Risk analysis of needle stick and sharp object injuries among health care workers in a tertiary care hospital (Saudi Arabia)

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DOI: 10.1016/j.jegh.2013.03.004 · Source: PubMed
Abstract
To study different risk factors associated with needle stick injury among health care workers of a tertiary care hospital in Saudi Arabia. Retrospective study involving all reported cases of needle stick and sharp object injury among health care workers through using Epinet™ access U.K. version 1.3 program in King Saud Medical City (KSMC) during the period (January 2007-December 2011). During the study period, 477 needle stick and sharp object injuries were reported with peak incidence (13.84%) during 2009. Distribution of needle stick and sharp object injuries according to the location of their occurrence clarified that patient room/ward was the most common place of occurrence of NSSIs 150/477, followed by emergency department 82/477, then the intensive and critical care units 70/477. The study presented that nurses were encountered as the most affected job category and use of items is the most common activity associated with the incidents. Most of the incidents were caused by needles with disposable needle and hands were the most affected body parts. Needle stick and sharp object injuries represent a major occupational challenge to health care workers. Prevention should be based on different working lines including immunization, education of health care workers and proper engineering control measures.
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Available from: Abdullah M Assiri
Risk analysis of needle stick and sharp object
injuries among health care workers in a tertiary
care hospital (Saudi Arabia)
Ziad A. Memish, Abdullah M. Assiri
*
, Mervat M. Eldalatony
1
, Hanan M.
Hathout
2
, Hend Alzoman, Monabae Undaya
Adult Infectious Diseases Division, King Fahad Medical City, Riyadh, Riyadh 11176, Saudi Arabia
Received 15 December 2012; received in revised form 13 March 2013; accepted 14 March 2013
KEYWORDS
Occupational health;
Healthcare workers; Epi-
net; Needle-stick injury
Abstract Objective: To study different risk factors associated with needle stick
injury among health care workers of a tertiary care hospital in Saudi Arabia.
Subjects and methodology: Retrospective study involving all reported cases of
needle stick and sharp object injury among health care workers through using Epi-
net
TM
access U.K. version 1.3 program in King Saud Medical City (KSMC) during the
period (January 2007–December 2011).
Results: During the study period, 477 needle stick and sharp object injuries were
reported with peak incidence (13.84%) during 2009. Distribution of needle stick and
sharp object injuries according to the location of their occurrence clarified that
patient room/ward was the most common place of occurrence of NSSIs 150/477, fol-
lowed by emergency department 82/477, then the intensive and critical care units
70/477. The study presented that nurses were encountered as the most affected job
category and use of items is the most common activity associated with the inci-
dents. Most of the incidents were caused by needles with disposable needle and
hands were the most affected body parts.
Conclusion: Needle stick and sharp object injuries represent a major occupa-
tional challenge to health care workers. Prevention should be based on different
working lines including immunization, education of health care workers and proper
engineering control measures.
ª 2013 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights
reserved.
1. Introduction
Needle stick and sharp object injuries (NSSIs)
are commonly encountered by people handling
needles in the medical setting, such injuries are
2210-6006/$ - see front matter ª 2013 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.jegh.2013.03.004
*
Corresponding author. Tel.: +966 1 212 4256, mobile: +966 50
437 2388; fax: +966 1 212 4255.
E-mail address: abassiri@me.com (A.M. Assiri).
1
MD of Industrial Medicine and Occupational Health. Menoufia
University, Egypt.
2
MD of Community Medicine and Environmental Health.
Menoufia University, Egypt.
Journal of Epidemiology and Global Health (2013) xxx, xxx xxx
http:// www.elsevier.com/locate/jegh
Please cite this article in press as: Memish Z.A. et al., Risk analysis of needle stick and sharp object injuries among health care workers in a
tertiary care hospital (Saudi Arabia), J Epidemiol Global Health (2013), http://dx.doi.org/10.1016/j.jegh.2013.03.004
an occupational hazard in the medical community.
The National Institute for Occupational Safety and
Health (NIOSH) USA has defined needle stick inju-
ries as injuries caused by needles such as hypoder-
mic needles, Intravenous (IV) stylets, and needles
used to connect parts of IV delivery systems [1].
The frequency of such events has been esti-
mated to be about 600,000–800,000 cases annually
in the USA [1], and it is estimated that 100,000
NSSIs occur annually in the UK [2] and 500,000
annually in Germany [3].
