Combatting the occurrence of needle-stick injuries in a medical school: why is it still an issue?

BACKGROUND: Needle-stick injuries (NSIs) pose a safety risk for healthcare workers with great potential for serious infections. The aim was to determine numbers and causes of NSIs as well as the frequency with which medical students report NSIs in the final stages of study. METHODS: An online questionnaire was developed and made available in January and February 2023 to all undergraduate medical students (n = 423) in the last 1.5 years of their degree course at Würzburg University, Germany. RESULTS: The response rate was 19.6% (n = 84). Among respondents, 27.4% (n = 23) reported at least one NSI. Occurrence was particularly frequent in surgery, obstetrics and gynaecology, and internal medicine. Assisting with procedures, suturing, and blood sampling were considered high-risk activities. Lack of concentration, distraction, and time pressure played a role in incidents. Respondents did not report 18.8% of NSIs with the main reasons being fear of the consequences, self-assessment of the injury as minor, or the opinion of supervisors that reporting was unnecessary. Students with previous practice on simulators or patients were significantly more likely to suffer NSIs. Instructions from occupational health specialists beforehand correlated with fewer NSIs. CONCLUSION: We assume that trained students are more experienced in handling invasive procedures, leading to a greater adoption of corresponding activities and thus an increased risk of injuries in absolute numbers. This does not counter the need for didactic interventions prior to workplace-based training to raise awareness of NSI risks. Simultaneously, concepts must be developed and implemented to support reporting and alleviate fears regarding consequences.

Needle Stick Injury: A Decade Retrospection Among Health Care Workers in a Tertiary Care Center.

Needle stick injury (NSI) is a common incidence in a health care facility which can have a great impact on the psychological status of a health care worker (HCW). In the present study, over a decade, 76 incidents of NSI were reported. Nurses (47.3%) were at high risk followed by doctors (28.94%). Recapping (30.2%) was the major activity associated with NSI. Percutaneous injury (97.3%) with a hollow bore needle to the fingers was the most common type of injury. Three (3.9%) of the sources were positive for Hepatitis B virus (HBV), and one (1.3%) for human immunodeficiency virus (HIV). Postexposure prophylaxis was administered to eight (10.5%) HCWs with high-risk exposure. The incidence of NSI is low, as there exists an underreporting which cannot be denied. Following stringent universal precautions and adoption of safety-guided devices can reduce the rate of injury to a great extent. Regular training, monitoring, auditing, and adequate control modalities are the core strategies to reduce the incidence of NSI.

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.

PREVALENCE AND RISK FACTORS OF NEEDLE STICK INJURIES AMONG CLEANERS IN A TERTIARY HEALTH FACILITY IN GOMBE, NORTHEAST, NIGERIA.

Introduction: The cleaning staff working in a health facility are at risk of needle stick injuries (NSI) because of the nature of their work which involves the disposal of used needles and sharps. This study aimed to determine the prevalence and risk factors of NSI among cleaning staff at Federal Teaching Hospital Gombe. Methodology: A cross-sectional study was carried out among 150 cleaning staff, selected using simple random sampling technique. An interviewer-administered questionnaire was used to collect data on the research variables. Data was analyzed using SPSS Version 23. Bivariate analysis was conducted to examine the relationships between sociodemographic factors and the prevalence of injury, while logistic regression was used to determine the predictors of needle stick injuries. Statistical significance was determined at a p-value of ≤0.05. Result: Majority of the respondents were males (64%) and uneducated (63.3%) with a mean age of 39.9±9 years. The prevalence of NSI among the cleaners was 35.3% with 23.3% having experienced injury at least once. Uneducated individuals were found to have experienced NSI more than those who were educated. Risk factors found to be predictors of NSI were sex, educational level, job duration of > 10 years, and number of hours spent during cleaning activity. Conclusion: Most of the staff were uneducated with no formal training before the commencement of work. Prevalence of NSI was high and therefore, there is a need for health education on the risks of the job and formal training of staff before commencement of work.

A large-scale survey on epidemiology and underreporting of needlestick and sharp injuries among healthcare workers in China.

