Causes of Needlestick and Sharps Injuries When Using Devices with and without Safety Features

Abstract

Safety-engineered devices (SEDs) have been developed to protect healthcare personnel (HCP) from needlestick and sharps injuries (NSIs). The aim of this study was to analyze NSIs associated with SEDs and non-SEDs among HCP in hospitals, medical offices and care facilities. Records from online questionnaires on NSIs were used. Causes of NSIs were compared for SED use and healthcare setting. A sample of 835 files was included. Injuries with SEDs accounted for 35.0% of all NSIs, whereas the proportions were higher in medical offices and lower in care facilities. NSIs in nurses were more often associated with SEDs than NSIs in physicians. NSIs from intravenous needles were associated with SEDs in more than 60% of cases in hospitals and medical offices and in about 30.0% of cases in care facilities. In contrast, suturing was associated with every fourth NSI in hospitals, of which fewer than 10.0% were associated with SEDs. In care facilities, SEDs were involved in 36.1% of NSIs during subcutaneous injections. NSIs during disposal accounted for 29.2% of total NSIs, of which 36.1% were associated with SEDs. Frequent reasons for SED-associated NSIs were technical problems, unexpected patient movement and problems during disposal. Our analysis shows that many NSIs are associated with SEDs. Continuous training is necessary in the handling and disposal of SEDs.

Prevention from Sharp Injuries in the Hospital Sector: An Italian National Observatory on the Implementation of the Council Directive 2010/32/EU before and during the COVID-19 Pandemic

“…Nurses reported total replacement in nearly 50% of cases in both surveys; in 2021, RSPP reported total replacement almost in 60% of cases, but pharmacists (in charge of purchasing devices) only in 31%. As in other European studies [ 41 ], costs were identified as one of the main reasons for not replacing conventional devices, but in 2021, pharmacists and RSPP indicated also difficulties in ordering safety devices. Device purchases are currently made through regional tenders, and safety features may not be included, or not be prioritized, within the required characteristics of the device, depending on the choices of the committee developing the tender.…”

“…The sore point is that, in none of these investigations, there was a total replacement of conventional devices with their safety counterpart: in 2013, the SIROH hospitals reported a total replacement in 70% of cases; in 17% it was total for some devices and partial for others, and in 13% only partial for all safety devices [ 27 ]. Although the effectiveness of safety devices is variable [ 36 ], as reported also in a Cochrane review [ 37 ], several studies report positive results regarding the ability of SED to reduce the number of percutaneous accidents [ 13 , 38 , 39 ]; the contemporary use of conventional, non-safety devices and SED is not beneficial [ 40 , 41 ]. Nurses reported total replacement in nearly 50% of cases in both surveys; in 2021, RSPP reported total replacement almost in 60% of cases, but pharmacists (in charge of purchasing devices) only in 31%.…”

Comparing risk changes of needlestick injuries between countries adopted and not adopted the needlestick safety and prevention act: A meta-analysis

“…NSIs among Italian and German physicians were more correlated with conventional sharps, whereas in nurses, NSIs were more correlated with SEMDs. [24][25][26] Further study is needed to understand the usage rates of SEMDs based on occupation, which can lead to improved preventive strategies against NSIs in higher-incidence groups.…”

Preventing Perioperative Sharps Injuries

“…Results of a 2017 survey of perioperative nurse perception of teamwork performance and mental stress in Japan showed that 38 (30.6%) of 124 RN circulators experienced mental stress during procedures 18 . Findings from a 2020 study on the causes of needlestick and sharps injuries showed that a variety of factors contributed to such injuries for hospital HCWs, including stress, not paying attention, and device failure 19 …”

“…18 Findings from a 2020 study on the causes of needlestick and sharps injuries showed that a variety of factors contributed to such injuries for hospital HCWs, including stress, not paying attention, and device failure. 19…”