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Sharps-Related Injuries in California Healthcare Facilities: Pilot Study Results From the Sharps Injury Surveillance Registry

Published online by Cambridge University Press:  02 January 2015

Marion Gillen*
Affiliation:
School of Nursing, University of California, San Francisco
Jennifer McNary
Affiliation:
School of Nursing, University of California, San Francisco
Julieann Lewis
Affiliation:
School of Nursing, University of California, San Francisco
Martha Davis
Affiliation:
School of Nursing, University of California, San Francisco
Alisa Boyd
Affiliation:
School of Nursing, University of California, San Francisco
Mary Schuller
Affiliation:
School of Nursing, University of California, San Francisco
Chris Curran
Affiliation:
School of Nursing, University of California, San Francisco
Carol A. Young
Affiliation:
School of Nursing, University of California, San Francisco
James Cone
Affiliation:
Occupational Health Branch, California Department of Health Services, Oakland, California
*
UCSF School of Nursing, Department of Community Health Systems, Box 0608, San Francisco, CA 94143-0608

Abstract

Background and Objectives:

In 1998, the California Department of Health Services invited all healthcare facilities in California (n = 2,532) to participate in a statewide, voluntary sharps injury surveillance project The objectives were to determine whether a low-cost sharps registry could be established and maintained, and to evaluate the circumstances surrounding sharps injuries in California.

Results:

Approximately 450 facilities responded and reported a total of 1,940 sharps-related injuries from January 1998 through January 2000. Injuries occurred in a variety of healthcare workers (80 different job titles). Nurses sustained the highest number of injuries (n = 658). In hospital settings (n = 1,780), approximately 20% of the injuries were associated with drawing venous blood, injections, or assisting with a procedure such as suturing. As expected, injuries were caused by tasks conventionally related to specific job classifications. The overall results approximate those reported by the Centers for Disease Control and Prevention's National Surveillance System for Health Care Workers and the University of Virginia's Exposure Prevention Information Network.

Conclusion:

These data further support findings from previous studies documenting the complex and persistent nature of sharps-related injuries in healthcare workers. In the future, mandated reporting using standardized forms and consistent application of decision rules would facilitate a more thorough analysis of injury events.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2003

