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

AIMS: This study aims to investigate the current situation of needlestick injuries (NSIs) of clinical nurses and identify associated factors by using the theoretical framework of the human factors analysis and classification system (HFACS). DESIGN: A nationwide cross-sectional survey was conducted. METHODS: Multi-stage sampling was used to investigate 3336 nurses in 14 Chinese hospitals. Descriptive statistics and univariate and multivariate logistic regression were employed to reveal the rate of NSIs and their associated factors. RESULTS: A total of 970 nurses (29.1%) reported having experienced at least one NSI in the past year. The multivariate logistic regression analysis showed that good hospital safety climate and clinical nurses in intensive care unit (ICU) and emergency department had protective effects against NSIs compared with nurses in internal medicine department. The nurse, senior nurse, and nurse in charge have significantly increased the risk for NSIs compared with the associate chief nurse or above. Patients with poor vision but wearing glasses and poor vision but not wearing glasses were more prone to have NSIs. Working in the operating room compared with internal medicine, average weekly working time of >45 h compared with ≤40 h and poor general health led to increased risk of NSIs. CONCLUSION: The rate of NSIs in clinical nurses was high in China. Individual factors including professional title, department, visual acuity and general mental health and organisational factors including weekly working hours and hospital safety atmosphere were significantly correlated with the occurrence of NSIs. RELEVANCE TO CLINICAL PRACTICE: Nursing managers should focused on physical and psychological conditions of clinical nurses, and organisational support is required to enhance the hospital safety atmosphere. NO PATIENT OR PUBLIC CONTRIBUTION: Contributions from patients or the public are irrelevant because this study aims to explore current situation and factors associated with NSIs in clinical nurses.

Case Report and Literature Review of Occupational Transmission of Monkeypox Virus to Healthcare Workers, South Korea.

We report a case of occupational monkeypox virus infection from a needlestick injury in a healthcare worker in South Korea and review similar reports in the literature during 2022. Postexposure prophylactic treatment with a third-generation smallpox vaccine and antiviral agent tecovirimat inhibited local virus spread and alleviated lesion pain.

Monkeypox Virus Transmission to Healthcare Worker through Needlestick Injury, Brazil.

We describe monkeypox virus (MPXV) transmission from a patient to a healthcare worker through needlestick injury. A lesion appeared at the inoculation site 5 days after injury. Blood tested MPXV-positive by PCR before symptoms worsened; blood remained MPXV-positive at discharge 19 days after symptom onset. Postexposure prophylaxis could prevent potential MPXV bloodborne transmission.

Epidemiology and risk factors of needlestick injuries among healthcare workers in Iran: a systematic reviews and meta-analysis.

BACKGROUND: Occupational contact with blood and body fluids poses a significant risk to healthcare workers. The aim of this systematic review is to investigate the epidemiology and risk factors affecting needlestick injuries (NSI) in healthcare personnel in Iran. METHODS: In March 2020, researchers studied six international databases such as Medline/PubMed, ProQuest, ISI/WOS, Scopus, Embase, and Google Scholar for English papers and two Iranian databases (MagIran and SID) for Persian papers. Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess quality of studies. The method of reporting was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. RESULTS: A total of 43 articles were included in the analysis. Results showed that females (OR = 1.30, 95 % CI 1.06-1.58, P value = 0.009), younger age (OR = 2.75, 95 % CI 2.27-3.33, P value < 0.001, rotated shift workers (OR = 2.16, 95 % CI 1.47-3.15, P value < 0.001), not attending training courses (OR = 1.30, 95 % CI 1.07-1.56, P value = 0.006), working in the surgery ward (OR = 1.83, 95 % CI 1.33-2.50, P value < 0.001), less work experience (OR = 1.43, 95 % CI 1.04-1.95, P value = 0.025) apposed a greater risk factors for NSI among healthcare workers. CONCLUSION: Based on the results of this review, factors such as young age, less work experience, work shift, and female gender are considered as strong risk factors for NSI injury in Iran. Preventive measures including education programs can reduce the burden of NSI among healthcare personnel.

Needlestick-Associated Rocky Mountain Spotted Fever, Brazil.

We report a fatal case of Rocky Mountain spotted fever (RMSF) in a man in Brazil without recent history of tick bites or environmental exposure. He received an accidental needlestick while working as a nurse. The nurse and his patient died. Both cases were confirmed as RMSF by molecular methods.