Some published studies about NSSIs in Saudi Ara-
bia show that there are a reported 282 cases of
NSSIs among health care workers from 11 hospitals
in the Eastern province region during the period
from 1995 to 1997 [4]. Also, there are a reported
116 cases of NSSIs from Assir central hospital during
the period from 1996 to 2000 [5]. Several other re-
ports on sharp object injuries among health care
workers have emerged from the Kingdom of Saudi
Arabia as that of [6–11].
Among healthcare workers nurses and physicians
appear especially at risk [12]. An investigation
among American surgeons indicates that almost
every surgeon experienced at least one such injury
during their training [13].
These events are of concern because of the risk
to transmit blood-borne diseases as hepatitis B
virus (HBV), the hepatitis C virus (HCV), and the hu-
man immunodeficiency virus (HIV) [1]. It is esti-
mated that annually as a consequence there are
66,000 infections with HBV, 16,000 with HCV, and
1000 with HIV worldwide [14].
While the infectiousness of HIV and HCV de-
creases within a couple of hours, HBV remains sta-
ble during desiccation and infectious for more than
a week [15], so, Hepatitis B carries the greatest risk
of transmission, with 37–62% of exposed workers
eventually showing seroconvertion and 22–31%
showing clinical Hepatitis B infection [16]. Esti-
mates of the risk of a single injury indicate a risk
of 300 HBV infections (30% risk), 30 HCV infection
(3% risk) and three HIV infections (0.3% risk) per
1000 respective exposures [15].
As of the World Health Organization in the East-
ern Mediterranean region (including Saudi Arabia)
the estimated number of health care workers ex-
posed annually to at least one percutaneous injury
with sharp objects contaminated with HCV is
18,000, with HBV 43,000 and with HIV 170 [14].
While the number of infections among health-care
workers attributable to sharp object injuries on the
average value for ages 20–65 in the same region of
WHO is 310 for HCV infections 2300 for HBV and 1
for HIV infections [14,17].
The specific risk of a single injury depends on a
number of factors when the patients harbor the
virus of concern. Injuries with a hollow-bore nee-
dle, deep penetration, visible blood on the needle,
a needle that was located in a deep artery or vein,
or with blood from terminally ill patients are
known to increase the risk for HIV infection
[18,19].
As there is a marked underreporting of needle
stick incidents acquired by health care workers in
Saudi Arabia like many other countries the study
of [20] shows that more than half of dental health
care workers experiencing NSSIs did not report
those injuries to the appropriate department. The
study of [20] shows that the under-reporting rate
after a needle stick injury was 67.4% (161/239)
and that the major reasons for underreporting
after needle stick injuries were the assumption
that no blood-borne pathogens existed in the
source patient (62.8%), annoyance (17.9%), and
no knowledge about the reporting procedure
(6.0%).
Also this could be attributed to the fact that a
great proportion of health care workers are con-
tractors coming from different countries with dif-
ferent levels of awareness of infection control
measures and there is also, a high rate of turnover,
so the problem presents a great challenge to the
infection control staff in Saudi Arabia and requires
further research.
This study was therefore designed in a trial to
highlight some issues related to this important
problem in Saudi Arabia in an attempt to find more
practical solutions for it.
2. Objectives
To establish a baseline data of needle stick injuries
among health care workers in one of the biggest
MOH hospitals in Riyadh region (King Saud Medical
City) (KSMC) using the Epinet
TM
access U.K. version
1.3 program.
To study different risk factors associated with needle
stick injury among health care workers of the studied
hospital.
Establish recommendations to prevent needle stick
and sharp object injuries among health care workers.
N.B.: EPINET (The Exposure Prevention Information
Network).
3. Subjects and methodology
A retrospective study involving all reported cases
of needle stick and sharp object injury among
2 Z.A. Memish et al.
Please cite this article in press as: Memish Z.A. et al., Risk analysis of needle stick and sharp object injuries among health care workers
in a tertiary care hospital (Saudi Arabia), J Epidemiol Global Health (2013), http://dx.doi.org/10.1016/j.jegh.2013.03.004
health care workers by using Epinet
TM
access U.K.
version 1.3 program in King Saud Medical City
(KSMC) during the period (January 2007–December
2011) was carried out.
KSMC includes three hospitals (general, chil-
dren, and maternity hospitals) with the mean bed
capacity (694, 256, 157 beds over the duration of
the study respectively).
