training in sharps use and disposal are essential.

Diagnostic differentiation of wrist cut homicides via strikingly similar but two atypical rarities in projection of a specific criminal psyche in perpetrating a murder

Wrist cut exsanguination is usually suicidal, but it can also be accidental. The lack of recognition of homicide wrist cut as a differential diagnosis is exemplified by its rarity. Authors present two cases of homicide wrist cut with strikingly similar attributes. Fatal head injuries were concomitantly present in both of them. There was usage of a characteristic bondage to incapacitate the victim in one of them. These wrists-cut murders imply the involvement of a specific criminal psyche that has yet to be discovered in literature. The presence of typical features of suicide wrist cut was another highlight of these murders. The personal and demographic details of the two victims also matched to some extent. The report outlines a method for distinguishing homicidal wrist cuts from suicidal and accidental wrist cuts. It will be of an exclusive help to deduce manner in isolated, fatal and non-fatal wrist cuts. Authors aim to initiate growth of literature on homicide wrist cut/s which is otherwise non-existent for them being rare entity/s. Similar fatalities have not been reported to the best claim of the authors.

A case report of radiopharmaceutical needlestick injury with scintigraphic imaging and dose quantification

Attention to the implications of common needle stick injuries has focused heavily on the risk of cross-infection from blood-borne pathogens. An additional risk to the nuclear medicine healthcare worker is that of subcutaneous radioactive contamination from radiopharmaceuticals. This case report provides a rare opportunity to examine the clinical and operator causes of one such event during the dispensing of ^99mTc-Tetrofosmin. Contamination monitoring, scintigraphic imaging, and quantification of effective radiation dose provide the level of risk to the operator from the subcutaneous radioactive contamination. Findings demonstrated a very low dose to operator and no deterministic radiobiological effects. Delayed imaging demonstrated negligible biological clearance from the injury site. Implications of the findings for clinical practice are discussed, highlighting the need for a careful and calm approach to radiopharmacy activities.

The experience and psychological impact of a sharps injury on a nursing student population in the UK

AIMS

The aims of this study were to explore the experience and psychological impact of sustaining a sharps injury within a nursing student population in the UK. Design: A qualitative approach was taken, using two methods to gather data, namely a Twitter chat and interviews.

METHODS

A Twitter chat was orchestrated to investigate the experiences of sharps injury with nursing students and registered nurses nationwide (n=71). Interviews were conducted with nursing students from a university in the UK who had sustained a sharps injury (n=12) to discover their experiences and the impact of the injury. Findings were then synthesised and examined.

RESULTS

Some nursing students reported psychological impacts after sustaining the sharps injury, which affected both their professional and personal life. The qualitative findings were synthesised into eight themes.

CONCLUSION

Sharps injuries can have many psychological impacts on the individual nursing student and necessary support should be available.

Needlestick Occurrences and Reporting Among Residents in the Operative Setting

OBJECTIVE

Needlesticks are common work-related injuries suffered by health care professionals. We sought to identify prevalence of needlestick/sharps injuries of residents working in the operating room and identify contributing factors and barriers to reporting/seeking treatment.

METHODS

A 17-question survey on needlestick injuries was distributed to 168 residents in anesthesiology, surgery, and surgical subspecialties and the responses were analyzed for statistical significance of differences observed between departments.

RESULTS

Of 138 respondents (82% response rate), 49% of residents had at least one needlestick injury during training. One quarter did not report their injuries to employee health or seek treatment, with the largest percentage from general surgery (53%). The primary reasons for not reporting injuries or seeking treatment included time away from patient care and lack of concern about the injury. More than half (64%) of the anesthesiology residents who reported an injury thought fatigue was a contributing factor.

CONCLUSIONS

Half of residents sustained an injury and a quarter of injuries did not get reported, with the most valid reason being too much time away from patient care. Only anesthesiology residents commonly cited fatigue as a contributor to their needlestick/sharps injury. Understanding the program-specific needlestick/sharps injury incidence and prevalence, and the attitudes about reporting injuries and seeking treatment, is a first step toward prevention of injury for residents in training. ACGME Core Competencies: Medical Knowledge, Practice-based Learning and Improvement, Professionalism.

Awareness About Sharps Disposal Leads to Significant Improvement in Healthcare Safety: an Audit of Compliance in the National Health Service During the COVID-19 Pandemic

Needle-stick injuries (NSIs) pose serious health risks and can transmit blood-borne diseases (BBDs), such as hepatitis B virus, hepatitis C virus, and human immunodeficiency virus from the patient to the staff member. The purpose of this study was evaluation of appropriate and safe disposal of sharps within a 730-bed acute district general hospital (DGH) in the UK. One hundred sharps containers were audited in November 2019 to assess whether they complied with the health and safety regulations across surgical, medical, and acute wards. Meetings with the appropriate staff members were organised and posters placed throughout the hospital to raise awareness. One hundred twenty-five sharps containers were re-audited in July 2020, in the midst of the COVID-19 pandemic to ascertain if there was an improvement. In November 2019, a total of 56% of sharps containers were overfilled and hence were non-compliant with safety regulations. A re-audit performed in July 2020 found only 17% of sharps containers to be overfilled, which was a significant improvement (p = 0.0064) in practice. We noted that the overall compliance improved from being 44% in 2019 to 82.64 in the year 2020. This audit showed a significant improvement in the compliance of sharps bin containers in a DGH, signifying the increased awareness. It is necessary to audit sharps management regularly to accurately assess practice and prevent exposure to BBDs.

