Do safety engineered devices reduce needlestick injuries?

Schuurmans, Jaap; Lutgens, Suzanne P. M.; Groen, Leon; Schneeberger, P.M.

doi:10.1016/j.jhin.2018.04.026

Cited by 24 publications

(22 citation statements)

References 10 publications

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“…30 Moreover, provision of feedback to the manufacturers to keep improving the design is critical. 28 The results of our study should be interpreted in the context of study limitations. The most important limitation was that the data was based on a self-reporting system.…”

Section: Discussionmentioning

confidence: 84%

Needlestick and sharps injuries in an Indonesian tertiary teaching hospital from 2014 to 2017: a cohort study

et al. 2020

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ObjectiveNeedlestick and sharps injuries among healthcare workers (HCWs) pose significant occupational health problems. We aim to provide incidence and other epidemiological aspects of needlestick and sharp injuries (NSSIs) among HCWs in a tertiary teaching hospital in Indonesia, to inform the evaluation of NSSIs prevention programme.MethodsA cohort study was conducted at Cipto Mangunkusumo Hospital in Jakarta. We analysed data of the sharps injury programme at the hospital between January 2014 and December 2017. Incidence of NSSIs was calculated per 1000 person-years (1000-PY).ResultsOver the 4-year period, a total of 286 NSSIs were reported. The mean NSSIs incidence rate for 4 years was 13.3/1000-PY, peaking in 2015 (15.5/1000-PY) then decreasing afterward. Most NSSIs were experienced by nurses (42.7%), but the highest incidence was among midwives (18.9/1000-PY), followed by nurses, medical students and medical doctors (15.2/1000-PY, 12.6/1000-PY and 11.8/1000-PY, respectively). The devices causing the highest proportion of NSSIs were hollow-bore needles (66.8%), followed by suture needles (14.3%) and solid needles (10.8%). 9.4% of NSSIs were related to insulin pen injection. Of all the incidents, 31.3% occurred during surgical procedures, 25.9% during blood collections, 14.3% during administering injection of drugs and 13.3% during waste cleaning.ConclusionIn conclusion, this study showed varied incidences of NSSI among different occupations, with the highest among midwives and nurses. Many unsafe work practices still continue, which is of utmost concern. We suggest opportunities for prevention including training and cultivating safer workplace practices.

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Section: Discussionmentioning

confidence: 84%

Needlestick and sharps injuries in an Indonesian tertiary teaching hospital from 2014 to 2017: a cohort study

et al. 2020

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“…However, both studies demonstrated an increasing number of injuries with SEDs over time. A study performed in the Netherlands reported that the introduction of SEDs did not result in a decrease in the overall number of NSIs, but in a reduction in NSIs after the use of blood sugar needles with a passive system [23]. Other authors have also reported that the number of NSIs is reduced when passive SEDs are used [24].…”

Section: Discussionmentioning

confidence: 99%

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

Dulon¹,

Stranzinger²,

Wendeler³

et al. 2020

IJERPH

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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.

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“…Safety-engineered devices are designed to improve safe handling of sharps by incorporating a built-in protection mechanism. Safety-engineered devices are used predominantly in nonsurgical settings and have been found to have mixed efficacy in reducing NSIs, with some studies finding that safety-engineered devices actually increase risk of these injuries [16,17]. In fact, a Cochrane review analyzing 24 studies investigating devices for preventing NSIs in nonsurgical settings reported uniformly low-quality evidence with inconsistent results [18].…”

Section: Principal Findingsmentioning

confidence: 99%

Efficacy of a Novel Intraoperative Engineered Sharps Injury Prevention Device: Pilot Usability and Efficacy Trial

Jenny¹,

Yesantharao²,

Xun³

et al. 2020

JMIR Perioper Med

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Background The American College of Surgeons reports 88,320 intraoperative needlestick injuries (NSIs) per year, resulting in US $376 to US $2456 in costs per NSI. Engineered sharps injury prevention (ESIP) devices protect against NSIs. To our knowledge, no study has been published to date to demonstrate clinical effectiveness of an intraoperative ESIP device. Operative Armour is a wearable arm cuff that can be donned during surgical closure to allow surgeons to keep a suture pack and sharps protection container on their forearm. Objective We characterize Operative Armour’s ESIP device effectiveness in a tertiary hospital, hypothesizing that this device will decrease NSI risk by decreasing behaviors associated with NSIs: needle passing and handling. Methods A prospective case-control study was conducted with institutional review board quality improvement designation in which authors observed skin closures of plastic surgery procedures. To ensure accuracy, one surgeon was observed at a time. Control surgeries were purely observational; intervention cases involved surgeon use of the device during skin closure. Outcomes of interest included needle passing, needle handling, lost needles, and loaded waiting needles. Results Surgeons were observed in 50 control and 50 intervention cases. Operative Armour eliminated needle passing during skin closure. One NSI occurred in one control case; no NSIs were observed in intervention cases (P=.36). The mean number of loaded and unprotected waiting needles was also significantly decreased in the intervention group from 2.3 to 0.2 (P<.001). Furthermore, a multivariable linear regression established that Operative Armour significantly decreased the number of needle adjustments by hand per stitch observed (F4, 21.68=3.72; P=.01). In fact, needle adjustments by hand decreased overall (1 adjustment per 10 stitches vs 1 adjustment per 5 stitches, P=.004), and adjustments occurred half as frequently with use of Operative Armour in free flap reconstruction (1 adjustment per 10 stitches vs 1 adjustment per 5 stitches, P=.03) and a quarter as frequently in other breast reconstruction cases such as mastopexy (1 adjustment per 20 stitches vs 1 adjustment per 5 stitches, P=.002). Conclusions Operative Armour effectively functions as an ESIP device by decreasing intraoperative needle passing and handling. Although sample size prohibits demonstrating a decrease in NSIs during observed cases, by decreasing behaviors that drive NSI risk, we anticipate an associated decrease in NSIs with use of the device.

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Do safety engineered devices reduce needlestick injuries?

Cited by 24 publications

References 10 publications

Needlestick and sharps injuries in an Indonesian tertiary teaching hospital from 2014 to 2017: a cohort study

Needlestick and sharps injuries in an Indonesian tertiary teaching hospital from 2014 to 2017: a cohort study

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

Efficacy of a Novel Intraoperative Engineered Sharps Injury Prevention Device: Pilot Usability and Efficacy Trial

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