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References

1. California Senate Bill No. 2005, Chapter 683. (September 23, 1996).Google Scholar
2. California Assembly Bill No. 1208, Chapter 999. (September 30, 1998).Google Scholar
3.Department of Labor, Occupational Safety and Health Administration. Occupational exposure to bloodborne pathogens; needlestick and other sharps injuries: final rule. Federal Register 2001;66:53185325.Google Scholar
4. Pub L No. 106430, Needlestick Safety and Prevention Act. (November 6, 2000).Google Scholar
5.National Institute for Occupational Safety and Health. NIOSH Alert: Preventing Needlestick Injuries in Health Care Settings. Washington, DC: National Institute for Occupational Safety and Health; 1999. DHHS (NIOSH) publication no. 2000-108.Google Scholar
6.Burke, S, Madan, I. Contamination incidents among doctors and mid-wives: reasons for non-reporting and knowledge of risks. Occup Med (London) 1997;47:357360.CrossRefGoogle Scholar
7.Hamory, BH. Under reporting of needlestick injuries in a university hospital. Am J Infect Control 1983;11:174177.Google Scholar
8.Mercier, C. Reducing the incidence of sharps injuries. Br J Nurs 1994;3:897-898, 900901.CrossRefGoogle ScholarPubMed
9.Occupational Safety and Health Administration, Directorate of Technical Support, Office of Occupational Health Nursing. Safer Needle Devices: Protecting Health Care Workers. Washington, DC: Occupational Safety and Health Administration; 1997.Google Scholar
10.Centers for Disease Control. Recommendations for preventing transmission of HIV and HBV to patients during exposure-prone invasive procedures. MMWR 1991;40(RR-8):19.Google Scholar
11.Centers for Disease Control and Prevention. Immunization of health care workers: recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC). MMWR 1997;46(RR-18):142.Google Scholar
12.Centers for Disease Control and Prevention. Recommendations for follow-up of health care workers after occupational exposure to hepatitis C virus. MMWR 1997;46:603606.Google Scholar
13.Centers for Disease Control and Prevention. Evaluation of blunt suture needles in preventing percutaneous injuries among health-care workers during gynecologic surgical procedures: New York City, March 1993-June 1994. MMWR 1997;46:2529.Google Scholar
14.Centers for Disease Control and Prevention. Evaluation of safety devices for preventing percutaneous injuries among health-care workers during phlebotomy procedures: Minneapolis-St. Paul, New York City, and San Francisco, 1993-1995. MMWR 1997;46:2125.Google Scholar
15.Centers for Disease Control and Prevention. Public health service guidelines for the management of health-care worker exposures to HIV and recommendations for postexposure prophylaxis. MMWR 1998;47(RR-7):128.Google Scholar
16.Gerberding, JL. Management of occupational exposures to blood-borne viruses. NEngl J Med 1995;332:444451.Google Scholar
17.Hanrahan, A, Reutter, L. A critical review of the literature on sharps injuries: epidemiology, management of exposures and prevention. J Adv Nurs 1997;25:144154.CrossRefGoogle ScholarPubMed
18.Aiken, LH, Sloane, DM, Klocinski, JL. Hospital nurses' occupational exposure to blood: prospective, retrospective, and institutional reports. Am J Public Health 1997;87:103107.CrossRefGoogle ScholarPubMed
19.Folin, AC, Nordstrom, OM. Accidental blood contact during orthopedic surgical procedures. Infect Control Hosp Epidemiol 1997;18:244246.Google Scholar
20.Fraser, VJ, Powderly, WG. Risks of HIV infection in the health care setting. Annu Rev Med 1995;46:203211.CrossRefGoogle ScholarPubMed
21.Gershon, RRM, Karkashian, CD, Vlahov, D, et al. Compliance with universal precautions in correctional health care facilities. J Occup Environ Med 1999;41:181189.Google Scholar
22.Haiduven, D, Askari, E, Gross, R, Fisher, J. Bloodborne exposures in the home care setting: a multi-center analysis. Am J Infect Control 1997;25:134. Abstract.Google Scholar
23.Lum, D, Mason, Z, Meyer-Rochow, G, et al. Needle stick injuries in country general practice. N Z Med J 1997;110:122125.Google ScholarPubMed
24.Lymer, UB, Schutz, AA, Isaksson, B. A descriptive study of blood exposure incidents among healthcare workers in a university hospital in Sweden. J Hosp Infect 1997;35:223235.CrossRefGoogle Scholar
25.White, MC, Lynch, P. Blood contact and exposures among operating room personnel: a multicenter study. Am J Infect Control 1993;21:243248.Google Scholar
26.Asai, T, Matsumoto, S, Matsumoto, H, Yamamoto, K, Shingu, K. Prevention of needle-stick injury: efficacy of a safeguarded intravenous cannula. Anaesthesia 1999;54:258261.CrossRefGoogle ScholarPubMed
27.Bhardwaj, D, Norris, A, Wong, DT. Is skin puncture beneficial prior to arterial catheter insertion? Can J Anaesth 1999;46:129132.Google Scholar
28.Brown, JD, Moss, HA, Elliott, TSJ. The potential for catheter microbial contamination from a needleless catheter. J Hosp Infect 1997;36:181189.CrossRefGoogle ScholarPubMed
29.Chiarello, LA. Selection of needlestick prevention devices: a conceptual framework for approaching product evaluation. Am J Infect Control 1995;23:386395.Google Scholar
30.Ihrig, M, Cookson, ST, Campbell, K, Harstein, AI, Jarvis, WR. Evaluation of the acceptability of a needleless vascular-access system by nurses. Am J Infect Control 1997;25:434438.Google Scholar
31.Jagger, J, Bentley, MB, the Collaborative EPINet Surveillance Group. Injuries from vascular access devices: high risk and preventable. J Intraven Nurs 1997;20(suppl):S33S39.Google Scholar
32.Kempen, PM. Assessing blunt cannulae as replacements for hypodermic needles during intravenous therapy: safety and utility. Infect Control Hosp Epidemiol 1997;18:169174.Google Scholar