3.1. Tools of data collection
EPINet
TM
is a software package that has been specif-
ically created for the purpose of recording and ana-
lyzing occupational exposures to blood borne
viruses. The focus of the software is to monitor
sharp object injuries, body fluid splashes and the
consequences of such exposures. EPINet
TM
has the
capacity to record detailed information about the
exposure including the device involved and the pro-
cedure and then provide a detailed feedback on
which areas are at the highest risk from exposures.
Subsequently, this information can be used to iden-
tify methods for reducing the frequency of occupa-
tional exposures to blood borne viruses. EPINet
TM
also, has the ability to record the follow-up to
these exposures [21].
3.2. Data analysis and interpretation
The collected data of needle stick and sharp object
incidents among health care workers during the
period of the study in KSMC were analyzed using
SPSS Program version 13, then risk analyses were
conducted to identify associated significant risk
factors.
3.2.1. Calculating the rates of needle stick
and sharp object injury per 100 occupied
beds
Calculation of the rates of needle stick and sharp
object injury was done with the total number of
needle stick injuries (NSI) reported during each
year of study as numerator over the number of
occupied hospital beds in the same year as
denominator.
N.B.: The average daily census of occupied hos-
pital beds for the same year is the relevant number
to use in the denominator, since it corrects for un-
used hospital beds.
3.3. Ethical considerations
To ensure privacy, dignity, and integrity of the par-
ticipants, names of the health care workers are
kept confidential.
Institutional ethics committee clearance for
accessing health worker records was taken.
4. Results
Table 1 shows that in the 5 years from January 2007
to December 2011, 477 NSSIs were reported with a
maximum rate in 2009 (13.84)% of all reported inci-
dents during the study period.
Distribution of needle stick and sharp object
injuries according to the location of their
Table 1 Distribution of needle stick incidents by year.
Year Frequency of
recorded needle
stick and sharp
object injury
No. of occupied
hospital beds
Rate of needle stick
per 100 occupied
hospital beds (%)
2007 98 766 12.79
2008 111 816 13.60
2009 115 831 13.84
2010 90 819 10.99
2011 63 816 7.72
Total 477
Table 2 Distribution of needle stick and sharp object
injuries by location of injuries.
Location Frequency (%)
Patient room/ward 150 31.4
Treatment/procedure room 19 4.0
Clinical laboratories 22 4.6
Mortuary/pathology 12 2.5
Labor and delivery room 8 1.7
Emergency Dept. (A&E) 82 17.2
Intensive/critical care unit 70 14.7
Operating theater/recovery 55 11.5
Outpatient clinic/office 14 2.9
Blood bank 3 0.6
Dialysis facility 15 3.1
Other, describe 27 5.7
Total 477 100.0
Risk analysis of needle stick and sharp object injuries among health care workers 3
Please cite this article in press as: Memish Z.A. et al., Risk analysis of needle stick and sharp object injuries among health care workers in a
tertiary care hospital (Saudi Arabia), J Epidemiol Global Health (2013), http://dx.doi.org/10.1016/j.jegh.2013.03.004
occurrence clarified that patient room/ward was
the most common place of occurrence of NSSIs,
followed by emergency department, then the
intensive and critical care units (Table 2).
Table 3 shows the frequency and percent distri-
bution of NSSIs related to the respective job cate-
gories. Nurses were encountered as the most
affected job category.
Most of the incidents occur during the use of
items (Table 5).
Most of the incidents are caused by syringes with
disposable needles (Table 6).
Table 7 shows the part of the body mostly af-
fected during incidents, and it was found that
hands are the most affected body parts.
70.4% of injured health care workers was wear-
ing a single pair of gloves at time of incidents,
and by analyzing the relationship between glove
use during incident and job category 22.2% of in-
jured domestic workers and porters were not wear-
ing gloves at the time of incidents followed by
nursing students and nurses (20.8% and 19.6%,
respectively) (Table 8).
5. Discussions
Analysis of needle stick and sharp object injury
incidents during the period of study from January
2007 to December 2011 represented that 477 NSSIs
were reported with a peak distribution in 2009
(13.8 per 100 occupied hospital bed) (Table 1).
Most of the reported needle stick injuries during
the period of study took place in the patient room
(Table 2) which is consistent with the finding of
other studies [8,22]. While other studies found that
areas of the hospital with the highest activities
such as operating room and intensive care units
had the highest number of sharp object injuries
[5] the proportion of sharp object injuries pertain-
ing to each clinical specialty differed across various
studies which may be attributed to the type of
sharp devices used and the variation in clinical
practices between different health care settings.