Background: Needlestick and sharp injuries (NSI) carry the risk of transmitting numerous bloodborne pathogens, leading to both health and economic burdens. The underreporting of NSIs among healthcare workers (HCWs) is a global issue of concern, as timely treatment and prevention of complications rely on proper reporting. Underreporting further impedes accurate surveillance and appropriate resource allocation, with developed and developing nations facing disparities due to differences in healthcare policy. Purpose: The purpose of this research is to examine the epidemiology of NSIs and NSI underreporting, as well as to identify the determinants associated with the occurrence of NSIs and the underreporting of such injuries. Method: A retrospective online survey was conducted from January 15 to January 31, 2022 among healthcare workers (HCWs) across Gansu Province, China. Results: A total of 7,283 healthcare workers (HCWs) from various institutions participated in this study. After quality assurance checks, 6,464 (88.77%) responses were included in the final analysis. Results revealed a 32.86% self-reported needlestick and sharp injury (NSI) incidence among respondents, with 28.53% of NSIs going unreported. Contrary to common belief, more experienced HCWs exhibited higher rates of both NSIs and underreporting compared to their less experienced peers. The primary reasons cited for NSIs and underreporting were lapses in concentration and not perceiving patients as infectious. Multivariate regression analysis exposes the significant influence of training frequency, occupation, department and years of services on the occurrence of NSIs. Conversely, the reporting of NSIs is primarily influenced by training, reimbursement,occupation, department and hospital grade. Compared to HCWs with no training, those who received ≥3 training sessions per year showed a 12.16% lower NSI incidence (27.12% vs. 39.28%, p < 0.001) and a 55.68% lower underreporting rate (14.61% vs. 70.29%, p < 0.001). Conclusion: There is a pressing need for enhanced surveillance, tailored training programs, and more efficient reporting mechanisms to combat this significant occupational health challenge.

Needlestick and sharps injuries among healthcare workers in an oncology setting: a retrospective 7-year cross-sectional study.

OBJECTIVE: To assess the prevalence of needlestick and sharps injuries (NSSIs) and associated factors among healthcare workers (HCWs) at King Hussein Cancer Centre (KHCC), Amman, Jordan. METHODS: This retrospective cross-sectional study undertook a chart review of all HCWs that reported an NSSI between January 2015 and December 2021. Data collected included sociodemographic factors including age, sex, qualifications, and predictors of NSSIs such as working hours, work shift, and specific job roles within the oncology setting, work experience in KHCC, overall work experience and occupational category. RESULTS: A total of 355 NSSIs were included in this study with a peak prevalence in 2019 (81 of 355; 22.8%). Nurses (220 of 355; 62.0%), housekeeping staff (59of 355; 16.6%) and physicians (45 of 355; 12.7%) were the most affected occupations. NSSIs were most common in the surgical floor (65 of 355; 18.3%) and operating rooms (56 of 355; 15.8%). Blood collection (94 of 355; 26.5%) and waste collection (65 of 355; 18.3%) were the two primary procedures resulting in NSSIs. The risk of injury was significantly associated with the locations of NSSIs, procedure that caused NSSIs, shift and overall experience. CONCLUSION: NSSIs remain common among HCWs, which highlights the need for targeted education.

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

INTRODUCTION: Needlestick injuries (NSIs) are a major hazard in the workplace for healthcare workers. To prevent these injuries, it is essential to determine the important factors affecting the occurrence of them. This study aimed to identify, classify and prioritize these factors using techniques of Delphi and fuzzy analytical hierarchy process (FAHP). METHODS: This descriptive-analytical study was conducted in 2022. Firstly, the factors affecting the occurrence of needlestick injuries were identified by the literature review. Moreover, the Delphi technique was used to identify the factors. 20 experts (physicians, nurses, and occupational health experts) participated in the steps of the Delphi method. Then, these factors were grouped into six groups. In the next step, the fuzzy analytical hierarchy process (FAHP) was applied to prioritize the factors. For this purpose, the pairwise comparison questionnaire was designed and filled out by 20 experts. Finally, data were analyzed using MATLAB software (version 2018a). RESULTS: 42 factors (31 factors extracted from the literature review and 11 factors obtained from the Delphi technique) were identified in this study. These factors were categorized into six groups. Based on the results, the relative weight of non-demographic personal factors, tool and technology factors, job factors, organizational factors, demographic personal factors, and environmental factors were computed by 0.200, 0.185, 0.184, 0.157, 0.142, and 0.133, respectively. CONCLUSION: These results determined the importance of the factors affecting the occurrence of needlestick injuries. These findings can be useful for planning preventive measures.

