Unsafe Sharps Disposal Among Insulin-Using Patients With Diabetes Mellitus: An Emerging Global Crisis

Approximately eight billion therapeutic injections are administered outside of medical treatment facilities annually. The management of diabetes mellitus (DM) includes self-monitoring of blood glucose levels and administration of insulin and injectable non–insulin-related medications. The lancets, needles, and syringes used for DM management are categorized as medical sharps. Improperly discarded medical sharps can cause needlestick injuries in unsuspecting individuals and thereby pose a considerable public health risk. Release of these items into the environment will likely increase with the rising worldwide prevalence of DM, and a public safety crisis will emerge if proper disposal measures are not emphasized. This article reviews the literature from various geopolitical regions and describes how a substantial number of patients with DM improperly discard their sharps. Data support the need to develop multifaceted and innovative approaches to reduce risk associated with improper disposal of DM-related medical sharps into local communities.

Comparing risk changes of needlestick injuries between countries adopted and not adopted the needlestick safety and prevention act: A meta-analysis

Objectives: To determine whether countries that adopted the Needlestick Safety and Prevention Act (NSPA) achieved a reduced risk of needlestick injuries (NSIs). Method: In this meta-analysis, 3 international databases (Embase, PubMed, and MEDLINE EBSCO) and 1 Chinese database (Airiti Library) were searched using appropriate keywords to retrieve relevant articles, including multiyear NSI incidences that were published after 2010. The Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies was used to evaluate article prevalence. A binary random-effects model was used to estimate risk ratio as summary effect. A log scale was used to evaluate differences in risk ratios of NSIs between countries that adopted versus those that did not adopt the NSPA. Results: In total, 11 articles were included in the meta-analysis from 9 countries, and NSI incidence rates were surveyed between 1993 and 2016. The risk ratios of NSIs in countries with and without the NSPA were 0.78 (95% CI, 0.67–0.91) and 0.98 (95% CI, 0.85–1.12), respectively, and the ratio of risk ratios was 0.79 (95% CI, 0.65–0.98). Reduction in NSI incidence was more prominent in nurses than in physicians. Conclusions: Our findings suggest that the mandatory use of safety-engineered medical devices in countries that adopted the NSPA had lower NSI incidence in healthcare workers compared with countries without needlestick safety and prevention regulatory policies. Further studies are needed to develop preventive strategies to protect against NSIs in physicians, which should be incorporated into the standards of care established by national regulatory agencies.

Factors associated with needlestick injuries among healthcare workers: implications for prevention

Background Our study sought to determine the frequency of Needlestick injuries (NSIs) among Healthcare Workers (HCWs) working at governmental hospital and to study the factors that associated with occurrence of NSIs, and to develop recommendations for a comprehensive program for prevention. Methods Retrospective study of all reported cases of NSIs in the period from April 2016 to May 2018 among healthcare workers at a governmental hospital. Results Incidence of NSIs over 26 months was 8.4% among all participants. Nurses were the most affected staff (52.5%) resulted commonly from disposing syringes (58.9%). In contrast, the incidence of NSIs among physicians was 24.9% where surgical devices were the primary source of NSIs among them (40%). Failure to complete all required hepatitis B vaccination was common among expatriates of the participants of this study. Conclusions NSIs was common among HCWs participated in this study. Preventive measures should be implemented including adequate hepatitis B immunization.

The Need for Sharps Waste Disposal Guidelines for Commercial Airports

Travelers frequently eat at an airport before their flight. Travelers with diabetes also frequently need to lance their fingertips to check a blood glucose concentration and/or inject themselves with insulin. These actions generate medical sharps waste. Bloody sharps can be a source of needlestick injuries for other travelers or waste handlers if the waste is not safely disposed of. There are currently no guidelines or standards for medical sharps waste disposal in commercial airports or similar public places. We advocate for the establishment of guidelines for medical sharps waste disposal in commercial airports. These guidelines should include four elements: (1) design of sharps disposal bins, (2) placement of sharp disposal bins, (3) publication of locations with sharps disposal bins, and (4) safety protocols for both sharps disposal and handling sharps waste. In this article, we present the background and reasons behind our recommendation for establishing guidelines for medical waste disposal in commercial airports.

Knowledge, Attitude and Practice Regarding Needle-Stick Injuries among Nursing Staff in a Tertiary Care Hospital, Mangalore, India

BACKGROUND Health care workers are more prone to occupational hazards, like needlestick injuries, blood, and body fluid exposures. Needlestick injuries (NSI) are responsible for the transmission of serious infections like HIV, HBV and HCV. The occurrence of needlestick injuries is highest among the nurses. The objective of the study was to assess the knowledge, attitude and practice regarding needlestick injuries among nursing faculty in Justice K. S. Hegde Charitable Hospital, Mangalore. METHODS A cross-sectional survey was conducted among the nursing faculty working in a tertiary care hospital based on a structured questionnaire, and the obtained data were further analysed statistically. RESULTS The percentage of needle stick injury was 13.3 % among 75 nursing faculty. 94.7 % of the nurses were aware of the universal precaution guidelines and 84 % knew about post-exposure prophylaxis (PEP). 36 % of nurses knew the preventive guidelines' full details, but 50.7 % of the nurses were unaware of it. Many participants were aware that NSI transmits HIV (92 %) and Hepatitis B (68 %). The leading cause of NSI might be heavy work (54.7 %) followed by hurried procedures (41.3 %). 29.3 % of the nurses were still inclined to recapping the needle after use. 68 % of the nurses were mindful of washing hands with only water post exposure. 28 % were not willing to report a NSI. 80 % of nurses were fully immunised against Hepatitis B. CONCLUSIONS The best way to reduce NSI is to impart knowledge and awareness to the faculty. Our study showed that the knowledge, attitude, and practice among the nursing faculty were promising but requires to be further strengthened. KEY WORDS Needlestick Injury, Nursing Staff, Knowledge, Attitude, Practice