Self-reported percutaneous injuries of students and interns at the School of Dentistry in Trinidad: A follow up study of an updated sharps protocol

Objective: To report the results of a survey of all percutaneous injuries that occurred between 2009 ­ 2014 among students and interns at the dental school in Trinidad and to evaluate compliance with the protocol for the management of percutaneous injuries. Methods: Data was collected via questionnaires administered to 186 clinical students and interns in 2012 and 2014. Data were analysed using SPSS® 17.0 Statistical software. Results: A 90% response rate was obtained. Forty-eight persons (29%) reported one or more sharps injuries at the dental school. Of the 76 sharps injuries reported, 55 were percutaneous. Needle sticks and burs accounted for the majority of injuries and mostly occurred while working on patients. There were no significant relationships (p>0.05) between sex nor student year with the occurrence of injuries. 76% of the respondents described their concern for contracting blood borne injuries from sharps injuries as "high." After injury, 41% of the respondents followed the school's protocol for sharps injuries. Conclusion: The prevalence of percutaneous injuries among students and interns at the UWI dental school in Trinidad is 23% and occur most commonly while working on patients. Compliance with the protocol for percutaneous injuries needs to be improved. The protocol needs to be audited to improve efficiency and reinforced to the students, interns and clinical supervisors during their clinical years.

Prevention of needle stick injury in the clinical setting among new registered nurses

Background: Needle stick injury is one of the greatest work-related health hazard, that registered nurses encounter on an everyday basis for example the risk of being exposed to dangerous and deadly blood borne pathogens through contaminated needle sticks such as human immunodeficiency virus (HIV) and hepatitis viruses. New registered nurses' lacking knowledge and skills regarding standard precautions are exposed to needle stick injuries from unsafe practices such as recapping of needles, manipulating used needles such as bending, breaking or cutting hypodermic needles and passing needles from one nurse to another (American Nurses Association 2002). Methods: This was a quantitative descriptive study. The dependent variable was the needle stick injury and the independent variables consisted of factors which influenced the occurrence of needle stick injuries among new registered nurses. The factors are practice, knowledge, resources and attitudes. The population was new registered nurses with less than three years' experience at the San Fernando General Hospital. A total of 120 new registered nurses were employed during the period under review and the entire population was used as the sample. A 26 item instrument was used to collect data which were analyzed using SPSS version 20. Findings: Most of the respondents 59 (49.2%) were between the ages 20-<30 years and 88 (73.4%) were female. The most common years' experience was 53 (44.2%). Almost half 54 (45%) respondents had experienced a needle stick injury with the most common exposure being while in use (17.5%) and recapping needles (215%). A total of 49 (40.8%) respondents had at least one to less than 3 needle sticks since employment and this was most common among staff on the medical wards. There was a moderate correlation between respondents knowledge about institution's policies and need for training (r0.409, p0.01) and strong correlation between their perception of the need to be more vigilant and the quality of the sharps that they are provided with (r0.913, p0.01). Conclusion: Avoidable practices such as non-adherence to standard precautions while using hypodermic needles are contributing factors to needle stick injuries. Prevention of NSI's should be an integral part of occupational health programs in the work place. Therefore, mandatory training and evaluation of health care worker's, knowledge and attitude regarding safety practices and proper use of available resources should be enforced when carrying out their duties in the clinical area.

Inoculation injuries in hospitals in Trinidad and Tobago

This paper reviews the frequency of inoculation injures, which occurred in hospitals in Trinidad and Tobago from 1991 to 1997, inclusive. A total of 397 cases of inoculation injuries were detected. Significantly more of this injures occurred during diagnostic or therapeutic procedures (231, or 58.2 percent: G=41.2, df 9, p < 0.001) than during disposal of needles and other sharps (136, or 34.3 percent), certain situations remote from patient care (21, or 5.2 percent), and "rogue incidents" related to unsafe disposal with later injury to janitors or others (9, or 2.3 percent). No statistically significant monthly or seasonal variations occurred in the incidence of reported inoculation injuries. The two institutions that saw the largest number of patients, the Port-of-Spain General and San Fernando General Hospitals, accounted for the largest number of cases of inoculation injury, with 139 (35.0 percent) and 135 (34.0 percent), respectively. Interestingly enough, there were 42 reported inoculation incidents at the St. Ann's Hospital for the Mentally Impaired and 23 (52.5 percent of these were bites, most of them occurring during attempted procedures. Nurses were the main recipients of inoculation injuries (287 cases, or > 72 percent), followed by doctors (9.3 percent), and ward maids (6.2 percent). The main modes of inoculation were needle sticks (305, pr 76.8 percent). Bites (34, 8.6 percent) injuries with sharps other than needles (29, or 7.3 percent), and splashes (29, or 7.3 percent) were the other types seen. One recipient was found to be infected with HIV following accidental inoculation. The infection control methodologies used in hospitals in Trinidad and Tobago was reviewed and recommendations for preventing injuries are outlined.(AU)