Prevalence of needle stick and its related factors in Iranian health worker: an updated systematic review and meta-analysis.

Background: Healthcare workers (HCWs) are at risk of acquiring blood-borne infections such as hepatitis B, hepatitis C, and human immunodeficiency virus through needlestick injuries (NSIs). We aimed to investigate the prevalence of needlestick injuries and other related indicators among HCWs in Iran through a systematic review and meta-analysis. Methods: We searched various databases until the end of May 2023 for studies reporting the prevalence of NSIs among healthcare workers in Iran. We used a random model with 95% confidence intervals (CIs) to analyse the data and the Joanna Briggs Institute (JBI) tool to evaluate the quality of included studies. We conducted and reported the study according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: We included 87 studies in the analysis and found that 47% (95% CI = 42-52, I2 = 98.9%) of Iranian HCWs experienced NSI. NSIs were most frequently related to syringe needles (58%; 95% CI = 52-65, I2 = 96.8%) and most often caused by recapping (30%; 95% CI = 22-38, I2 = 98.5%). In this study, 56% (95% CI = 45-67, I2 = 98.6%) of HCWs with NSIs did not report their injury. Moreover, the prevalence of NSIs the highest in the morning shift (0.44; 95% CI = 0.36-0.53, I2 = 97.2%), emergency unit (0.20; 95% CI = 0.16-0.24, I2 = 93.7%), and intensive care unit (0.20; 95% CI = 0.16-0.24, I2 = 94.3%). Conclusions: To reduce the high prevalence of NSIs, HCWs, especially those in emergency departments, should use safety equipment. Healthcare managers should provide a calm and stress-free environment for HCWs, educate them on safety principles and standards, and support experienced HCWs with NSIs.

Needlestick injuries in dentistry: Time to revisit.

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.

A Cross-Sectional Analysis of Sharps Injuries Among Dermatologic Surgeons: A Survey of American College of Mohs Surgery Members.

BACKGROUND: There is a paucity of data on sharps injuries and bloodborne pathogen exposure among Dermatologic Surgeons. OBJECTIVE: Quantify occupational risks from sharps injuries among Mohs surgeons. Determine rate of injury, reporting, and confidence in staff's sharps handling. METHODS: A cross-sectional analysis performed using survey responses from Mohs surgeons with membership in the American College of Mohs Surgery (ACMS). RESULTS: A total of 60 ACMS members completed the survey. Overall, 56.7% reported at least 1 sharps injury within the past year, of which 14.7% resulted in a bloodborne exposure (odds of exposure: 7.5% per year). The most common type of injury was self-inflicted suture needlestick (76.5%). Forty-four-point-one percent did not report their injuries. Ninety-five percent reported access to postexposure prophylaxis at their workplace. In addition, respondents in academic and single-specialty practices were more likely to report high or moderate confidence in staff sharps handling knowledge and in injury reporting compared with respondents from multispecialty and solo practices (88% vs 54% p = .02, 76%-81% vs 27% p = .0004, respectively). CONCLUSION: Sharps injuries and under-reporting of these injuries are common among Mohs surgeons. Despite reporting of higher confidence in staff knowledge and training in academic and single-specialty practices, there was no correlation with surgeon's rate of injury.

Assessment of sharps penetrating injury, mucosal exposure and compliance with standard precautions of health workers at a University Hospital in Turkey.