33.Lawrence, LW, Delclos, GL, Felknor, SA, et al. The effectiveness of a needleless intravenous connection system: an assessment by injury rate and user satisfaction. Infect Control Hosp Epidemiol 1997;18:175182.CrossRefGoogle ScholarPubMed
34.L'Ecuyer, PB, Schwab, EO, Iademarco, E, Barr, N, Aton, EA, Fraser, VJ. Randomized prospective study of the impact of three needleless intravenous systems on needlestick injury rates. Infect Control Hosp Epidemiol 1996;17:803808.CrossRefGoogle ScholarPubMed
35.Loudon, MA, Stonebridge, PA. Minimizing the risk of penetrating injury to surgical staff in the operating theatre: towards sharp-free surgery. J R Coll Surg Edinb 1998;43:68.Google Scholar
36.Mendelson, MH, Short, LI, Schechter, CB, et al. Study of a needleless intermittent intravenous-access system for peripheral infusions: analysis of staff, patient, and institutional outcomes. Infect Control Hosp Epidemiol 1997;19:401406.Google Scholar
37.Quiroga, R, Halkyer, P, Gil, F, Nelson, C, Kristensen, D. A prefilled injection device for outreach tetanus immunization by Bolivian traditional birth attendants. Pan American Journal of Public Health 1998;4:2025.Google Scholar
38.Yassi, A, McGill, ML, Khokhar, JB. Efficacy and cost-effectiveness of a needleless intravenous access system. Am J Infect Control 1995;23:5764.Google Scholar
39.Younger, B, Hunt, EH, Robinson, C, McLemore, C. Impact of a shielded safety syringe on needlestick injuries among healthcare workers. Infect Control Hosp Epidemiol 1992;13:349353.Google Scholar
40.Zafar, AB, Butler, C, Podgorny, JM, Mennonna, PA, Gaydos, LA, Sandiford, JA. Effect of a comprehensive program to reduce needlestick injuries. Infect Control Hosp Epidemiol 1997;18:712715.CrossRefGoogle ScholarPubMed
41.Arduino, MJ, Bland, IA, Danzig, LE, McAllister, SK, Aguero, SM. Microbiologic evaluation of needleless and needle-access devices. Am J Infect Control 1997;26:377380.Google Scholar
42.Chodoff, A, Pettis, A, Schoonmaker, D, Shelly, M. Polymicrobial gram-negative bacteremia associated with saline solution flush used with a needleless intravenous system. Am J Infect Control 1995;23:357363.CrossRefGoogle ScholarPubMed
43.Danzig, LE, Short, LJ, Collins, K, et al. Bloodstream infections associated with a needleless intravenous infusion system in patients receiving home infusion therapy. JAMA 1995;273:18621864.CrossRefGoogle ScholarPubMed
44.McDonald, IX, Banerjee, S, Jarvis, W. Central venous catheter (CVQ-associated bloodstream infections (BSI) in intensive care unit patients associated with needleless access devices. Infect Control Hosp Epidemiol 1997;18:24.Google Scholar
45.Russo, PL, Harrington, GA, Spelman, DW. Needleless intravenous systems: a review. Am J Infect Control 1999;27:431434.Google Scholar
46.Emergency Care Research Institute (ECRI). Health devices: special report and product review. Health Devices 1991;20:154180.Google Scholar
47.Becker, CE, Gerberding, J, Cone, J. HIV risk and risk reduction. Ann Intern Med 1989;110:653656.CrossRefGoogle ScholarPubMed
48.Centers for Disease Control and Prevention, The National Surveillance System for Health Care Workers (NaSH). Summary Report for Data Collected From June 1995 Through July 1999, Division of Healthcare Quality Promotion. Atlanta, GA: Centers for Disease Control and Prevention; 2001. Available at www.cdc.gov/ncidod/hip/NASH/reporthtm.Google Scholar
49.Exposure Prevention Information Network (EPINet). Exposure Prevention Information Network Data Reports. Charlottesville, VA: International Health Care Worker Safety Center, University of Virginia; 1999. Available at www.med.Virginia.EDU/medcntr/centers/epinet/epinet4.html.Google Scholar
50.California Office of Statewide Health Planning and Development (OSHPD). Hospital Annual Financial Data Profile, 1999. Available at www.oshpd.cahwnetgov/defaulthtm. 2001.Google Scholar
51.Baker, EL, Matte, TP. Surveillance of occupational illness and injury. In: Halperin, W, Baker, EL, Monson, RR, eds. Public Health Surveillance. New York: Van Nostrand Reinhold; 1992:178194.Google Scholar
52.Puro, V, Ippolito, G. Safety butterfly needles for blood drawing. Infect Control Hosp Epidemiol 1998;19:299.Google Scholar
53.Exposure Prevention Information Network (EPINet). Data Reports: 1993 through 1995, 77 Hospitals. Charlottesville, VA: International Health Care Worker Safety Center, University of Virginia; 1997. Available at www.med.Virginia.EDU/medcntr/centers/epinet/soid6.html.Google Scholar
54.Froom, P, Kristal-Boneh, E, Melamed, S, Shalom, A, Ribak, J. Prevention of needle-stick injury by the scooping-resheathing method. Am J Ind Med 1998;34:1519.Google Scholar
55.Gillen, M, Davis, M, McNary, J, et al. Sharps injury recordkeeping activities and safety product use in California healthcare facilities: pilot study results from the Sharps Injury Control Program. Am J Infect Control 2002;30:269276.CrossRefGoogle Scholar
56.Exposure Prevention Information Network (EPINet). Data Reports (2000). Charlottesville, VA: International Health Care Workers Safety Center, University of Virginia. Available at www.med.Virginia.EDU/medcntr/centers/epinet/epinet3.html. 2001.Google Scholar
57.Centers for Disease Control and Prevention, National Surveillance System for Health Care Workers (NaSH). Spotlights—March 2000: Needlestick Injuries Involving Winged Steel Needles. Atlanta, GA: Centers for Disease Control and Prevention, Division of Healthcare Quality Promotion; 2001. Available at www.cdc.gov/ncidod/hip/NASH/winged.htm.Google Scholar
58.Patel, N, Tignor, GH. Device-specific sharps injury and usage rates: an analysis by hospital department. Am J Infect Control 1997;25:7784.Google Scholar