Reported Hospital Needlestick Injuries in Relation to Knowledge/Skill, Design, and Management Problems

1992 ◽  
Vol 13 (5) ◽  
pp. 259-264 ◽  
Author(s):  
Judith Fay Boylan English
Keyword(s):  
Healthcare Workers ◽  
Management Practices ◽  
Washington Dc ◽  
Needlestick Injuries ◽  
Hospital Workers ◽  
Hours Of Work ◽  
Disposable Needle ◽  
Returning To Work ◽  
Medical Technologists ◽  
Knowledge And Practice

AbstractObjectives:To investigate reported needlestick injuries in hospital workers from an adult learner theory perspective: identifying safe needle device knowledge and practice, and flaws in needle designs and management practices surrounding such problems.Design:Exploratory descriptive study of reported needlestick injuries from hollow needled devices in a hospital. Injured healthcare workers were counseled via hospital protocol, then a survey was filled out containing no identifiers of individual or institution.Setting:Seventeen Metropolitan Washington, DC, area hospitals.Participants:All workers reporting needlestick injuries during February 1-28, 1990.Results:Seventy-two injuries were reported; there were no multiple injuries to any individual. Thirty-three (45.8%) were to registered nurses (RNs)-more than any other group of workers. Recapping accounted for a higher percentage than any other activity (10 sticks, 14.1%). Of workers incurring recapping injuries, 3 identified a knowledge of a one-handed spearing technique and did not practice it; 4 neither knew nor practiced it. Eighteen (25.0%) were to “down-stream” housekeepers and aides who did not use such devices in their practice. Disposable needle/syringes caused 49.3% of injuries; hypodermic needles on intravenous lines caused 16.9%. Of the needlesticks, 60.6% were after use and before disposal, 4.2% occurred as the worker was putting an item into a needlebox, and 9.9% occurred from needles protruding from inappropriate bags. Many injuries occurred in the first 2 hours of work after being off the previous day, on Sunday, and on MondayConclusions:Of nurses and medical technologists reporting knowledge of a spearing recapping technique, 97.3% suffered injury via other methods. This strongly suggests that knowledge leads to different action. Safer needled devices and needle-free systems would make a safer workplace. Further study is indicated to identify if and why the first two hours after returning to work on Sunday or Monday are risky for needlestick injuries. Management practices must ensure compliance to safe practice both by employees and related medical staff.

‘Stat’ workflow modifications to expedite care after needlestick injuries

2021 ◽  
Author(s):  
J L Smith ◽  
R Banerjee ◽  
D R Linkin ◽  
E P Schwab ◽  
P Saberi ◽  
...  
Keyword(s):  
Psychological Health ◽  
Healthcare Workers ◽  
Post Exposure Prophylaxis ◽  
Psychological Consequences ◽  
Intervention Period ◽  
Needlestick Injuries ◽  
Post Intervention ◽  
Immunodeficiency Virus ◽  
Physical And Psychological Health ◽  
Exposure Prophylaxis

Abstract Background Post-exposure prophylaxis (PEP) for human immunodeficiency virus (HIV) is recommended to start within hours of needlestick injuries (NSIs) among healthcare workers (HCWs). Delays associated with awaiting the results of testing from the source patient (whose blood was involved in the NSI) can lead to psychological consequences for the exposed HCW as well as symptomatic toxicities from empiric PEP. Aims After developing a ‘stat’ (immediate) workflow that prioritized phlebotomy and resulting of source patient bloodwork for immediate handling and processing, we retrospectively investigated whether our new workflow had (i) decreased HIV order-result interval times for source patient HIV bloodwork and (ii) decreased the frequency of HIV PEP prescriptions being dispensed to exposed HCWs. Methods We retrospectively analysed NSI records to identify source patient HIV order-result intervals and PEP dispensing frequencies across a 6-year period (encompassing a 54-month pre-intervention period and 16-month post-intervention period). Results We identified 251 NSIs, which occurred at similar frequencies before versus after our intervention (means 3.54 NSIs and 3.75 NSIs per month, respectively). Median HIV order-result intervals decreased significantly (P < 0.05) from 195 to 156 min after our intervention, while the proportion of HCWs who received one or more doses of PEP decreased significantly (P < 0.001) from 50% (96/191) to 23% (14/60). Conclusion Using a ‘stat’ workflow to prioritize source patient testing after NSIs, we achieved a modest decrease in order-result intervals and a dramatic decrease in HIV PEP dispensing rates. This simple intervention may improve HCWs’ physical and psychological health during a traumatic time.