OBJECTIVES: To evaluate the compliance with standard precautions in healthcare workers who experienced a sharps penetrating injury or mucosal exposure using the compliance with Standard Precautions Scale, Turkish version. METHODS: This descriptive cross-sectional study was conducted in a tertiary hospital. The occupational health and safety unit records of healthcare workers who were injured by a sharps penetrating injury or experienced mucosal exposure between January 2018 and July 2020 were examined. Compliance with the Standard Precautions Scale was assessed by having participants answer a questionnaire. RESULTS: Of the 100 participants, 59% were men. Of all healthcare workers in the university hospital, 4.5% (n=100) were injured by sharps penetrating injuries or mucosal exposure. Of the participants, 95% were wounded by a sharps penetrating injury and 5% had mucosal exposure. The mean Compliance with Standard Precautions Scale score of participants with a sharps penetrating injury was 16.36±2.39 and with mucosal exposure was 16.80±3.03. There was no significant difference between the mean Compliance with Standard Precautions Scale scores of the sharps penetrating injury and mucosal exposure groups regardless of training on occupational health and safety (p=0.794). CONCLUSION: In conclusion, the frequency of a sharps penetrating injury and mucosal exposure in healthcare workers was similar to the literature. The compliance level of the healthcare workers measured with the Compliance with Standard Precautions Scale was high.

Sharps injuries with Lovenox and generic enoxaparin prefilled safety syringes: A 12-year retrospective cross-sectional analytical study.

PURPOSE: Investigate the incidence and mechanisms of sharps injuries (SI) to staff using Lovenox and generic enoxaparin prefilled syringes. METHODS: Four national adverse event databases were examined over a 12-year period for incidence and brands involved with injury events to staff using enoxaparin prefilled syringes. RESULTS: The search revealed 581 adverse events (including 20 sharps injuries) associated with device malfunction in 8 of 16 brands, with one brand mentioned significantly more frequently than others. No national alert had been issued. CONCLUSIONS: Use of certain brands of enoxaparin prefilled syringes poses a small but serious risk of injury to staff. Conducting root cause analyses on all SI is essential, as is the need for regularly evaluating safer devices, reporting all device incidents, enabling simpler reporting of adverse events, and establishing more effective intervention by FDA and manufacturers.

Incidence, knowledge, attitude and practice toward needle stick injury among nursing students in Saudi Arabia.

Background: Needle stick injuries constitute the greatest threat to nursing students during clinical practice because of accidental exposure to body fluids and infected blood. The purpose of this study was to (1) determine the prevalence of needle stick injuries and (2) measure the level of knowledge, attitude and practice among nursing students about needle stick injuries. Methods: Three hundred participants undergraduate nursing students at a private college in Saudi Arabia were included, of whom 281 participated, for an effective response rate of 82%. Results: The participants showed good knowledge scores with a mean score of 6.4 (SD = 1.4), and results showed that students had positive attitudes (Mean = 27.1, SD = 4.12). Students reported a low level of needle stick practice (Mean = 14.1, SD = 2.0). The total prevalence of needle stick injuries in the sample was 14.1%. The majority, 65.1%, reported one incidence in the last year, while (24.4%) 15 students reported two incident of needle stick injuries. Recapping was the most prevalent (74.1%), followed by during injection (22.3%). Most students did not write a report (77.4%), and being worried and afraid were the main reasons for non-reports (91.2%). The results showed that female students and seniors scored higher level in all needle stick injuries domains (knowledge, attitude and practice) than male students and juniors. Students who had needle stick injuries more than three times last year reported a lower level of all needle stick injury domains than other groups (Mean = 1.5, SD =1.1; Mean = 19.5, SD =1.1; Mean = 9.5, SD =1.1, respectively). Conclusion: Although the student's showed good knowledge and positive attitudes in NSI, the students reported a low level of needle stick practice. Raising awareness among nursing students and conducting continuing education related to sharp devices and safety and how to write an incident reporting is highly recommended.

Occupational needle stick injuries and related factors among healthcare workers in military hospitals in Tehran.