Could pre-filled safety syringes facilitate the adoption of home administration for cancer patients?

Today, healthcare systems around the world are under increasing pressure, not least with the current health crisis. One of the leading efforts to relieve this burden in recent years has been through the promotion and facilitation of self-administration, particularly for patients with chronic illnesses. By relocating certain treatments to patients' homes, hospitals are minimizing the risk of over-crowding and giving patients a more active role in their own medication regime. Fuelled by this trend toward self-care, the prefilled safety syringe market has seen exponential growth in recent years - providing greater ease-of-use and safety for all carers and self-administering patients in non-clinical settings. When looking at the benefit of switching intravenous hospital-based to subcutaneous home-based administration while maintaining the same clinical outcomes, a similar change is also being considered in some areas of oncology. Drawing on the experience of home-treatment for chronic conditions, this article looks at the challenges and considerations of extending this to eligible cancer patients in the future.

Education and devices to prevent blood and body fluid exposures.

BACKGROUND: Healthcare workers are at risk of blood and body fluid exposures (BBFE) while delivering care to patients. Despite recent technological advances such as safety-engineered devices (SEDs), these injuries continue to occur in healthcare facilities worldwide. AIMS: To assess the impact of an education and SEDs workplace programme on rates of reported exposures. METHODS: A retrospective cohort study, utilizing interrupted time series analysis to examine reported exposures between 2005 and 2015 at a 600-bed hospital in Perth, Western Australia. The hospital wards were divided into four cohorts. RESULTS: A total of 2223 records were available for analysis. The intervention was most effective for the first cohort, with significant improvements both short-term (reduction of 12 (95% CI 7-17) incidents per 1000 full-time equivalent (FTE) hospital staff) and long-term (reduction of 2 (CI 0.6-4) incidents per 1000 FTE per year). Less significant or consistent impacts were observed for the other three cohorts. Overall, the intervention decreased BBFE exposure rates at the hospital level from 19 (CI 18-20) incidents per 1000 FTE pre-intervention to 11 (CI 10-12) incidents per 1000 FTE post-intervention, a 41% reduction. No exposures resulted in a blood-borne virus infection. CONCLUSIONS: The intervention was most effective in reducing exposures at a time when incidence rates were increasing. The overall effect was short-term and did not further reduce an already stabilized trend, which was likely due to improved safety awareness and practice, induced by the first cohort intervention.

Needlestick injuries: the role of safety-engineered devices in prevention.

The first documented mention of a needlestick injury (NSI) in the medical literature appeared in 1906. Despite growth in academic and clinical interest for NSI prevention, a global report identified that approximately 3 million healthcare workers have suffered percutaneous exposure to blood-borne pathogens. Legislation is an important component of NSI prevention. Unfortunately, the impact of legislation may not always reduce the incidence of NSI as much as expected. Safety-engineered device (SED) implementation has demonstrated a substantial reduction in NSI rates compared with non-SEDs. More importantly, passive SEDs are 10 times less likely to be connected with an NSI incident.

The State of Needlestick Training for Undergraduate Medical Students at Canadian Universities.

Canadian undergraduate medical students sustain needlestick injuries, which have adverse implications, including blood-borne illnesses and personal anxiety. This study sought to determine students' needle handling efficacy and to examine the prevalence of formal training around needlestick safety and reporting procedures both nationally and, specifically, within the University of Toronto in Toronto, Ontario (U of T). A seven-question survey electronic survey was distributed to 116 undergraduate medical education (UME) leaders practising in high-risk rotations at 13 Canadian universities. Additionally, an eight-question survey was delivered electronically to 428 residents, fellows, and faculty in the Department of Obstetrics and Gynaecology at the U of T. A total of 34% of UME leaders and 36% from the U of T responded. Of UME respondents, 53% reported that their institution lacks needlestick training, and 35% were unsure whether their institution provides reporting instruction. At the U of T, 53% were "concerned" or "very concerned" that students pose a risk to themselves, and 27% "disagreed" or "strongly disagreed" that students handle instruments correctly. Our findings suggest that needlestick safety training for medical students across Canadian universities is insufficient. It is concerning that students are frequently exposed to patients in high-risk and surgically intensive rotations, despite their inexperience with needles. Furthermore, non-reporting among students may prevent them from receiving early prophylaxis or treatment. There is a need for the national implementation of a standardized and formalized needlestick safety curriculum for medical students before and during clerkship.