Understanding sharps use in an Australian Emergency Department: A mixed methods organisational case study

BACKGROUND

Despite the introduction of a range of safety policies and sharps equipment designed to protect healthcare workers, rates of percutaneous injuries from occupational exposure to sharps remains high. This study examined the availability and use of various types of sharps devices in a tertiary hospital emergency department, to understand clinician choice between non-safety and safety devices; and to document their safe and unsafe use of sharps.

METHODS

This mixed methods study consisted of areview of stock levels, a survey of staff usage, and a content analysis of semi-structured interview data to explore factors which impact on staff preferences for different sharps devices.

RESULTS

Staff identified a range of sharps risks, as well as barriers and enablers to the use of safety devices. Availability of, and preference for, familiar devices influenced choice of devices used in clinical practice, despite awareness of associated risks.

CONCLUSIONS

This understanding of equipment use and the factors that motivate such use have informed the first stage of the knowledge-to-action cycle. Knowledge translation, should include the development of policies to help reduce the risk of sharps injury. Culture change and ongoing skills development might help to overcome entrenched procedures and increase voluntary engagement with safer sharps.

Arterial blood gas sampling: using a safety and pre-heparinised syringe

Taking arterial blood gases (ABG) is an essential part of the diagnosis and management of critically ill patients. An arterial blood sample is collected from an artery, primarily to determine the ABGs. Health professionals should only undertake this if the procedure is in the legal scope of practice for their profession in their country, and they have demonstrated skilled, proficient, safe practice after formal training. Blood samples can be obtained via an arterial catheter inserted into an artery or percutaneously by using a needle to directly puncture into the artery. This article provides an overview of this subject area. It includes case studies where the Pulsator Plus Arterial Blood Gas Syringe (Smiths Medical) was used to safely and effectively collect blood samples for analysis.

Self-reported healthcare waste segregation practice and its correlate among healthcare workers in hospitals of Southeast Ethiopia

BACKGROUND

The key to the effective management of healthcare wastes is segregation of the waste at the point of generation; no matter what final strategy for treatment and disposal of wastes is selected, it is critical that waste streams are separated. In Ethiopia, healthcare waste segregation practice among healthcare workers is overlooked and scarcely addressed in the scientific literature. This hospital-based cross-sectional study was, therefore, conducted to assess healthcare waste segregation practice and its correlate among healthcare workers in Bale zone, southeast Ethiopia.

METHODS

All five hospitals found in Bale zone were included and the study participants were selected using a systematic sampling technique from each hospital. Data were collected through interview using structured questionnaires. Descriptive statistics were computed. Bivariate and multivariable logistic regression analyses were employed to identify factors that correlate with healthcare waste segregation practice.

RESULTS

A total of four hundred and nine healthcare workers participated in the study, for a response rate of 97.4%. Of these, 220(53.8%) (95% CI: 49.1-58.9) of healthcare workers were found to have reported good healthcare waste segregation practice. Being male gender (AOR = 1.70, 95%CI: 1.04-2.78), less than 30 years of age (AOR = 2.02, 95%CI: 1.06-3.84), less than 2 years work experience (AOR = 2.95, 95%CI: 1.39-6.26), having good self-reported standard precaution practice (AOR = 8.47,95%CI:4.98-14.42), and working in a department with an on-site healthcare waste segregation container (AOR = 2.10, 95%CI:1.24-3.55) were factors that correlated with self-reported healthcare waste segregation practice.

CONCLUSION

Overall, only half of the healthcare workers had good healthcare waste segregation practice, which is low and unsatisfactory. Less service year, having good standard precaution practice, and the presence of onsite waste segregation container were the most important variables that correlate with self-reported healthcare waste segregation practice. Therefore, to improve healthcare waste segregation practice health authorities should focus on sufficient allocation of onsite waste receptacles. In addition, periodic training on standard precaution will improve compliance with segregation practice.

Legal regulation of the management of waste

Healthcare providers such as hospitals and clinics have a duty of care under the Environmental Protection Act 1990 and its regulations to ensure that the waste they produce does not cause pollution or present a hazard to health. Nurses are well placed to ensure that the trust they work for discharge that duty. In this article, Richard Griffith outlines the legislation regulating the safe management and disposal of waste and considers how the law applies to nurses.