scholarly journals Socioeconomic and Behavioral Correlates of COVID-19 Infections among Hospital Workers in the Greater Jakarta Area, Indonesia: A Cross-Sectional Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5048
Author(s):  
Adrianna Bella ◽  
Mochamad Thoriq Akbar ◽  
Gita Kusnadi ◽  
Olivia Herlinda ◽  
Putri Aprilia Regita ◽  
...  
Keyword(s):  
Healthcare Worker ◽  
Healthcare Workers ◽  
Hospital Staff ◽  
Cross Sectional Study ◽  
Household Size ◽  
Risk Of Infection ◽  
Sectional Study ◽  
Hospital Workers ◽  
Behavioral Correlates ◽  
Cross Sectional

(1) Background: because of close contacts with COVID-19 patients, hospital workers are among the highest risk groups for infection. This study examined the socioeconomic and behavioral correlates of COVID-19 infection among hospital workers in Indonesia, the country hardest-hit by the disease in the Southeast Asia region. (2) Methods: we conducted a cross-sectional study, which collected data from 1397 hospital staff from eight hospitals in the Greater Jakarta area during April–July 2020. The data was collected using an online self-administered questionnaire and Reverse Transcription-Polymerase Chain Reaction (RT-PCR) tests. We employed descriptive statistics and adjusted and unadjusted logistic regressions to analyze the data of hospital workers as well as the subgroups of healthcare and non-healthcare workers. (3) Results: from a total of 1397 hospital staff in the study, 22 (1.6%) were infected. In terms of correlates, being a healthcare worker (adjusted odds ratio (AOR) = 8.31, 95% CI 1.27–54.54) and having a household size of more than five (AOR = 4.09, 1.02–16.43) were significantly associated with a higher risk of infection. On the other hand, those with middle- and upper-expenditure levels were shown to have a lower risk of infection (AOR = 0.06, 0.01–0.66). Behavioral factors associated with COVID-19 infection among healthcare and non-healthcare workers included knowledge of standard personal protective equipment (PPE) (AOR = 0.08, 0.01–0.54) and application of the six-step handwashing technique (AOR = 0.32, 0.12–0.83). (4) Conclusion: among hospital staff, correlates of COVID-19 infection included being a healthcare worker, household size, expenditure level, knowledge and use of PPE, and application of appropriate hand washing techniques.

scholarly journals Assessment of cold chain and logistics management practices: a cross sectional study in Bundelkhand region of Madhya Pradesh

2018 ◽  
Vol 5 (12) ◽  
pp. 5143
Author(s):  
Ram K. Panika ◽  
Amarnath Gupta
Keyword(s):  
Management Practices ◽  
Cross Sectional Study ◽  
Logistics Management ◽  
Cold Chain ◽  
Temperature Sensitive ◽  
Sectional Study ◽  
Cross Sectional ◽  
Shake Test ◽  
The Status ◽  
Knowledge And Practice

