With regard to experience, the odds of sustaining nee- dle stickinjury was higher for nurses with work expe- rience greater than 10 years than those whose work experience is less than or equals to 5 years with. This is in line with report from Portugal and Pakistan indicat- ing experience greater than 10 years increases risk for sustaining needlestickinjury and those with experience greater than 5 years are at greater risk to sustain NSI respectively [27, 28]. This could be explained by more exposure due to longer duration of services and hence more NSI among more experienced nurses as compare to those working for greater than 5 years. Younger workers apply more recently acquired knowledge into practice, while experienced familiarity may contribute to tak- ing fewer precautions and paying less attention at work, which are likely to increase the chance of human error and contribute to risk behaviors.
Abstract: An academic institution based cross- sectional survey was done to identify the incidence density of needlestickinjury among PCL level nursing students. Multi stage sampling method was used to select 407 samples from nursing students studying inside Kathmandu valley. Self administered questionnaire and review the records guideline were used as research tool. Incidence density was calculated by using R software. Out of total participated students, 46.9 % had have needlestick injuries in the past and 44.7% experienced it more than one time. The overall incidence density was found 5.82/person 1000 days exposure. The incidence density in night shift (6.86) and in second year practicum period (6.91) was found higher than day shift (5.41) and first year (4.21) respectively. Out of total 298 injuries, 67.8 % were happened during medication, 41% while drawing medicine, 20% while recapping the needle and 45.1 % at medical ward. Only 46.6% injuries were reported and prophylaxis was used only in five injuries. However, almost all the students (98.3%) stated that they follow universal precaution but only 28% practicing no-recapping. Although the curriculum focuses on no recapping, there is a common practice of reusing syringes for the same patient in Nepal. Therefore, students must have to recap the needle. So, it is recommended that content in the curriculum and universal precaution training should be revised in the context of Nepal. Thirty one percent students also stated that needle should recap properly by using one hand technique for the prevention of needlestickinjury. It is also recommended to develop standard operating procedure for proper post exposure management of needlestickinjury.
Statistics from the US provide some insight into these occupational risks. Every year, healthcare workers experience between 6, 00,000 and 8, 00,000 exposures to blood-borne pathogens. The most serious and commonly transmitted pathogens are Hepatitis B and C virus (HBV, HCV) and the Human Immunodeficiency Virus (HIV), the virus that causes AIDS. Each of these viruses poses a different risk if a healthcare worker is exposed. More than 20 other infections can be transmitted through needle sticks, including Syphilis, Malaria, and Herpes etc. At least 1,000 healthcare workers are estimated to contract serious infections annually from needlestick and sharp injuries. As of June 2001, CDC documented there were at least 57 cases of healthcare workers with occupationally acquired HIV and at least 137 cases of possible transmissions. According to World Health Report 2002 published by WHO, needlestickinjury is accountable for 40 per cent of Hepatitis B, 40 per cent of Hepatitis C, and 2 per cent of HIV infections. The centers for disease control and prevention (CDC) estimates that each year, 85,000 needle sticks and other sharps related injuries are sustained by hospital based healthcare personnel. 35
injection (31%), disposing needle to sharp bin (9%) and transfer of blood to container (3%). Most of the injuries were due to hollow bore needle (62%), followed by solid bore (35%) and 1(3%) was not sure the type of needle used during the procedure. Regarding the standard precaution, only one (3%) wore double gloves as their personal protective equipment while the others wore single glove (29%) and (68%) not wearing a glove. The majority of the needlestickinjury incident (63%) was from the nursing group, (22%) from the medical students and (15%) was the paramedic students. 68% of the students with positive needlestickinjury experienced the injury during the medical posting while the rest are during non-medical posting (surgical, psychiatry, emergency and klinik kesihatan) (32%). Only7 students (26%) reported the incident which consist of nursing 4(23.5%) and paramedic students 3(75%).
A quasi-experimental was undertaken to assess the effectiveness of structured programme on knowledge level regarding needlestickinjury among nursing students in selected college of Jalandhar, Punjab. The objectives of the study were: to assess the pretest & posttest knowledge level of nursing students regarding needlestickinjury, to assess the effectiveness of structured teaching programme on knowledge of student nurses regarding needlestickinjury, to assess the relationship of knowledge with selected demographic variables. A sample of 60 nursing students of army college of nursing were selected by simple randomization technique. The knowledge of students was collected using structured knowledge questionnaire. Results in pretest showed that 29(48.33%) were having adequate knowledge, 25(38.34%) were having moderate knowledge & 6(13.33%) were having inadequate knowledge. A significant improvement in knowledge was found in post-test: 54(90%) were having adequate knowledge, 46(6.67%) were moderate knowledge & 2(3.33%) were having inadequate knowledge.
applying educational and biosafety training programs and needle protective devices [24, 25]. The finding of the present study that needlestick injuries were strongly asso- ciated with the lack of training on biosafety and private clinics confirmed the importance of education in reducing sharp injuries in medical laboratories. Finally, the results showed that needledstick injuries were less frequent in governmental clinics and recapping was performed more frequently. Thus, additional factors seem to contribute to needlestick injury, such as workloads and adherence to safety guidelines that are expected to differ in governmen- tal and private clinics. More studies are required to deter- mine the exact factors that contribute to the observed high frequency of needlestick injury among Al-Madinah clinical laboratory workers.
