Influence of an educational program and mechanical opening needle disposal boxes on occupational needlestick injuries.

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 needleboxes 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.