AIM: Healthcare workers (HCWs) are always at risk of experiencing occupational needle stick injuries (NSIs). The primary aim of this study was to assess the prevalence of NSIs among Iranian HCWs in military hospitals in Tehran. DESIGN: This cross-sectional study was conducted in four military hospitals in the summer of 2019 in Tehran. METHOD: By Census, 802 HCWs were included. Data were collected through a questionnaire consisting of vaccination history, safety equipment, use of safety box, history of NSIs and demographic variables. The logistics regression was used to estimate the odds ratios (OR) and 95% confidence interval (CI). The statistical significance level was set at 5%. The data were analysed using the SPSS software version 23. RESULTS: A total of 203 (25.3%, CI: 22.3-28.4) of the participants reported a history of NSIs at least once during the past year. Single HCWs had a higher risk of NSIs compared to married HCWs (OR: 1.59, 95% CI (1.09, 2.30)). Also, the night shift working (OR: 1.91, 95% CI (1.18, 3.12)), higher educational degree (OR: 2.25, 95% CI (1.21, 4.20)), working overtime (OR: 1.50, 95% CI: (1.07, 2.12)), older age (OR: 1.02, 95% CI (1.01, 1.04)) and needle recapping (OR: 2.90, 95% CI: (1.98, 4.22)) were identified as significant associated factors. The study draws attention to a relatively high prevalence of NSIs as well as high-risk activities among military HCWs. The primary source of NSIs is needle recapping. Measures such as setting up training courses for the military HCWs are needed to be planned.

Identifying and Decreasing Sharps Injuries Through Root Cause Analysis in a Large Urban Hospital System.

BACKGROUND: Despite safety mandates and interventions, sharps injuries remain an occupational risk for registered nurses (RNs). Sharps and needlestick injuries increase the risk of exposure to blood-borne pathogens. Post-exposure direct and indirect costs of these percutaneous injuries have been estimated at about US$700 per incident. The goal of this quality improvement project was to identify root causes of sharps injuries for RNs at a large urban hospital system. METHODS: A retrospective evaluation of sharps injuries sustained by RNs, identification epsication of themes or root causes, and the development of a fishbone diagram to sort the causes into categories to identify workable solutions were conducted. Fisher's exact tests were performed to identify association between variables and root causes. FINDINGS: A total of 47 sharps injuries were reported from January 2020 through June 2020. Among sharps injuries sustained by nurses, 68.1% were among nurses 19 to 25 years of age and 57.4% reported job tenure of 1 to 2 years. There was a statistically significant association between root causes and tenure range, gender, and procedure type (p < .05) with moderate effect size (Cramer's V = 0.35-0.60). Technique also was a primary cause of sharps injuries for blood draw (77%), discontinuing line (75%), injection (46%), intravenous (IV) start (100%), and suturing (50%). CONCLUSIONS/APPLICATIONS TO PRACTICE: Technique and patient behavior were primary root causes of sharps injuries in this study. More sharps injuries caused by technique occurred among nurses with job tenure of 1 to 10 years, female, blood draw, discontinuing line, injection, IV start, and suturing procedures. The root cause analysis identified tenure, technique, and behavior as potential root causes of sharps injuries specifically occurring most during blood draw and injections at a large urban hospital system. These findings will inform nurses, especially new nurses in the proper use of safety devices and behaviors to prevent injury.

Prevalence and characteristics of needlestick injuries among dental interns during their first-year clinical training: an observational study.