Needlestick injuries among Malaysian healthcare workers.

BACKGROUND: Needlestick injury (NSI) is a significant occupational health issue among healthcare workers (HCWs). AIMS: To determine the national self-reported incidence and risk factors for NSI among Malaysian Ministry of Health (MOH) HCWs. METHODS: Using data from the MOH national sharps injury surveillance programme, information on reported NSIs over a 1-year period (2016) for different HCW subgroups were extracted and analysed. RESULTS: A total of 1234 NSI cases were reported in 2016, giving an overall incidence of 6 injuries per 1000 HCWs. Medical doctors recorded the highest incidence (21.1 per 1000 HCWs) followed by dental staff (7.5), pharmacy staff (4.2), nurses (3.7), medical assistants (3.4) and allied and auxiliary staff (1.0). Doctors had significantly increased risk of NSI compared with allied and auxiliary staff (relative risk [RR] = 20.7, 95% confidence interval [CI] 15.5-27.5), medical assistants (RR = 6.1, 95% CI 4.5-8.2), nurses (RR = 5.7, 95% CI 5.0-6.6), pharmacy staff (RR = 5.0, 95% CI 3.7-6.6) and dental staff (RR = 2.8, 95% CI 2.2-3.5). Significant differences were found in age and sharps- handling experience between occupational subgroups (P < 0.001 for both variables). Male employees had higher risk than females (RR = 1.33, 95% CI 1.18-1.50), with a significant difference seen in their sharps-handling experience (P < 0.01). Important risk factors included unsafe practices such as recapping of needles and their improper disposal. CONCLUSIONS: The national incidence of NSI amongst Malaysian HCWs was lower compared with other countries, but unsafe practices remain an important concern. There is a need to formulate, implement and monitor safe and consistent practices for the different healthcare professionals.

Needlestick injury prevention training among health care workers in the Caribbean.

The rate of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) infections among health care workers that is caused by sharps injuries is higher in the Caribbean and Latin America than in other regions of the world. To respond to and reduce occupational exposures to bloodborne pathogens while also strengthening capacities in the Caribbean, needlestick injury prevention training programs for health care workers were implemented, beginning in 2011. The programs included lectures, workshops, policy reviews, evaluations of safety devices, and workplace assessment. During the training, baseline data from health care workers on their personal history of needlestick injuries and bloodborne pathogen exposure was collected. That baseline data showed that 40% of the participants had sustained sharps injuries during their professional career. In this capacity-building effort, 210 health care workers from five countries have been trained, six health care centers in the Caribbean have been evaluated. and occupational safety and health committees have been established in various countries to monitor and improve safety policies and practices.

La tasa de infecciones por los virus de la inmunodeficiencia humana (VIH), de la hepatitis B (VHB) y de la hepatitis C (VHC) en los trabajadores de atención de salud debidas a heridas por materiales punzocortantes es mayor en América Latina y el Caribe que en otras regiones del mundo. Con objeto de responder a las exposiciones laborales a los agentes patógenos de transmisión sanguínea y reducirlas, además de reforzar las capacidades en el Caribe, se instituyeron programas de capacitación para la prevención de las heridas por pinchazos accidentales en los trabajadores de salud a partir del 2011. Los programas comprendían conferencias, talleres, revisión de las políticas, análisis de los dispositivos de seguridad y evaluación de los lugares de trabajo. Durante la capacitación, se recopilaron datos iniciales suministrados por los trabajadores de atención de salud sobre sus antecedentes personales de heridas por pinchazos accidentales y exposición a agentes patógenos de transmisión sanguínea. Esos datos iniciales indicaron que 40% de los participantes habían sufrido alguna herida por materiales punzocortantes a lo largo de su carrera profesional. En esta iniciativa de formación de capacidades, se han capacitado 210 trabajadores de atención de salud de cinco países, se han evaluado seis centros de atención de salud en el Caribe y se han establecido comités de seguridad y salud ocupacional en diversos países para vigilar y mejorar las normas y prácticas de seguridad.

