Needlestick and sharps injuries among nursing students

AIMS: This paper reports the first investigation of the prevalence and nature of needlestick injuries among Australian nursing students. BACKGROUND: Needlestick and sharps injuries are the most efficient method of transmitting blood-borne pathogens between patients and healthcare staff. Although nurses are known to be a high-risk subgroup for these events, nursing students may be at even greater risk due to their limited clinical experience. Despite this fact, the epidemiology of needlestick and sharps injuries among nursing students has not been clearly elucidated in Australia. METHODS: A questionnaire-based methodology adapted from other international investigations was conducted among nursing students. We recruited a complete cross-section of students from a large university nursing school in North Queensland, Australia, in March 2004, and analysed needlestick and sharps events as a percentage of all students and also as a proportion of all cases. Risk factors were evaluated using logistic regression. RESULTS: From a group of 319 students, 274 successfully completed questionnaires were obtained (overall response rate 85.9%). A total of 38 students (13.9%) reported a needlestick or sharps injury during the previous 12 months. By causative item, 6.2% of students had been injured by a normal hollow-bore syringe needle, 3.6% by a glass item and 3.3% by an insulin syringe needle. Regarding prior usage, 81.6% of all injuring items were unused, 15.8% had been used on a patient and the status of 2.6% was unknown. Most needlestick injuries occurred either in the nursing laboratory (45%) or the teaching hospital (37%). Opening the needle cap was the most common causative event (28% of all cases). A total of 39.5% of needlestick injuries were not reported. The main reason for non-reporting was that the item was unused (42%). Logistic regression analysis revealed that students in the third year were 14.8 times more likely to have experienced a needlestick injury than their counterparts in other years (odds ratio 14.8, 95% confidence interval 5.2-50.3, P < 0.01). These injury rates were higher among Australian nursing students than in other international studies. CONCLUSIONS: Although hepatitis B vaccination coverage among the students was excellent, it is important that the principles of infection-control training and reporting of all needlestick and sharps continue to be emphasized throughout undergraduate nursing education.     

Needlestick and sharps injuries: practice update

Member states of the European Union have until May 112013 to implement the Council Directive 2010/32/EU Implementing the Framework Agreement on Prevention from Sharps Injuries in the Hospital and Healthcare Sector. The aim of this legislation is to achieve a safe working environment and prevent injuries to healthcare professionals caused by all medical sharps, including needlesticks. This article examines the issues surrounding needlestick and sharps injuries, including risk assessment and prevention, information provision, raising awareness, use of safety devices, training and reporting procedures.     

Needlestick and sharps injuries: avoiding the risk in clinical practice

What is the true incidence of needlestick and sharps injuries among health-care professionals in the UK and what is the real cost of such injuries? This article identifies the obvious and not-so-obvious risks to staff in community and hospital settings and examines how such risks can be minimised, drawing on guidance from NICE and the RCN.     

Needlestick and sharps injuries among Turkish nursing students: A cross‐sectional study

Irmak Z, Baybuga MS. International Journal of Nursing Practice 2011; 17 : 151–157 Needlestick and sharps injuries among Turkish nursing students: A cross‐sectional study This cross‐sectional study was performed to investigate the prevalence of and other factors associated with needlestick and sharps injuries (NSIs) among nursing students in Turkey. A total of 60 (19.4%) nursing students reported NSIs during the past 1 year. The most common item causing injury was from a syringe needle (54.0%). Among nursing students, giving intravenous/intramuscular injections (60.0%) was the most common cause of NSIs. In total, 31.7% were not using gloves when injured. A total of 68.3% of NSIs were said to have gone unreported in any official report. A total of 43.5% of the nursing students had not received the hepatitis B vaccine. Finally, no single sociodemographic variables were shown to be significant as a risk factor for needlestick and sharps injury during logistic regression analysis. To decrease NSIs among nursing students, an education programme related to NSIs and standard precautions must be provided and immunized against hepatitis B before beginning clinical practice.     

