Study of Prevalence and Response to Needle Stick Injuries among Health Care Workers in a Tertiary Care Hospital in Delhi, India

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Abstract

Background:

Because of the environment in which they work, many health care workers are at an increased risk of accidental needle stick injuries (NSI).

Objective:

To study prevalence and response to needle stick injuries among health care workers.

Materials and Methods:

Study Design: Cross-sectional study. Setting: A tertiary care hospital in Delhi. Participants: 322 resident doctors, interns, nursing staff, nursing students, and technicians. Statistical Analysis: Proportions and Chi-square test.

Results:

A large percentage (79.5%) of HCWs reported having had one or more NSIs in their career. The average number of NSIs ever was found to be 3.85 per HCW (range 0-20). 72 (22.4%) reported having received a NSI within the last month. More than half (50.4%) ascribed fatigue as a cause in their injury. Most of the injuries (34.0%) occurred during recapping. In response to their most recent NSI, 60.9% washed the site of injury with water and soap while 38 (14.8%) did nothing. Only 20 (7.8%) of the HCWs took post-exposure prophylaxis (PEP) against HIV/AIDS after their injury.

Conclusions:

The occurrence of NSI was found to be quite common. Avoidable practices like recapping of needles were contributing to the injuries. Prevention of NSI is an integral part of prevention programs in the work place, and training of HCWs regarding safety practices indispensably needs to be an ongoing activity at a hospital.

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Most cited references 15

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Extended work duration and the risk of self-reported percutaneous injuries in interns.

Najib T Ayas, Laura K Barger, Brian E Cade … (2006)

In their first year of postgraduate training, interns commonly work shifts that are longer than 24 hours. Extended-duration work shifts are associated with increased risks of automobile crash, particularly during a commute from work. Interns may be at risk for other occupation-related injuries. To assess the relationship between extended work duration and rates of percutaneous injuries in a diverse population of interns in the United States. National prospective cohort study of 2737 of the estimated 18,447 interns in US postgraduate residency programs from July 2002 through May 2003. Each month, comprehensive Web-based surveys that asked about work schedules and the occurrence of percutaneous injuries in the previous month were sent to all participants. Case-crossover within-subjects analyses were performed. Comparisons of rates of percutaneous injuries during day work (6:30 am to 5:30 pm) after working overnight (extended work) vs day work that was not preceded by working overnight (nonextended work). We also compared injuries during the nighttime (11:30 pm to 7:30 am) vs the daytime (7:30 am to 3:30 pm). From a total of 17,003 monthly surveys, 498 percutaneous injuries were reported (0.029/intern-month). In 448 injuries, at least 1 contributing factor was reported. Lapse in concentration and fatigue were the 2 most commonly reported contributing factors (64% and 31% of injuries, respectively). Percutaneous injuries were more frequent during extended work compared with nonextended work (1.31/1000 opportunities vs 0.76/1000 opportunities, respectively; odds ratio [OR], 1.61; 95% confidence interval [CI], 1.46-1.78). Extended work injuries occurred after a mean of 29.1 consecutive work hours; nonextended work injuries occurred after a mean of 6.1 consecutive work hours. Injuries were more frequent during the nighttime than during the daytime (1.48/1000 opportunities vs 0.70/1000 opportunities, respectively; OR, 2.04; 95% CI, 1.98-2.11). Extended work duration and night work were associated with an increased risk of percutaneous injuries in this study population of physicians during their first year of clinical training.

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Needlestick injuries among surgeons in training.

