Hostname: page-component-848d4c4894-xm8r8 Total loading time: 0 Render date: 2024-06-23T06:26:00.924Z Has data issue: false hasContentIssue false

Influence of an Educational Program and Mechanical Opening Needle Disposal Boxes on Occupational Needlestick Injuries

Published online by Cambridge University Press:  21 June 2016

John A. Sellick Jr.*
Affiliation:
Division of Infectious Diseases, State University of New York at Buffalo and Buffalo General Hospital, Bufilo, New York
Peggy Ann Hazamy
Affiliation:
Division of Infectious Diseases, State University of New York at Buffalo and Buffalo General Hospital, Bufilo, New York
Joseph M. Mylotte
Affiliation:
Division of Infectious Diseases, State University of New York at Buffalo and Buffalo General Hospital, Bufilo, New York
*
Department of Medicine, Buffalo General Hospital, 100 High St., Buffalo NY14203

Abstract

Objectives:

To determine whether an educational program had a beneficial impact on healthcare worker needlestick injuries, particularly those caused by recapping. Secondary goals were to evaluate the efficacy of in-room needle-boxes and to determine whether surveillance data were useful when evaluating new products.

Design:

Survey of employee health department reports.

Setting:

Tertiary care teaching hospital.

Participants:

Healthcare workers who reported needlestick injuries and other blood and body fluid exposures to the employee health department.

Interventions:

Exposure data from the 10 months prior to institution of the educational program and installation of disposal boxes were compared with data from the following 27 months. Additionally, the type of disposal box was changed for the last 9 months of the survey.

Results:

Needlestick injuries caused by recapping fell significantly following the educational program (p=.005). However, injuries caused by previously disposed needles protruding into the mechanical opening of the needle-boxes increased significantly (p=.002). Following a change of needleboxes to a nonmechanical opening design, the latter type of injury declined (p=.052). Total needlestick injuries, most other categories of needlestick injury, and other exposures did not change significantly during the 37 months of the study.

Conclusions:

The educational programs appeared to have positive impact on reducing recapping injuries, but many other needlestick categories did not change significantly. Mechanical opening needle disposal boxes appear to present a hazard when compared with fixed opening boxes. Surveillance data appear to be useful in monitoring injuries as well as evaluating products.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Jonas, MM, Schiff, ER, O'Sullivan, MJ, et al. Failure of Centers for Disease Control criteria to identify hepatitis B infection in a large municipal obstetrical population. Ann Intern Med. 1987;107:335337.Google Scholar
2. Centers for Disease Control. Recommendations for prevention of HIV transmission in healthcare settings. MMWR. 1987;36:S1S18.Google Scholar
3. Centers for Disease Control. Recommendations for protection against viral hepatitis. MMWR. 1985;34:313335.Google Scholar
4. Centers for Disease Control. Protection against viral hepatitis. MMWR 1990;39(suppl 2):126.Google Scholar
5. Lynch, P, Jackson, MM, Cummings, MJ, Stamm, WE. Rethinking the role of isolation practices in the prevention of nosocomial infections. Ann Intern Med. 1987;107:243246.Google Scholar
6. Centers for Disease Control. Public health service statement on management of occupational exposure to human immunodeficiency virus, including considerations regarding zidovudine postexposure use. MMWR. 1990;39:114.Google Scholar
7. Glantz, SA. Primer of Biostatistics. 2nd ed. New York. NY: McGraw-Hill Book Company; 1987.Google Scholar
8. Reed, JS, Anderson, AC, Hodges, GR. Needlestick and puncture wounds: definition of the problem. Am J Infect Control. 1980;8:101106.Google Scholar
9. McCormick, RD, Maki, DG. Epidemiology of needlestick injuries in hospital personnel. Am J Med. 1981;70:928932.Google Scholar
10. Jacobson, JT, Burke, JP, Conti, MT Injuries of hospital employees from needles and sharp objects. Infect Control. 1983;4:100102.CrossRefGoogle ScholarPubMed
11. Ruben, FL, Norden, CW, Rockwell, K, Hruska, E. Epidemiology of accidental needle-puncture wounds in hospital workers. Am J Med Sci. 1983;286:2630.Google Scholar
12. Jagger, J, Hunt, EH, Brand-Elnaggar, J, Pearson, RD. Rates of needlestick injury caused by various devices in a university hospital. N Engl J Med. 1988;319:284288.Google Scholar
13. Jagger, J, Hunt, EH, Pearson, RD. Sharp object injuries in the hospital: causes and strategies for prevention. Am J Infect Control. 1990;18:227231.Google Scholar
14. Yassi, A, McGill, M. Determinants of blood and body fluid exposure in a large teaching hospital: hazards of the intermittent intravenous procedure. Am J Infect Control. 1991;19:129135.Google Scholar
15. Hamory, BH. Underreporting of needlestick injuries in a university hospital. Am JZnfect Control. 1983;11:174177.CrossRefGoogle ScholarPubMed
16. Jackson, MM, Dechairo, DC, Gardner, DE Perceptions and beliefs of nursing and medical personnel about needle-handling practices and needlestick injuries. Am JZnfect Control. 1986;14:110.Google Scholar
17. Melzer, SM, Vermund, SH, Shelov, SP. Needle injuries among pediatric housestaff physicians in New York City. Pediatrics. 1989;84:211–4.Google Scholar
18. McGeer, A, Simor, AE, Low, DE. Epidemiology of needlestick injuries in house officers. J Infect Dis. 1990;162:961964.Google Scholar
19. Heald, AE, Ransohoff, DE Needlestick injuries among resident physicians. J Gen Intern Med. 1990;5:389393.Google Scholar
20. Lowenfels, AB, Wormser, GP, Jain, R. Frequency of puncture injuries in surgeons and estimated risk of HIV infection. Arch Surg. 1989;124:12841286.Google Scholar
21. Krasinski, K, LaCouture, R, Holzman, RS. Effect of changing needle disposal systems on needle puncture injuries. Inject Control. 1987;8:5962.Google Scholar
22. Ribner, BS, Landry, MN, Gholson, GL, Linden, LA. Impact of a rigid, puncture resistant container system upon needlestick injuries. Infect Control. 1987;8:63–6.Google Scholar
23. Seto, WH, Ching, TY, Chu, YB, Fielding, F. Brief report: reduction in the frequency of needle recapping by effective education: a need for conceptual alteration. Znfect Control Hosp Epidemiol. 1990;11:194196.CrossRefGoogle ScholarPubMed
24. Linnemann, CC Jr Cannon, C, DeRonde, M, Lanphear, B. Effect of educational programs, rigid sharps containers, and universal precautions on reported needlestick injuries in healthcare workers. Infect Control Hosp Epidemiol. 1991;12:214219.Google Scholar
25. Whitby, M, Stead, P, Najman, JM. Needlestick injury: impact of a recapping device and an associated education program. Infect Control Hosp Epidemiol. 1991;12:220225.Google Scholar
26. Becker, MH, Janz, NK, Band, J, Bartley, J, Snyder, MB, Gaynes, RP. Noncompliance with universal precautions policy: why do physicians and nurses recap needles? Am J Infect Control. 1990;18:232239.Google Scholar
27. Edmond, M, Khakoo, R, McTaggart, B, Solomon, R. Effect of bedside needle disposal units on needle recapping frequency and needlestick injury. Infect Control Hosp Epidemiol. 1988;9:114116.Google Scholar
28. Jagger, J, Pearson, RD. Universal Precautions: still missing the point on needlesticks. Infect Control Hosp Epidemiol. 1991;12:211213.CrossRefGoogle ScholarPubMed
29. Panlilio, AL, Foy, DR, Edwards, JR, et al. Blood contacts during surgical procedures. JAMA. 1991;265:15331537.Google Scholar
30. Fahey, BJ, Koziol, DE, Banks, SM, Henderson, DK. Frequency of nonparenteral occupational exposures to blood and body fluids before and after universal precautions training. Am J Med. 1991;90:145153.CrossRefGoogle ScholarPubMed
31. Gerberding, JL. Surgery and AIDS. Reducing the risk. JAMA. 1991;265:15721573.Google Scholar
32. Jagger, J, Pearson, RD. A view from the cutting edge. Infect Control. 1987;8:5152.Google Scholar
33. Huber, K, Sumner, W II. Recapping the accidental needlestick problem. Am J Infect Control. 1987;15:127130.Google Scholar
34. Kennedy, DA. Needlestick injuries: mechanisms and control. J Hosp Infect. 1988;12:315322.Google Scholar
35. Goldwater, PN, Law, R, Nixon, AD, Officer, JA, Cleland, JF. Impact of a recapping device on venepuncture-related needlestick injury. Infect Control Hosp Epidemiol. 1989;10:2125.Google Scholar
36. Sumner, W II. Needlecaps to prevent needlestick injuries. Infect Control. 1985;6:495497.Google Scholar
37. Bailey, E. Recapping needles safely using a recapping adapter. Infect Control. 1986;14:30A31A.Google Scholar
38. Klein, RS. Universal precautions for preventing occupational exposures to human immunodeficiency virus type 1. Am J Med. 1991;90:141144.Google Scholar