Needlestick and sharps injuries among nurses in a tropical Australian hospital

Although needlestick and sharps injuries (NSI) represent a major hazard in nursing practice, most studies rely on officially reported data and none have yet been undertaken in tropical environments. Therefore, we conducted a cross-sectional NSI survey targeting all nurses within a tropical Australian hospital, regardless of whether they had experienced an NSI or not. Our overall response rate was 76.7%. A total of 39 nurses reported 43 NSI events in the previous 12 months. The most common causative device was a normal syringe needle, followed by insulin syringe needles, i.v. needles or kits and blood collection needles. Half of the nurses' NSI events occurred beside the patient's bed: drawing up medication was the most common reason. Nurses working in the maternity/neonatal wards were only 0.3 times as likely to have experienced an NSI as their counterparts in the medical or surgical wards. Overall, our study has shown that NSI events represent an important workplace issue for tropical Australian nurses. Their actual rate might also be higher than official reports suggest.     

Needlestick and sharps injury prevention

Every day while caring for patients, nurses are at risk to exposure to bloodborne pathogens potentially resulting in infections such as HIV or hepatitis B and C. These exposures, while preventable, are often accepted as being a part of the job. In the United States, needlestick injuries have begun to decrease from an estimated one million exposures per year in 1996 to 385,000 per year in 2000. This decline has resulted from the protections afforded by the Occupational Safety and Health Administration's (OSHA) Bloodborne Pathogens Standard. Reasons for the success in decreasing needlestick and sharps injuries may be attributed to the elimination of needle recapping and the use of safer needle devices, sharps collection boxes, gloves and personal protective gear, and universal precautions. The prevention of needlestick injuries has made slow progress over the past 20 years since the HIV epidemic drew attention to the deadly nature of health care work and to protection of health care worker health and safety. In Africa, where the AIDS virus originated and where the prevalence of the human immunodeficiency virus (HIV) among hospitalized patients is highest in the world, attention has been directed only recently at protecting health care workers. Nurses, especially those infected from a preventable exposure, have been at the forefront of advocacy for prevention. This article includes a review about the hazard of exposure to bloodborne pathogens and epidemiology of occupational infection. The author discusses how to apply standard methods of occupational health and industry hygiene using the hierarchy of controls framework to prevent exposure to blood, and discusses evidence-based prevention and efficacy of particular control measures. Legislative progress and implementation of enforceable policy to protect health care workers is outlined.     

Risks and effects of sharps injuries

Nurses face the risk of exposure to blood-borne infections if they suffer a needlestick or other injury from sharp devices such as lancets, scalpels and razors. In order to minimise their risk of contracting viruses such as HIV, hepatitis B and C, or other infections, risk assessment exercises must be undertaken so that safer systems of work can be implemented to protect nurses and other health care professionals.     

Cutting down on sharps injuries

A collaborative and participative approach is helpful in reducing the transmission of bloodborne pathogens and other sharps-related injuries.     

Peer bullying in a pre-registration student nursing population

Peer bullying is a major problem in schools and workplaces including the National Health Service. Although there are a few published studies exploring the incidence of peer bullying among university students, none is specific to pre-registration nursing students. Nursing programmes are delivered across two campuses of the university however students registered at individual campuses do not mix which makes the experiences of each campus individual. The aim of this study was to explore the incidence and manifestation of peer bullying amongst pre-registration nursing students in the university setting. The study describes the reported incidence of the three types of peer bullying behaviour: physical, verbal and non-verbal bullying. Participants in their final year of adult nurse education were asked to explore their perceptions of peer bullying, the frequency of witnessed or experienced behaviour and the location of where this behaviour occurred on the university campuses via a quantitative questionnaire. In total 190 students were surveyed with 156 (82%) responding. Participants reported peer bullying is experienced by student nurses on university premises and that academic members of staff are sometimes present when this behaviour is demonstrated. Reported levels of bullying decreased during their 2nd and 3rd years of the course compared to the foundation year. This decrease may have been in response to the university's strong anti-bullying stance.     

Reducing the risks of sharps injuries in health professionals

Sharps injuries can transmit blood-borne infections and are a serious health risk to nurses and other health professionals. However, there is limited data on the incidence of these injuries in the UK, and low awareness of the risks they pose. New products with enhanced safety features are becoming available but their introduction should be accompanied by education and training to improve practice in relation to sharps and their disposal.