Background: Immunization is one of the most effective disease prevention strategies. Potency of vaccine is dependent on effective management of cold chain system at all levels of vaccine handling. This study was carried out to assess the status of cold chain equipment and logistics management practices, Knowledge and practice of CCHs about cold chain equipment and logistics management.Methods: Cross-sectional study was conducted in all functional cold chain points of Damoh district using structured questionnaires provided by UNICEF.Results: Only 57.14% and 71% CCPs had dedicated space for dry storage and for conditioning of ice packs respectably. 50% CCPs had correct placement of ice-packs inside DFs. Functional thermometer inside every equipment was available in 86% CCPs. Twice daily temperature recording and temperature of ILRs was within normal range in 93% CCPs. Record of power failures and defrosting/cleaning in temperature log books was found in 57% and 43% CCPs. Temp log book was countersigned by facility in charge in 43% CCPs. UIP vaccines were stored within basket in 93%. Fractional IPV was stock out in 29% CCPs and in 07% CCPs OPV vials were found with not usable VVM. 86%, 72% and 64% of CCHs had knowledge on freeze/temperature sensitive vaccines, cold chain pray and, Shake test. In 79% CCPs expired/wasted vaccines were not documented in stock.Conclusions: Most of the components of cold chain and logistics management practices were satisfactory while there is a gap in other components which needs to be improved. 

Influenza vaccine uptake and attitudes of healthcare workers in Ireland

2019 ◽  
Author(s):  
V Hogan ◽  
M Lenehan ◽  
M Hogan ◽  
D P Natin
Keyword(s):  
Influenza Vaccination ◽  
Healthcare Workers ◽  
Vaccine Uptake ◽  
Hospital Workers ◽  
Line Managers ◽  
Vaccination Uptake ◽  
Flu Vaccination ◽  
Irish Hospital ◽  
Local Initiatives ◽  
Specific Barriers

Abstract Background Influenza vaccination uptake by Irish healthcare workers remains sub-optimal despite local initiatives to increase it. Aims To investigate hospital workers' attitudes to influenza vaccination and how this influenced their decisions about vaccination. Methods A questionnaire survey of Irish hospital workers, measuring uptake of and attitudes to influenza vaccination. Results There were 747 responders, of whom 361 (48%) reported having received influenza vaccination. Attitudes predicting vaccination uptake included a belief that vaccination would protect family members (P < 0.0005, CI 1.191–1.739), a perception of susceptibility to ’flu (P < 0.0005, CI 1.182–1.685), a belief that all healthcare workers should be vaccinated (P < 0.005, CI 1.153–1.783), perceived ease of getting ’flu vaccination at work (P < 0.0005, CI 1.851–2.842) and encouragement by line managers (P < 0.05, CI 1.018–1.400). Attitudes negatively associated with vaccination uptake included fear of needles (P < 0.05, CI 0.663–0.985) and a belief that vaccination would cause illness (P < 0.0005, CI 0.436–0.647). Medical staff were significantly more likely to be vaccinated. Healthcare students were least likely to be vaccinated (P < 0.0005). Conclusion Addressing specific barriers to influenza vaccination in healthcare workers may improve uptake.

scholarly journals Knowledge and Compliance Toward Standard Precaution Among Health Care Workers at Bahria International Hospital Lahore, Pakistan

2020 ◽  
Vol 7 (1) ◽  
pp. 17-20
Author(s):  
Humira Ather ◽  
Asaf Khan ◽  
Saima Shabnum
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Healthcare Workers ◽  
P Value ◽  
Hospital Acquired Infection ◽  
Standard Precaution ◽  
Care Workers ◽  
Knowledge And Practice ◽  
Control Infection ◽  
Hospital Acquired

Introduction: Standard precaution is a way to stop the spread of hospital acquired infection which may be in the form of blood, secretions, body waste, body fluids and mucous membrane that may contain contagious infectious agents. Healthcare workers are the persons who have the moral obligation to care for sick persons and improve their regaining health and attain excellent worth of treatment care. Therefore, health care providers should have proper knowledge and good practice to strictly adhere to standard precaution control infection. Aim: To determine the knowledge and compliance toward standard precaution among health care workers in Bahria international Hospital Lahore. Methodology: a descriptive cross sectional study design were used for this study with sample size of 180 participants which were randomly selected from the target population. Results: The association between knowledge and practice was assessed through chi square test with p value=0.05, after apply this test the p value found .000 which is significant association between knowledge and practice. Whereas regression test shows value of adjusted R² showing 60% (F=.141, p <.001) of variance caused by independent variable (knowledge) in dependent variable (practice). Hence, it is proved that there is a significant positive relationship between knowledge and practice. Conclusion: The current study concluded that adhering to standard precaution is very important for all health care workers to control hospital acquired infection. Study finding also show that majority of the healthcare workers have good knowledge regarding standard precautions but they have unsatisfactory compliance to prevent and control infection. Int. J. Soc. Sc. Manage. 7(1): 17-20