In this study nurses have been reported to be the
major occupational group (64.6%, Table 3) which
was consistent with the findings of many studies
published locally and internationally [5, 8, 22, 23]
which may be explained by the fact that nurses
are responsible for most of blood sampling and
other IV access procedure in the hospital.
Table 3 Distribution of needle stick and sharp object
injuries by job category.
Job category Frequency Percent (%)
Consultant/registrar
(all grades)
26 5.5
Dentist/dental hygienist/
dental nurse
22 4.6
Domestic/porter 18 3.8
Senior house officer/
house officer
25 5.2
Nurse 308 64.6
Nursing student 24 5.0
Other attendant 53 11.1
Total 476 100.0
N.B.: The data concerning distribution of needle stick and
sharp object injuries by job category are missing in one
record.
Table 5 Distribution of activities leading to incidents.
Type of activity Frequency (%)
Before use of item 1 0.2
While putting the item into the disposal container 18 3.8
Item pierced side of disposal container 13 2.7
Device left on floor, table, bed or other inappropriate place 14 2.9
During use of item 221 46.4
Between steps of a multi-step procedure 12 2.5
While recapping a used needle 35 7.4
Withdrawing a needle from rubber or other resistance 11 2.3
Other, describe 151 31.7
Total 476 100.0
N.B.: The data concerning distribution of activities leading to incidents are missing in one record.
Table 4 Distribution of incidents according to identifi-
cation of source.
Identification of source Frequency (%)
Yes 349 73.2
Unknown 128 26.8
Total 477 100.0
4 Z.A. Memish et al.
Please cite this article in press as: Memish Z.A. et al., Risk analysis of needle stick and sharp object injuries among health care workers
in a tertiary care hospital (Saudi Arabia), J Epidemiol Global Health (2013), http://dx.doi.org/10.1016/j.jegh.2013.03.004
In 26% of incidents, the source of injury was un-
known (Table 4) which was most probably due to
problems related to the disposal of sharp items
after using. Non identification of the source oc-
curred in 20% of incidents in another study [23].
Most of the incidents occur during the use of
sharp items (Table 5), this finding is similar to other
reported data which demonstrate 55% of injuries
occur during the use of devices which may be due
to a malpractice in handling sharp instruments
[22]. This percentage is higher than that of another
study which found that 35% of staff was in the pro-
cess of using devices as establishing a venous ac-
cess and during indirect patient care activities
due to disposal related malpractices [8]. Another
study reported needle recapping (26.4%), careless
disposal of sharp instruments (16.9%), and blood
extraction (11.5%) were responsible for more than
50% of sharp object injuries which could be easily
prevented by health education [5].
Most of the reported injuries occur due to dis-
posable syringes with needles (Table 6) and this is
consistent with other studies that reported similar
findings [6,9].
Table 6 Types of needles involved during incidents.
Needle type Frequency Percent (%)
Syringe, disposable with needle 233 64.1
Needle, unattached hypodermic 2 0.5
Needle, arterial catheter introducer 4 1.1
Needle, central line catheter introducer 1 0.3
Needle, other vascular catheter 2 0.5
Syringe, prefilled cartridge 8 2.2
Needle, unknown type 7 1.9
Needle, describe 31 8.5
Syringe, blood gas 16 4.4
Syringe, other type 7 1.9
Needle on IV tubing 20 5.5
Needle, winged steel 6 1.6
IV catheter stylet 24 6.6
Needle/holder vacuum tube blood collection 3 0.8
Total 364 100.0
N.B.: The data concerning types of needles involved during incidents are missing in 113 incidentsÕ records.
Table 8 Relationship between glove use during incident and job category.
Job categories Glove use Total
Single pair of
gloves
Double pair of
gloves
No gloves
No. % No. % No. %
Consultant/registrar (all grades) 14 53.8 10 38.5 2 7.7 26
Dentist/dental hygienist/dental nurse 17 72.3 4 18.2 1 4.5 22
Domestic/porter 12 66.7 2 11.1 4 22.2 18
SHO/HO 20 80 5 20 0 0 25
Medical student 3 100 0 0 0 0 3
Nurse 216 70.6 30 9.8 60 19.6 306
Nursing student 17 70.8 2 8.3 5 20.8 24
Other attendant 33 68.8 10 20.8 5 10.4 48
Total 332 70.3 63 13.3 77 16.3 472
Table 7 Distribution of needle stick and sharp object
injuries by part of the body affected.
