The Incidence of Needle Stick Injury Among Registered Nurses at a University Teaching Hospital in China and Implication for Prevention: A Survey Approach

Background:

Research findings indicate that a significant number of nurses suffer from needle-stick injuries (NSIs) when administering injections or in the storage and disposal of used needles. This places nurses at increased risk of infection from blood-borne pathogens(BBP) such as Hepatitis B virus(HBV),Hepatitis C virus and  Human Immunodeficiency Virus, which can result in serious illness including fatalities.The aim of the study is to assess the risk of NSIs to registered nurses.It is warranted because research suggests that such injuries are often unreported. The study would, therefore enable a better understanding of the incidence of NSIs and implications for prevention at the University hospital in China.

Objective:

To assess the incidence and risk of the NSIs among nurses, to examine the reporting and action taken after injury and to review participants’ HBV vaccination and the related training attendance.

Methods:

The intended research sample is all registered nurses employed at the hospital (n=500). They had worked more than six months before the survey, regardless of gender, age and religion. 399 participants' age ranged from 18 years to 55 years and mean length of employment was 7.5 years.

A standardized self-completion questionnaire was used as a survey instrument. It consisted of 22 items which focused upon the occurrence of NSIs experienced by the participants within the last 6 months. They also were asked to indicate the risk factors; training received; precautions taken; and any vaccinations against Hepatitis B. The results had been analyzed using the Statistical Percentage of Social Sciences (SPSS 13.0) to assess the frequency of NSIs and probability that the findings are reliable. Anonymity and voluntary participation of the participants had been protected.

Results:

1)38% sustained NSIs and the age had an effect on the occurrence of NSIs (OR=0.774, 95%CI=0.601-0.996); 2) The treatment rooms, the 8AM to 12 AM shift, fingers, hollow-bore devices and self-injury were factors strongly associated with NSIs; 3) Disposing improperly, recapping and removing needles caused high percentage of injuries; 4) 25.9% of nurses with NSIs wore gloves; 5) 21.8% of injuries were reported; 6) 18% were not vaccinated with HBV vaccine; 7) 50.6% knew the concept of Universal Precautions.

Conclusions:

The study indicates that nurses in China sustained frequent NSIs and high-risk exposure to BBP. The findings reflects on the inadequacy of existing policies and procedures regarding the administration of injections and disposal of used needles. Recommendations in the form of a proposed plan of action are offered as a strategy to ensure the results of the study are communicated to the hospital concerned.It suggests that intervention strategies should consider institutional, behavioral and device-related factors.