An Effective Educational Program to Reduce the Frequency of Needle Recapping

1990 ◽  
Vol 11 (12) ◽  
pp. 635-638 ◽  
Author(s):  
Bruce S. Ribner ◽  
Barbara S. Ribner
Keyword(s):  
Educational Program ◽  
Healthcare Workers ◽  
Needlestick Injuries

AbstractWe developed an educational program that reported the rate of needle recapping to healthcare workers, in conjunction with emphasis on appropriate disposal procedures. Over 12 months, the rate of recapping needles used for venipuncture and for percutaneous medication injections fell from 61% to 16% (p<.0001). Over the same period, the recapping of needles used primarily for intravenous (IV) administration fell from 44% to 33% (p = .03). Re-evaluation of the rate of recapping eight months later showed a continuation of these lowered rates. Needlestick injuries were too few in number during the study period to detect any change accompanying the decreased recapping rate. We conclude that programs that report back to employees their rate of recapping can significantly reduce this activity in the disposal of needles used for venipuncture and for percutaneous medication injections. While such reporting may reduce the rate of recapping of needles used for IV administration, the effect is not nearly so marked. Modifications in design remain the most promising approach to preventing needlestick injuries from recapping needles used for IV administration.

Economic burden of needlestick injuries among healthcare workers in China

2020 ◽  
Vol 23 (7) ◽  
pp. 683-689 ◽  
Author(s):  
Lei Zhang ◽  
Yaping Ai ◽  
Jing Liu ◽  
Ning Yue ◽  
Jianwei Xuan ◽  
...  
Keyword(s):  
Economic Burden ◽  
Healthcare Workers ◽  
Needlestick Injuries

Diarrhoea-related knowledge and practice of physicians in urban slums of Kolkata, India

2013 ◽  
Vol 142 (2) ◽  
pp. 314-326 ◽  
Author(s):  
S. KANUNGO ◽  
T. MAHAPATRA ◽  
B. BHADURI ◽  
S. MAHAPATRA ◽  
N. D. CHAKRABORTY ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Management Practices ◽  
Cross Sectional Study ◽  
Urban Slums ◽  
Stool Examination ◽  
Sectional Study ◽  
Cross Sectional ◽  
Lower Likelihood ◽  
Knowledge And Practice ◽  
Slum Areas

SUMMARYDiarrhoeal management practices are unsatisfactory in India especially in the slum areas. Dearth of information regarding physicians' diarrhoea-related knowledge and practice in India ncessitated this cross-sectional study of allopathic practitioners in the slums of Kolkata, to assess the distribution and interrelationship between physicians' characteristics, knowledge and practice regarding diarrhoea. A total of 264 randomly selected consenting practitioners were interviewed using a field-tested questionnaire. Nineteen percent had good overall knowledge, 49% and 80% prescribed antibiotics to diarrhoea and cholera patients, respectively, and 55% advised stool examination for every case. Qualified and Government physicians had better knowledge regarding diarrhoea [MBBS: odds ratio (OR) 5·96, P < 0·001; postgraduates: OR 9·33, P < 0·001; Government physicians: OR 11·49, P < 0·0001] and were less likely to prescribe antibiotics for all diarrhoea cases (MBBS: OR 0·30, P = 0·002; postgraduates: OR 0·20, P < 0·001; Government physicians OR 0·24, P < 0·029). Better knowledge was associated with a lower likelihood of prescribing antibiotics for diarrhoea (OR 0·72, P < 0·001), cholera (OR 0·78, P = 0·027) and investigative procedure (OR 0·85, P = 0·028). In the slums of Kolkata, diarrhoea-related knowledge and practice were poor with the exception of qualified physicians, hence an improvement in the knowledge of pharmacists and unqualified practitioners is necessary for the overall improvement of diarrhoeal management in these slums.