Timothy J. Sexton, Christine Holzmueller, Dora Syin … (2007)

Surgeons in training are at high risk for needlestick injuries. The reporting of such injuries is a critical step in initiating early prophylaxis or treatment. We surveyed surgeons in training at 17 medical centers about previous needlestick injuries. Survey items inquired about whether the most recent injury was reported to an employee health service or involved a "high-risk" patient (i.e., one with a history of infection with human immunodeficiency virus, hepatitis B or hepatitis C, or injection-drug use); we also asked about the perceived cause of the injury and the surrounding circumstances. The overall response rate was 95%. Of 699 respondents, 582 (83%) had had a needlestick injury during training; the mean number of needlestick injuries during residency increased according to the postgraduate year (PGY): PGY-1, 1.5 injuries; PGY-2, 3.7; PGY-3, 4.1; PGY-4, 5.3; and PGY-5, 7.7. By their final year of training, 99% of residents had had a needlestick injury; for 53%, the injury had involved a high-risk patient. Of the most recent injuries, 297 of 578 (51%) were not reported to an employee health service, and 15 of 91 of those involving high-risk patients (16%) were not reported. Lack of time was the most common reason given for not reporting such injuries among 126 of 297 respondents (42%). If someone other than the respondent knew about an unreported injury, that person was most frequently the attending physician (51%) and least frequently a "significant other" (13%). Needlestick injuries are common among surgeons in training and are often not reported. Improved prevention and reporting strategies are needed to increase occupational safety for surgical providers. Copyright 2007 Massachusetts Medical Society.

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Occupational exposure to blood and risk of bloodborne virus infection among health care workers in rural north Indian health care settings.

Damien Jolley, M. Thomas, Michelle Kermode … (2005)

Approximately 3 million health care workers (HCWs) experience percutaneous exposure to bloodborne viruses (BBVs) each year. This results in an estimated 16,000 hepatitis C, 66,000 hepatitis B, and 200 to 5000 human immunodeficiency virus (HIV) infections annually. More than 90% of these infections are occurring in low-income countries, and most are preventable. Several studies report the risks of occupational BBV infection for HCWs in high-income countries where a range of preventive interventions have been implemented. In contrast, the situation for HCWs in low-income countries is not well documented, and their health and safety remains a neglected issue. To describe the extent of occupational exposure to blood and the risk of BBV infection among a group of HCWs in rural north India. A cross-sectional survey of HCWs from 7 rural health settings gathered data pertaining to occupational exposure to blood and a range of other relevant variables (eg, demographic information, compliance with Universal Precautions, perception of risk, knowledge of BBVs). A mass action model was used to estimate the risk of occupational BBV infection for these HCWs over a 10-year period. A total of 266 HCWs returned questionnaires (response rate, 87%). Sixty-three percent reported at least 1 percutaneous injury (PI) in the last year (mean no. = 2.3) and 73% over their working lifetime (mean no. = 4.2). Predictors of PI during the last year were hospital site, job category, perception of risk, and compliance with Universal Precautions. The high level of occupational exposure to blood found among this group of rural north Indian HCWs highlights the urgent need for interventions to enhance their occupational safety to prevent unnecessary nosocomial transmission of BBVs.

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Author and article information

Journal

Journal ID (nlm-ta): Indian J Community Med

Journal ID (publisher-id): IJCM

Title: Indian Journal of Community Medicine : Official Publication of Indian Association of Preventive & Social Medicine

Publisher: Medknow Publications (India )

ISSN (Print): 0970-0218

ISSN (Electronic): 1998-3581

Publication date (Print): January 2010

Volume: 35

Issue: 1

Pages: 74-77

Affiliations

Department of Community Medicine, VMMC & Safdarjung Hospital, New Delhi, India

Author notes

Address for correspondence: Dr. Rahul Sharma, Department of Community Medicine, VMMC & Safdarjung Hospital, New Delhi, India. E-mail: studycorner@ 123456gmail.com

Article

Publisher ID: IJCM-35-74

DOI: 10.4103/0970-0218.62565

PMC ID: 2888373

PubMed ID: 20606925

SO-VID: 6f87b93a-f9db-4b43-acb6-5d9db7e98b20

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Study of Prevalence and Response to Needle Stick Injuries among Health Care Workers in a Tertiary Care Hospital in Delhi, India

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Abstract

Background:

Objective:

Materials and Methods:

Results:

Conclusions:

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HIV Self-Testing

Most cited references 15

Extended work duration and the risk of self-reported percutaneous injuries in interns.

Needlestick injuries among surgeons in training.

Occupational exposure to blood and risk of bloodborne virus infection among health care workers in rural north Indian health care settings.

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