Regarding the knowledge and preventive aspects in needlestickinjury, doctors had better knowledge but paramedical and supportive staff (lab technicians and sanitary staff) had poor knowledge about it. Health care workers revealed that education, training, newer and safety devices, positive work environment, decreased patient load per health care worker and standard precautions can prevent needlestickinjury. Further preventive measures and reporting of the incident should be made mandatory and health care workers should be aware of it in our hospital.
Results: The response rate of the survey was 85.7%. Sixty one students (33.9%) were from 3rd and 4th year each while 58 students (32.2%) were from 5th year. More than 85% students from each class were aware of the possibility of acquisition of Hepatitis B, Hepatitis C and HIV from needlestick injuries. Only 16.4% 3rd year students, 29.5% 4th year students and 36.2% final year students knew the full details of needlestickinjury prevention protocols. Curriculum was cited as an important source of information regarding needlestick injuries. Forty seven (26.1%) students had received a needlestickinjury in the past; however, only 14 students (29.7%) had reported the incident either to their consultant or the Infection Control Office.
There is a significant relationship between exposure ratio to needlestickinjury and age, educational level and the ward of activity. There is also a significant relationship between rate of exposure with gender and hospital ward. Exposure ratio to needlestickinjury is significantly higher among students older than 30, medical research fellows, and students working in the surgery and pathology wards in compared with the other groups. Besides, the rate of exposure is much higher among male participants compared with female participants and among students working in the surgery ward compared with the other groups. Various studies have pointed to the important role of these factors in the occurrence of needlestickinjury. For example, these studies reported a higher level of exposure to needlestickinjury among younger people and people with lower educational levels as well as among female health care workers compared with others. 37,39 In addition, some studies have pointed to the impact of the ward of activity on the incidence of needlestickinjury. For instance, Ghasemi reported employment in the surgical ward as a main factor in the occurrence of needlestickinjury. 40 In another study, the most injuries were occurred in the emergency department and Internal ward. 32
Frequency of needlestick in our study was 18.8%. In Hamadan teaching hospitals, incidence of needles and sharp objects injury was 24.1% . The rate of needlestickinjury in Africa is 4.2 per person annually . The prevalence of exposure to blood and other body fluids among health care workers in a hospital in Fars Province was 79% . In Brazil, the average incidence of occupational exposures to biological health personnel per 100 fulltime person (subjects- years) was 11.9%, and the annual cumulative incidence was 7% . In another study, the incidence of needlestick injuries was as follows: Nigeria, 31%, Turkey 62%, India (72%), Egypt, 35.6%, China (82%), Taiwan (93%) [21-26]. The incidence of needlestick injuries among nursing students has been reported as endemic in northern India, 48.1% , Taiwan (61.9%) , and Iran 71% . The results of the present study are in contrast with the results of mentioned studies. It can be suggested that the lower incident of needlestick injuries in our study may be attributed to a number of factors, including the existence of a comprehensive program to pursue occupational health by occupational health clinic and providing periodic preventive education program for staff and as well as other factors.
Introduction: Needlestickinjury is common amongst health care workers, particularly those who perform invasive procedures like collection of blood and insertion of canulae in patients. These pose significant risks of transmission of blood borne pathogens to the Health Care Workers (HCW). The study was designed to assess the knowledge, awareness, and practices regarding needlestick injuries in a sub-urban hospital in Bayelsa state of Nigeria.
The study participants completed a questionnaire prepared by study authors. Inquiry form included data about profession, seniority, questions regarding accidents at work (did the participant experienced an accident at work-needlestickinjury or other, with potential contact with patients material?), post-exposure preventive actions (did the participant performed local preventive actions-forcing blood from the wound, washing the wound, and applying aseptic wound dressing?; was there performed testing for HCV in the blood of potential source of infection?; was the participant checked for HCV-RNA after an accident to detect an acute hepatitis C?), and previous HCV testing. The results were summarized and subjected to statistical analysis.
