Chinese EPINet and Recall Rates for Percutaneous Injuries: An Epidemic Proportion of Underreporting in the Taiwan Healthcare System

Abstract

Objectives: As an occupational injury, percutaneous injury (PI) can result in chronic morbidity and death for healthcare workers (HCWs). A pilot surveillance system for PIs using the Chinese version of Exposure Prevention Information Network (EPINet) was introduced in Taiwan in 2003. We compared data from EPINet and recall of PIs using a cross-sectional survey for rates to establish the reliability of the new system. Methods: HCWs from hospitals that had implemented EPINet for ≥12 months completed a survey for recall of contaminated PIs sustained between October 2004 and September 2005, type of item involved, and reasons for reporting or not reporting the PI. Comparative data from EPINet for the same period were analyzed. Results: The EPINet rate, 36.1/1,000 HCW (95%CI 31.8-41.1) was almost 5 times lower (p<0.0001) than the PI recall rate for 2,464 HCWs of 170/1,000 HCWs (95%CI 155.4-185.5). Approximately 2.5 PIs were recalled for every 1,000 bed-days of care. The recall rate by physicians was 268.3/1,000, 188.5/1,000 for nurses, 88.9/1,000 for medical technologists and 81.3/1,000 for support staff. Hollow-bore needle items most commonly recorded on EPINet includ, disposable needles and syringes were underreported by 81%, vacuum tube holder/needles by 67%, and arterial blood gas needles by 75%. Nearly 63% of the reasons for underreporting were related to the complexity of the reporting process, while 37% were associated with incorrect knowledge about the risks associated with PIs. Conclusions: EPINet data underestimates a commonplace occupational injury with nearly four in five PIs not reported. Addressing the real barriers to reporting must begin with hospital administrators impressing on HCWs that reporting is essential for designing appropriate safety interventions. (J Occup Health 2009; 51: 132-136)

Factors Affecting Occupational Exposure to Needlestick and Sharps Injuries among Dentists in Taiwan: A Nationwide Survey

“…Second, given that exposure to NSIs is based on self-reported data, it is likely that not all NSIs were reported in the survey. A prior study found that nearly four in five NSIs were not reported in Taiwan [39]. Studies from other countries also showed that 22%∼78% of NSIs go unreported [40], [41].…”

Incidence of percutaneous injury in Taiwan healthcare workers

“…Several reports have noted that a large proportion of PIs (39-75%) go unreported [5,6]; the corresponding rate in an earlier study in Taiwan was 79-82% [7,8]. Such rates may pose a serious risk of exposure to blood-borne pathogens for HCWs.…”

Prevalência de subnotificação de acidentes com material biológico pela equipe de enfermagem de um hospital de urgência

“…Porém em relação à qualidade dos dados obtidos Osborne (2003) GANCZAK et al, 2007;GERSHON et al, 2009;TABAK;SHIAABANA;SHASHA, 2006 BOAL et al, 2008;ELMIYEH et al 2004;GANCZAK et al, 2007;GERSHON et al 2009;SHIAO et al, 2009).…”

“…Embora não tenha sido indicado pelos profissionais da presente investigação, estudos têm apontado que outra justificativa comum é estar muito ocupado no momento do acidente ou, ainda, alegar impedimentos para deixar o posto de trabalho para realizar a notificação (AU; GOSSAGE; BAILEY, 2008;AYRANCI;KOSGEROGLU, 2004;BOAL et al, 2008;GERSHON et al, 2007b;GERSHON et al 2009;KENNEDY et al 2009;SCHMID;SCHWAGER;DREXLER, 2007;SHIAO et al, 2009;SMITH et al, 2009;SOHN;EAGAN;SEPKOWITZ, 2004;WICKER et al, 2008b).…”

“…Além disso, a insatisfação com a burocracia para preenchimento de formulários, o longo tempo dispendido, bem como considerar o processo de notificação incômodo e complicado atuam como desmotivadores para a realização da notificação (AU; GOSSAGE; BAILEY, 2008;GERSHON et al 2009;KENNEDY et al 2009;OSBORNE, 2003;SCHMID;SCHWAGER;DREXLER, 2007;SHIAO et al, 2009;TABAK;SHIAABANA;SHASHA, 2006;WICKER et al, 2008b).…”