As taxas de infecção pelo vírus da imunodeficiência humana (HIV), vírus da hepatite B (HBV) e vírus da hepatite C (HCV) em profissionais da saúde decorrentes de acidentes com materiais perfurocortantes são mais elevadas no Caribe e na América Latina que em outras regiões do mundo. Para combater e reduzir a exposição ocupacional a patógenos de transmissão sanguínea, igualmente reforçando as competências no Caribe, programas de capacitação em prevenção de acidentes com agulhas para profissionais da saúde foram implementados a partir de 2011. Os programas consistiram de palestras, seminários, análises de políticas, avaliações de dispositivos de segurança e avaliação dos locais de trabalho. Durante a capacitação, foram coletados dados de base dos profissionais da saúde relativos ao histórico pessoal de acidentes com agulhas e exposição a patógenos de transmissão sanguínea. Estes dados indicaram que 40% dos participantes haviam sofrido acidentes com materiais perfurocortantes durante a atividade profissional. Como parte desta iniciativa de capacitação, foi dado treinamento a 210 profissionais da saúde de cinco países, foram avaliados seis centros de saúde no Caribe e instituídos comitês de saúde e segurança ocupacional em diversos países para monitorar e melhorar as políticas e práticas de segurança.

Knowledge, attitude, and practices regarding infection control measures among medical students.

OBJECTIVE: To assess the knowledge, attitude and reported practices of medical students regarding infection control measures. METHODS: The cross-sectional, questionnaire-based study was conducted at one public and one private medical university in Karachi from January to February 2016. The students enrolled were in their clinical years of the Bachelor of Medicine, Bachelor of Surgery course and their knowledge, attitude and practice were measured regarding infection control measures. SPSS 19 was used to analyse data. RESULTS: There were 413 medical students with a mean age of 21.78±1.10 years. Overall, 206(49.9%) students were from the private university and 207(50.1%) from the public institution. Students from the private institution had better knowledge compared to those from the public institution regarding hand hygiene (p<0.001), needlestick injuries (p<0.001) and surgical scrubbing (p=0.007), as well as better reported practices regarding hand hygiene (p<0.001) and surgical scrubbing (p=0.001). CONCLUSIONS: Knowledge and practices of medical students regarding the method of surgical scrubbing and needlestick injury protocols in particular needed improvement.

Do training and needle-safety devices prevent needlestick injuries? A systematised review of the literature.

This systematised review was undertaken to appraise research on the effects of training and the use of needle-safety devices (NSDs) on the prevention of needlestick injuries (NSIs) among health workers, focusing on a European perspective. A literature search from 2007 to 2017 was performed, which identified six studies that investigated the introduction of training and NSDs and their affect on NSIs. The six chosen studies identified that training, as well as the adoption of NSDs, has an impact on preventing NSIs. However, further information is required on the content and mode of delivery of training and on which types of NSDs are most effective at preventing injuries. This will help healthcare workers to understand and implement the most effective strategies to prevent injuries. This article provides a critique of the research approaches used in the six studies.

Managing sharps injuries and other occupational exposures to HIV, HBV, and HCV in the dermatology office.

Dermatologists and their staff are at risk for needlestick injuries and exposures to body fluids. Despite the availability of treatment to reduce the risk of blood-borne infection, many exposures go unreported. This paper identifies current recommendations and the specific details for response to occupational exposures to HIV, hepatitis B virus, and hepatitis C virus in the dermatology office. Issues surrounding each virus are discussed individually, and a summary step-by-step algorithm of how to proceed in the event of an occupational exposure is presented. In addition, a focused Practice Improvement Activity that is based on this paper and provides Maintenance of Certification credit has been developed. To view and participate, visit https://secure.dataharborsolutions.com/abdermorg/.

Epidemiological investigation of the first human brucellosis case in Spain due to Brucella suis biovar 1 strain 1330.

INTRODUCTION: No cases of human brucellosis caused by Brucella suis has been reported in Spain. METHODS: This study involved interviews with the case and his co-workers, inspection of their workplace, checking infection control measures, and typing the Brucella strain isolated in the blood culture. RESULTS: Brucella suis biovar 1 strain 1330 was isolated from a patient who worked in a waste treatment plant. Food borne transmission, contact with animals, and risk jobs were ruled out. An accidental inoculation with a contaminated needle from a research laboratory waste container was identified as the most probable mode of transmission. CONCLUSION: There should be controls to ensure that waste containers are sealed.

Period Prevalence and Reporting Rate of Needlestick Injuries to Nurses in Iran: A Systematic Review and Meta-Analysis.