BACKGROUND: Dental interns are vulnerable to needlestick injuries (NSI). The objectives of this study were to examine the prevalence and characteristics of NSI exposures among dental interns during their first-year clinical training, assess risk factors, and evaluate reporting behaviours. METHODS: An online survey was conducted among dental interns of Class 2011-2017 at Peking University School and Hospital of Stomatology (PKUSS), China. The self-administrated questionnaire consisted of information on demographic profiles, NSI characteristics, and reporting practices. The outcomes were presented by descriptive statistics. A multivariate regression analysis was performed to assess NSI sources using a forward step-wise approach. RESULTS: A total of 407 dental interns completed the survey (response rate 91.9%, 407/443), and 23.8% sustained at least one NSI. The mean number of NSIs per intern was 0.28 during the first clinical year. More occupation exposures occurred from October to December, between 13:00-15:00. Syringe needles were the most frequent sources, followed by dental burs, suture needles, and ultrasonic chips. The risk of peer-inflicted NSIs in the department of Paediatric Dentistry was 12.1 times higher than that in Oral Surgery (OR 12.1, 95% CI: 1.4-101.4). Appropriately 64.9% NSIs occurred when chairside assistants were absent. Compared to working alone, the risk of peer-inflicted NSIs was 32.3 times higher when providing chairside assistance (OR 32.3, 95% CI: 7.2-145.4). The left-hand index finger was the most commonly injured site. About 71.4% of exposures were reported in paperwork. CONCLUSIONS: Dental interns are susceptible to NSIs during their first-year clinical training. Extra attention should be paid to syringe needles, dental burs, suture needles, and ultrasonic chips. The lack of chairside assistance is hazardous regarding NSIs. The training of chairside assistance of the first-year dental interns should be enhanced. First-year dental interns are required to increase their awareness of ignored behaviors related to NSI exposures.

A survey of pain physicians: Needlesticks injuries.

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.

Reducing Sharps Injuries in the Operating Rooms of an Academic Tertiary Care Center.

BACKGROUND: Data on the prevalence and distribution of operating room (OR) sterile field sharps injuries sustained by attending surgeons, residents, scrub nurses, and surgical technologists are limited. The goal of this study is to understand current practices, injuries, and reporting behavior at an academic center, implement interventions, and assess their effect on sharps safety and reporting. METHODS: An electronic survey with questions pertaining to sharps handling practices, injuries, and reporting was e-mailed to 864 staff between July and September 2014. Adjusted analyses for risk of injury were performed. A follow-up survey was sent in January 2018, following the implementation of a shorter injury reporting form and a neutral zone. RESULTS: The overall response rate was 49.3%, with 363 completed surveys. Of respondents, 44.9% reported injuries occurring in the preceding three years. Physicians comprised 65.1% of injured staff and sustained 68.8% of the total injuries. Compared to attending surgeons, residents had a similar likelihood of injury (odds ratio 0.9, 95% confidence interval [CI] 0.37-2.2), whereas scrub nurses (odds ratio 0.3, 95% CI 0.17-0.54) and technologists (odds ratio 0.3, 95% CI 0.14-0.76) had a lower likelihood. Half of those injured reported to Occupational Health Services. Of those who did not report, 46.4% stated that time was a limiting factor. Following the interventions, the incidence of injuries among survey respondents remained unchanged. However, 54.0% of respondents stated that it was easier to report injuries. CONCLUSION: Attending surgeons and residents sustain the majority of OR sterile field sharps injuries and are the least likely to report them. Shorter reports made it easier to report the injuries.

Sharps injuries with Lovenox and generic enoxaparin prefilled safety syringes: A 12-year retrospective cross-sectional analytical study.

PURPOSE: Investigate the incidence and mechanisms of sharps injuries (SI) to staff using Lovenox and generic enoxaparin prefilled syringes. METHODS: Four national adverse event databases were examined over a 12-year period for incidence and brands involved with injury events to staff using enoxaparin prefilled syringes. RESULTS: The search revealed 581 adverse events (including 20 sharps injuries) associated with device malfunction in 8 of 16 brands, with one brand mentioned significantly more frequently than others. No national alert had been issued. CONCLUSIONS: Use of certain brands of enoxaparin prefilled syringes poses a small but serious risk of injury to staff. Conducting root cause analyses on all SI is essential, as is the need for regularly evaluating safer devices, reporting all device incidents, enabling simpler reporting of adverse events, and establishing more effective intervention by FDA and manufacturers.

Frequency of needle stick injuries among healthcare providers during large-scale SARS-CoV-2 vaccination brigades.

The frequency of needle stick-related accidents in large-scale vaccination brigades during the COVID-19 pandemic is unknown. We determined the incidence of needle stick injuries (NIs) from the SARS-CoV-2 vaccination brigades in the Monterrey metropolitan area. We calculated the rate of NI by 100,000 doses administered from a registry of over 4 million doses.