Unlike the study conducted in Arba Minch general hos- pital, Ethiopia , study subjects who had training on needlestick and sharp object injury were 4× less likely to experienced needlestick and sharp object injury as com- pared with those who had not training in this study. The difference may be more education and training might be given about needlestickinjury and infection prevention in this study. Education and training is the right tools to bring behavioral change about infection prevention and safety measures.
A needlestickinjury is a percutaneous wound, occurs due to needle point as well as due to other sharp instruments. Most common in those people, who are handling needles in the medical settings. These injuries are occupational hazard in medical community. Needlestick injuries are the most common health care workers issue(Atenstaed ,2007).These injuries are not only causing health consequences but also cause emotional distress in health care workers which results in missed workdays and directly affects the health care services and resources (Sharma , 2010). Most of the injuries occur due to three basic devices i.e. IV equipment, sutures needles and hollow bore needles. But for surgical personals and for perioperative nurses, sutures needles are most common equipment that causes injuries (Edwin, 2000).Other most important causes of NSI are two-handed recapping, the unsafe collection and disposal of sharps waste (Berguer, 2004). During surgery percutaneous injuries occur regularly due to which patient are at high risk of infection with blood borne pathogens (Tokars, 1992).The majority of gloves tears have an unknown mechanism that leads sharp injury, causes to transmit Blood borne pathogens in operating room (James, 1991). Needles should not recap after use because it can lead to an injury to health care providers (Marketa, 1990). Needlestick injuries are responsible to transmit blood-borne diseases through the passage of the hepatitis B virus (HBV), the hepatitis C virus (HCV), and the Human Immunodeficiency Virus (HIV), the virus which causes AIDS (William, 1988).
The Health Protection Agency report (2012) on health care workers stated that injuries during occupational exposure among the medical and dental professions increased by 131% (100-231) from 2002 to 2011. 6 Infections from each of these pathogens were potentially life threatening and preventable. The emotional impact of needlestickinjury could be severe and long lasting, even when a serious infection was not transmitted. Not knowing infection status of patient among those injured can accentuate the stress. More than 80% of needlestick injuries can be prevented through the use of safer devices and effective safety programs. 7 There not much of studies in south India, hence this study attempted.
Different methods have been used for intermaxillary fixation in the management of mandibular fractures. The most common technique is to use arch bars or eyelet wires. These techniques take a relatively long time to apply and to remove, can lead to perforation of the surgeon’s gloves and consequent ‘‘needlestick’’ injury of fingers caused by the sharp-ended wires, with disease transmission risk (Scully and Porter, 1991; Avery and Johnson, 1992; Busch, 1994). Moreover they are not easy to apply when the teeth carry extensive crown and bridgework. Finally, wires tightened during the application of arch bars around the teeth may cause an ischaemic necrosis of the mucosa, and make it difficult to maintain gingival health (Ayoub and Rowson, 2003). To get around these problems, Dal Pont presented a solution for intermaxillary fixation, using
However, in the current study a significant number of HCWs reported recapping needles after use. Re- spondents who practiced needle recapping were 2.25 times more likely to experience needlestick injury than those who did not recap needles after use. This finding is consistent with the previously conducted study (15). Likewise, other similar stud- ies from other countries (India, Cameron) reported recapping needles after use was associated with a higher risk of needle-stickinjury (28,29). A study conducted by Berhanu on prevalence and determi- nant factors for sharp injuries among Addis Ababa hospitals reported similar findings: those health professionals who never recap used needles were protected from sharp injuries in 61.6% of the cases (30). In another recent study in the same area simi- larly found a high prevalence of lifetime and one- year prevalence of blood and body fluid exposures 42.6% (95% CI: 36.8-48.4) and 29.2% (95% CI: 23.8-34.7), respectively (31).
Among the 377 healthcare workers who participated in the study, 69 (18.37%) had at least once been injured the last 12 months. Among them, 43.47% had once, 26.09 had twice, and 30.43% had three times or more had a needle-stick incident. Type of injuries was superficial in 89.85% and deep in 10.14%. In most case, the injuries had happened at the night shift (47.80%) and at the end of the shift (64.70%). After the needle-stickinjury, 46.38% had done primary measures such as washing the wound with soap and water or bleach, and 38.23% had reported the incident. Among the 69 individuals who had had needle-stickinjury, 38.23% had received prophylaxis drugs after the incident, and 20% had evaluated had been tested for viral infection.
According to study by Lal P et, al., (2017).nurses have low perception about the needlestick injuries and have a great risk to acquire the human immunodeficiency virus during their duties hours. The general reason of high risk of human immunodeficiency virus is lack of perception of needlestick injuries among nurses. Nurses undergo the needlestickinjury and become infected with blood borne and other diseases. Wide spread safety measures incorporate hand washing strategies before and after doing procedure and utilization of obstruction like glove as essential level of prevention.