Time Trends of Percutaneous Injuries in Hospital Nurses: Evidence of the Interference between Effects of Adoption of Safety Devices and Organizational Factors

Abstract

Few studies have focused on the combined effects of devices and work organization on needlestick injuries trends. The aim of the study was to estimate trends of percutaneous injury rates (IR) in nurses (N) and nurse assistants (NA) over a 10 year period, in which passive safety devices were progressively adopted. Percutaneous and mucocutaneous injuries registered in a University Hospital in Northern Italy in Ns and NAs in 2007–2016 were analyzed. Organizational data were also available on shift schedules, turnover, downsizing and age- and skill-mix. We estimated IRs per 100 full-time equivalent workers from Poisson models and their average annual percent changes (APC) from joinpoint regression model. In the entire period, monotonic decreases in percutaneous IRs occurred among day-shift Ns (APC = −20.9%; 95% CI: −29.8%, −12%) and NAs (APC = −15.4%; −32.9%, 2.2%). Joinpoint modeling revealed a turning point in 2012 for night-shift Ns, with a steady decline in 2007–2012 (APC = −19.4%; −27.9%, −10.9%), and an increase thereafter (APC = +13.5%; 1.5%, 25.5%). In comparison to 2008 and 2012, in 2016 night-shift Ns were 5.9 and 2.5 times more likely to be younger and less qualified or experienced than day-shift Ns. The observed declines in percutaneous injury rates occurred in a time period when safety devices were progressively implemented. The causal nature of multiple exposures and organizational procedures in affecting injury time trends should be further addressed by quasi-experimental studies.

Increased Bloodborne Pathogen Exposure Hotline Utilization During the COVID-19 Pandemic: An Unexpected Phenomenon

“…Other studies of nurses found that night shift work was a risk factor for sharps and needlestick injury (d’Ettorre, 2017; d’Ettorre et al, 2020; Ferrario et al, 2021). We have no evidence, however, that the pattern of night shift work changed at either HC1 or HC2 during the COVID-19 pandemic.…”

Temporal trend of accidents due to percutaneous exposure in a public hospital in Brazil, 2007-2019

“…This may be an acceptable hypothesis to explain the downward trend among mid-level professionals. A study that analyzed the temporal trend in the rate of percutaneous injuries in a hospital during the progressive implantation of NS with safety devices to replace conventional NS observed a downward trend among professionals (nurses assistants) who have secondary education ( 31 ) .…”

Tendência temporal dos acidentes por exposição percutânea em um hospital público no Brasil, 2007-2019

“…Um estudo que analisou a tendência temporal da taxa de lesões percutâneas em um hospital durante a implantação progressiva de MP com dispositivos de segurança para substituir MP convencionais observou uma tendência de queda entre profissionais (auxiliares de enfermagem) que possuem ensino médio (31) . A tendência temporal crescente da incidência de acidentes percutâneos entre os trabalhadores com tempo igual ou superior a 61 meses de experiência profissional na instituição hospitalar pode ser explicada pelos fatores comportamentais, como a dificuldade de adesão aos treinamentos (32) e excesso de confiança para realizar procedimentos invasivos (15,28) .…”