Part affected Frequency (No.) Percent (%)
Hand 378 95.5
Arms 9 2.3
Lower limb 8 2.0
Face 1 0.3
Total 396 100.0
N.B.: The data concerning distribution of needle stick and
sharp object injuries by part of the body affected are missing
in 81 incidentsÕ records.
Risk analysis of needle stick and sharp object injuries among health care workers 5
Please cite this article in press as: Memish Z.A. et al., Risk analysis of needle stick and sharp object injuries among health care workers in a
tertiary care hospital (Saudi Arabia), J Epidemiol Global Health (2013), http://dx.doi.org/10.1016/j.jegh.2013.03.004
Ninety five percent of injuries occur in the hand
(Table 7). Similar published data report that the
thumb, index and middle fingers of the non-domi-
nant hand were the most common anatomic sites
involved in all reported NSSIs, affecting 174 (48%)
of the injured employees [8].
Sixteen percent of the injured health care work-
ers did not wear protective gloves at the time of
incident most of them were nurses (Table 8). This
percent is similar to that reported by EPINET
2009 but with a difference that domestic/porter
was the most non-compliant group.
6. Conclusion
Needle stick and sharp object injuries represent a
major occupational challenge to health care work-
ers. Important risk factors for such injuries include
being a nurse, working in patient room, and using a
disposable syringe with a needle. Educational pro-
gram addressing such issues together with the
observation of sharp object handling and use prac-
tices, and proper engineering control measures is
an important intervention to control such
incidents.
7. Recommendations
Periodic training of health care workers on the proper
work procedures to avoid mistakes that may lead to
avoidable incidents.
Safely manage sharp wastes. This includes collecting
contaminated sharp wastes immediately after use
(without recapping the needle), and using puncture-
proof sharp containers that will not leak liquids.
Use engineering controls, such as auto disposable
syringes, needle-less devices, and retractable or
sheathed needles.
Provide personal protective equipment, such as
gloves, gowns, masks etc.
Train and inform workers on the risks of transmission
of blood borne pathogens and on safe practices to
combat transmission.
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Please cite this article in press as: Memish Z.A. et al., Risk analysis of needle stick and sharp object injuries among health care workers
in a tertiary care hospital (Saudi Arabia), J Epidemiol Global Health (2013), http://dx.doi.org/10.1016/j.jegh.2013.03.004
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Risk analysis of needle stick and sharp object injuries among health care workers 7
Please cite this article in press as: Memish Z.A. et al., Risk analysis of needle stick and sharp object injuries among health care workers in a
tertiary care hospital (Saudi Arabia), J Epidemiol Global Health (2013), http://dx.doi.org/10.1016/j.jegh.2013.03.004
    • In 2009, the total number of needle stick injuries were 477 recorded with peak incidence of 13.84 percent.The results allowed to consider the injuries from needle stick and sharp object in the tertiary care hospital a serious occupational issue among the health care workers. It was also affirmed that there is need of preventive actions directed to several working lines, which were assumed to include proper engineering control measures, immunization, and provision of efficient education to all health care workers [11]. In order to understand more about the type of injuries incurred by hospital staff and the factors that may increase the likelihood of injury, this study is an attempt to address this issue in the local context of a military hospital in the southern region of Saudi Arabia.
    Article · Jan 2016 · International Journal of Occupational Medicine and Environmental Health
    • Nursing was the most common profession among HCWs with OE in this study and previously reported studies. Memish et al. [12] and Lee et al. [13] reported similar results where 65.4% and 64.6% of exposures were among nurses, respectively. Nurses are the primary occupation group who are in charge of blood sampling and other parenteral procedures in hospitals.
    [Show abstract] [Hide abstract] ABSTRACT: The aim of this study is to determine the risk factors for percutaneous and mucocutaneous exposures in healthcare workers (HCW) in one of the largest centers of a middle income country, Turkey. This study has a retrospective design. HCWs who presented between August 2011 and June 2013, with Occupational Exposures (OEs) (cases) and those without (controls) were included. Demographic information was collected from infection control committee documents. A questionnaire was used to ask the HCWs about their awareness of preventive measures. HCWs who work with intensive work loads such as those found in emergency departments or intensive care units have a higher risk of OEs. Having heavy workloads and hours increases the risk of percutaneous and mucocutaneous exposures. For that reason the most common occupation groups are nurses and cleaning staff who are at risk of OEs. Increasing work experience has reduced the frequency of OEs. Copyright © 2015. Published by Elsevier Ltd.
