Rates of Needle-Stick Injury Caused by Various Devices in a University Hospital

Abstract

We identified characteristics of devices that caused needle-stick injuries in a university hospital over a 10-month period. Hospital employees who reported needle sticks were interviewed about the types of devices causing injury and the circumstances of the injuries. Of 326 injuries studied, disposable syringes accounted for 35 percent, intravenous tubing and needle assemblies for 26 percent, prefilled cartridge syringes for 12 percent, winged steel-needle intravenous sets for 7 percent, phlebotomy needles for 5 percent, intravenous catheter stylets for 2 percent, and other devices for 13 percent. When the data were corrected for the number of each type of device purchased, disposable syringes had the lowest rate of needle sticks (6.9 per 100,000 syringes purchased). Devices that required disassembly had rates of injury of up to 5.3 times the rate for disposable syringes. One third of the injuries were related to recapping. Competing hazards were often cited as reasons for recapping. They included the risk of disassembling a device with an uncapped, contaminated needle and the difficulty of safely carrying several uncapped items to a disposal box in a single trip. New designs could provide safer methods for covering contaminated needles. Devices should be designed so that the worker's hands remain behind the needle as it is covered, the needle should be covered before disassembly of the device, and the needle should remain covered after disposal. Such improvements could reduce the incentives for recapping needles and lower the risk of needle-stick injuries among health care workers.

Occupational blood and body fluid exposure in an Australian teaching hospital

“…At least 20 different pathogens have been documented as having been transmitted via sharps injury through body fluid exposure [1,2], with human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV) posing the greatest occupational risk to HCWs [3,4].…”

Effect of venepuncture process design on efficiency and failure rates: A simulation model study for secondary care

“…Jagger et al (1988) studied the number of needle stick injuries that were reported per 100,000 devices purchased and found that it depended on the device type used. For example, 6.9 injuries, 18.2 injuries and 25.4 injuries were reported per 100,000 disposable syringes, winged steel-needle intravenous sets and vacuum-tube phlebotomy assemblies that were purchased, respectively.…”

“…The literature review identified that another key variable that might influence procedure outcomes was the device type used to obtain the sample, e.g. Jagger et al (1988) and Barnard et al (2016). The questionnaire included a question on the types of needle used and associated estimated probability of successful blood sample collection and needle stick injury risk.…”

“…A value of 0.001 was chosen for the probability that a needle stick injury occurs. This was estimated based on the studies into the number of incidents that are reported per device purchased (Jagger et al, 1988) and the proportion of incidents that are reported (Gaffney et al, 1992;Hamory, 1983).…”

Safety-engineered intravenous catheter utilization among Canadian pediatric anesthesiologists

“…Domains specific to SEICs were identified from literature related to needlestick and sharps-related injuries among health care workers. 9,12,[14][15][16][17][18][19][20] They included perceived utility (primary outcome), availability, and mechanism type; physician uptake (usage); opportunities for improvement; and overall satisfaction. Domains related to limiting transmission of BBPs included Occupational Health and Safety Committee (OHSC) engagement, familiarity with related literature and evidence of engineering, work practice, and administrative controls.…”