Stick and Tell A Survey of Emergency Medicine Residents and Needlestick Exposures

2013 ◽  
Vol 34 (10) ◽  
pp. 1116-1118 ◽  
Author(s):  
Jessica Zuraw ◽  
Gretchen Sanford ◽  
Lori Winston ◽  
Shu Chan
Keyword(s):  
Emergency Medicine ◽  
Healthcare Workers ◽  
The United States ◽  
Perceived Barriers ◽  
Health Departments ◽  
Needlestick Injuries ◽  
Residency Programs ◽  
Paper Version ◽  
E Mail ◽  
New Procedures

An estimated 400,000–800,000 sharps-related injuries occur among healthcare workers (HCWs) annually in the United States. The risk of needlestick exposure may be particularly high among emergency medicine (EM) residents, who are learning new procedures in a relatively uncontrolled environment. Despite the potentially serious consequences of percutaneous injuries (PCIs), practitioners in training often down-play the occurrence of PCIs and do not report exposures.Current literature implies that underreporting of needlestick injuries is multifactorial. By not seeking care after needlesticks occur and thereby delaying treatment, residents incur more risk from exposures. We sought to elucidate the underlying issues that might contribute to this lack of reporting needlestick injuries. Using an anonymous survey, we collected information regarding factors that contributed to sustaining a PCI as well as perceived barriers that prevented residents from reporting these exposures. This information is desirable for both residency programs and employee health departments to reduce the occurrence of unreported exposures.The survey contained 19 questions, and all subjects were EM residents from the 8 Accreditation Council for Graduate Medical Education–accredited programs in the state of Illinois during the period January–February 2011. The voluntary survey was distributed via e-mail and through a paper version distributed at a regional EM residency conference.

Effect of Changing Needle Disposal Systems on Needle Puncture Injuries

1987 ◽  
Vol 8 (2) ◽  
pp. 59-62 ◽  
Author(s):  
Keith Krasinski ◽  
Rita LaCouture ◽  
Robert S. Holzman
Keyword(s):  
Health Care ◽  
Education Program ◽  
Educational Program ◽  
Needle Puncture ◽  
Mechanism Of Injury ◽  
Needlestick Injuries ◽  
Hospital Workers ◽  
Anatomic Site ◽  
Risk Of Injury ◽  
Before And After

AbstractAccidental needle puncture injuries continue to pose a hazard to hospital workers. In order to reduce the number of such injuries in our hospital, needle disposal procedures were revised to discourage recapping and prevent bending or clipping of needles before discard. Collapsible cardboard boxes were replaced with impervious containers. An educational program accompanied these changes. We compared reports of needlestick injuries before and after the change of procedure, for three parallel 9-month periods. During the 27-month study, injuries occurred during administration of medication (22%), or recapping of used needles (16%), from needles protruding through (10%) or out of the "mouth" (9%) of the container, from needles left in the patient's environment (10%), or those left on procedure trays (7%). Seven percent were the result of being stuck by someone else, usually in the operating room. The mechanism of injury for 19% was not, described. Altering the disposal procedures did not change the number or anatomic site of injuries, nor the risk of injury among the various job categories. A reduction in the rate of sticks from needles protruding through the container (1.3 vs 0.3/mo, p≤0.005) was the only difference observed. Changing the needle receptacle changed the type but not the overall number of injuries. The education program had little effect on the number and types of injuries. These data point to the need for developing innovative approaches for eliciting changes in behavior of health care personnel.

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