    Full-text · Article · Jul 2015
    • But Memish et al., (2013) found that medical/surgical wards were the places with the most frequency of NSIs, but unlike most of other studies she did not separate medical wards from surgical wards, which could have given different results. Nurses were found to be the most occupational health group to have NSSIs [Memish et al., (2013), Kebede et al., (2012), Yoshikawa et al., (2013), Hoffmann et al., (2013) and Voide et al., (2012)].This can be explained by the facts that the nurses administer most of the injections and intravenous fluid administration, basically nurses are the most healthcare group dealing with injections and sharp objects, plus the numbers of nurses are usually higher than any other occupational group inside hospitals, not forgetting that shortage of nurses inside hospitals is also an issue. Martins et al., (2012) reported a very interesting finding, which is some of the NSIs were actually caused by a HCW colleague; she reported that 4.3% of her sample reported their injury inflicted by another healthcare worker.
    [Show abstract] [Hide abstract] ABSTRACT: Background: Needlestick and sharp injuries (NSSIs) are defined as percutaneous injuries with needles or sharp objects contaminated with blood or other body fluids. NSSIs are considered as a major occupational hazard among healthcare workers (HCWs) since needles and sharp objects are commonly used in hospitals. Objectives: The objective of this study is to conduct a systematic review on the published scientific literature to provide accurate assessment of needlestick and sharp injuries among healthcare workers including prevalence, risk factors, predictors, reporting, and interventions. Methods: The following selection criteria were used to perform a systematic search of the literature: research studies published in English language between 2011 and 2014, targeted population is the healthcare workers providing direct care to the patients in the hospitals. The outcome of the study is the needlestick and sharp injuries. The following databases were searched: ScienceDirect, Scopus, and EBSCO. The included search terms were: needlestick injury, sharp injury, NSI or NSSI and healthworkers. The search was limited to cross-sectional studies, retrospective studies, and randomized controlled trials conducted in the hospital. The criteria to select articles were limited to peer-reviewed scientific publications and review articles were excluded. Result: Based on the inclusion and exclusion criteria, screening was done to the 35 articles. 18 articles were found eligible to be included while 17 studies were excluded. The included studies consisted of 10 cross-sectional, 7 retrospective, and 1 intervention study. In general, higher NSSI rates were found in nurses (average reported between 64.1% - 44.3%) compared to other occupational groups (average NSSI rate reported were first year resident physician 45%, interns 26% and housekeeper 12.3%). Conclusion: NSSIs is an important occupational hazard among health workers in their daily working. More emphasis must be put on investigating methods and strategies to reduce NSSIs. Safety devices must be used more by HCWs to reduce NSSIs along with planning educational and training programs with close monitoring to practices.
    Full-text · Article · Oct 2014 · International Journal of Occupational Medicine and Environmental Health
  • Article · Jan 2015 · International Journal of Occupational Medicine and Environmental Health
  • [Show abstract] [Hide abstract] ABSTRACT: Exposure to blood-borne pathogens from needle-stick and sharp injuries continues to pose a significant risk to health care workers. These events are of concern because of the risk to transmit blood-borne diseases such as hepatitis B virus, hepatitis C virus, and the human immunodeficiency virus. To benchmark different risk factors associated with needle-stick incidents among health care workers in the Ministry of Health hospitals in the Kingdom of Saudi Arabia compared to the US hospitals participating in Exposure Prevention Information Network (EPINet™). Prospective surveillance of needle-stick and sharp incidents carried out during the year 2012 using EPINet™ ver 1.5 that provides uniform needle stick and sharp injury report form. The annual percutaneous incidents (PIs) rate per 100 occupied beds was 3.2 at the studied MOH hospitals. Nurses were the most affected job category by PIs (59.4%). Most PIs happened in patients' wards in the Ministry of Health hospitals (34.6%). Disposable syringes were the most common cause of PIs (47.20%). Most PIs occurred during use of the syringes (36.4%). Among health care workers, nurses and physicians appear especially at risk of exposure to PIs. Important risk factors of injuries include working in patient room, using disposable syringes, devices without safety features. Preventive strategies such as continuous training of health care workers with special emphasis on nurses and physicians, encouragement of reporting of such incidents, observation of sharp handling, their use and implementation of safety devices are warranted.
    Full-text · Article · Jan 2015
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