The purpose of this systematic review and meta-analysis was to provide a precise estimate of the period prevalence of needlestick injuries (NSI) among nurses working in hospitals in Iran and the reporting rate of NSI to nurse managers. We searched both international (PubMed, Scopus and the Institute for Scientific Information) and Iranian (Scientific Information Database, Iranmedex and Magiran) scientific databases to find studies published from 2000 to 2016 of NSI among Iranian nurses. The following keywords in Persian and English were used: "needle-stick" or "needle stick" or "needlestick," with and without "injury" or "injuries," "prevalence" or "frequency," "nurses" or "nursing staff," and "Iran." In a sample of 21 articles with 6,480 participants, we estimated that the overall 1-year period prevalence of NSI was 44% (95% confidence interval [CI], 35-53%) among Iranian nurses. The overall 1-year period prevalence of reporting NSI to nurse managers was 42% (95% CI, 33-52%). In meta-regression analysis, sample size, mean age, years of experience, and gender ratio were not associated with prevalence of NSI or reporting rate. The year of data collection was positively associated with period prevalence of NSI (p < .05), but not with the period prevalence of reporting NSI to nurse managers. Results indicated a high NSI period prevalence and low NSI reporting rate among nurses in Iran. Thus, effective interventions are required in hospitals in Iran to reduce the prevalence and increase the reporting rate of NSI. © 2017 Wiley Periodicals, Inc.

Peripheral intravenous cannulation: protecting patients and nurses.

Peripheral intravenous cannulation is a common clinical procedure in today's healthcare setting. There are a range of different devices to choose from, and this article will consider the risk of catheter-related bloodstream infections and needlestick injuries, national and international guidelines on infection prevention and safety in intravenous access, the need for closed catheters, features of the Introcan Safety® 3 (B. Braun Melsungen AG) and research into peripheral cannulas.

Needlestick injuries at a tertiary teaching hospital in Singapore.

This study investigated the incidence and risk to staff groups for sustaining needlestick injuries (NSIs) in the National University Hospital (NUH), Singapore. A retrospective cohort review of incident NSI cases was undertaken to determine the injury rate, causation, and epidemiological profile of such injuries. Analysis of the risk of sustaining recurrent NSI by occupation and location was done using the Cox proportional hazards model. There were 244 NSI cases in 5957 employees in NUH in 2014, giving an incidence rate of 4·1/100 healthcare workers (HCWs) per year. The incidence rate was highest for doctors at 21·3, and 2·7 for nurses; 40·6% of injuries occurred in wards, and 32·8% in operating theatres. There were 27 cases of repeated NSI cases. The estimated cost due to NSIs in NUH ranged from US$ 109 800 to US$ 563 152 in 2014. We conclude that creating a workplace environment where top priority is given to prevention of NSIs in HCWs, is essential to address the high incidence of reported NSIs. The data collected will be of value to inform the design of prevention programmes to reduce further the risk of NSIs in HCWs.

Lymphocytic choriomeningitis virus infection induced by percutaneous exposure.

We report a case of acquired lymphocytic choriomeningitis virus (LCMV) infection due to an accidental percutaneous inoculation of LCMV at work. The injured worker developed a flu-like syndrome, followed by pericarditis and meningoencephalitis. Seroconversion was confirmed by ELISA. The patient made a complete recovery. We review measures undertaken to prevent a similar event and propose a follow-up protocol in the event of accidental LCMV exposure.

Job stress and needlestick injuries: which targets for organizational interventions?

BACKGROUND: Needlestick injuries (NSIs) represent a major concern for the safety of health care workers involved in clinical care. The percentage of health workers reporting these injuries varies between 9 and 38% and the occurrence of NSI is most frequent among employees having close clinical contact with patients or patient specimens. These injuries appear to occur most frequently where organizational factors contribute to the risk. AIMS: To investigate the interactions between organizational level interventions focused on work-related stress (WRS) and the occurrence of NSIs among nurses employed in hospital departments, and to determine the impact of such interventions on the safety budget. METHODS: Comparison of NSI occurrence among nurses employed in hospital health care departments in two 3-year periods, before and after interventions aimed at minimizing WRS. The economic cost of NSIs occurrence was calculated. RESULTS: The study group consisted of 765 nurses. The cumulative 3-year incidence of NSIs after the implementation of management stress interventions was significantly lower than the cumulative 3-year incidence observed before implementation (OR 0.60; 95% CI 0.43-0.83). A cost saving from managing fewer NSIs than during the first study period was found. CONCLUSIONS: This study found a reduction in NSI occurrence and associated costs following an intervention to bring about proactive, integrated and comprehensive management of stress in the workplace.