Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-12-02T19:47:19.688Z Has data issue: false hasContentIssue false
  • English
  • Français

The Impact of Multifocused Interventions on Sharps Injury Rates at an Acute-Care Hospital

Published online by Cambridge University Press:  02 January 2015

Robyn R.M. Gershon ,
Lisa Pearse ,
Martha Grimes ,
Patricia A. Flanagan  and
David Vlahov
Robyn R.M. Gershon*
Affiliation:
Department of Environmental Health Sciences, the Johns Hopkins University School of Public Health, Baltimore, Maryland
Lisa Pearse
Affiliation:
William Beaumont Army Medical Center, Fort Bliss, El Paso, Texas
Martha Grimes
Affiliation:
Department of Infection Control, Holy Cross Hospital, Silver Spring, Maryland
Patricia A. Flanagan
Affiliation:
Department of Environmental Health Sciences, the Johns Hopkins University School of Public Health, Baltimore, Maryland
David Vlahov
Affiliation:
New York Academy of Medicine, New York City, New York
*
The Johns Hopkins University, School of Public Health, 615 N. Wolfe St, Room 8503, Baltimore, MD 21205
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To determine the impact of a multifocused interventional program on sharps injury rates.

Design:

Sharps injury data were collected prospectively over a 9-year period (1990-1998). Pre- and postinterventional rates were compared after the implementation of sharps injury prevention interventions, which consisted of administrative, work-practice, and engineering controls (ie, the introduction of an anti-needlestick intravenous catheter and a new sharps disposal system).

Setting:

Sharps injury data were collected from healthcare workers employed by a mid-sized, acute-care community hospital.

Results:

Preinterventional annual sharps injury incidence rates decreased significantly from 82 sharps injuries/1,000 worked full-time-equivalent employees (WFTE) to 24 sharps injuries/1,000 WFTE employees postintervention (P<.0001), representing a 70% decline in incidence rate overall. Over the course of the study, the incidence rate for sharps injuries related to intravenous lines declined by 93%, hollow-bore needlesticks decreased by 75%, and non-hollow-bore injuries decreased by 25%.

Conclusion:

The implementation of a multifocused interventional program led to a significant and sustained decrease in the overall rate of sharps injuries in hospital-based healthcare workers.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 20 , Issue 12 , December 1999 , pp. 806 - 811
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1999

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Bell, DM. Occupational risk of human immunodeficiency virus infections in health care workers: an overview. Am J Med 1997;102:9-15.Google Scholar
2. Centers for Disease Control and Prevention. Health care workers with documented and possible occupationally acquired AIDS/HIV infections, by occupation, reported through June 1998, United States, HIV/AIDS Surveillance Report 1998;10(1):24. http://www.cdc.gov/nchstp/hiv_AIDS/stats/hasr1001.pdf.Google Scholar
3. Gerberding, JL. Current epidemiologic evidence and case reports of occupationally acquired HrV and other bloodborne diseases. Infect Control Hosp Epidemiol 1990;11:558–560.CrossRefGoogle Scholar
4. Chamberland, ME, Ciesielski, CA, Howard, RJ, Fry, DE, Bell, DM. Occupational risk of infection with human immunodeficiency virus. Surg Clin North Am 1995;75:1057–1070.Google Scholar
5. Bell, DM, Shapiro, CN, Ciesielski, CA, Chamberland, ME. Preventing bloodborne pathogen transmission from health-care workers to patients. The CDC perspective. Surg Clin North Am 1995;75:1189–1203.Google Scholar
6. Centers for Disease Control and Prevention. Case-control study of HIV seroconversion in health-care workers after percutaneous exposure to HIV-infected blood—France, United Kingdom, and United States, January 1988-August 1994. MMWR 1995;44:929–933.Google Scholar
7. Davis, GL, Hepatitis C virus infection among health care workers. JAMA 1996;75:1474.Google Scholar
8. Gerberding, JLBryant-LeBlanc, CE, Nelson, K, Moss, AR, Osmond, D, Chambers, HF, et al. Risk of transmitting the human immunodeficiency virus, cytomegalovirus, and the hepatitis B virus to health care workers exposed to patients with AIDS and AIDS-related conditions. J Infect Dis 1987;156:1–8.Google Scholar
9. Type B hepatitis after needle-stick exposure: prevention with hepatitis B immune globulin. Final report of the Veterans' Administration Cooperative Study. Ann Intern Med 1978;88:285–293.Google Scholar
10. Mitsui, T, Iwano, K, Masuko, K, Yamazaki, C, Okamoto, H, Tsuda, F, et al. Hepatitis C virus infection in medical personnel after needlestick accident. Hepatology 1992;16:1109–1114.Google Scholar
11. Alter, MJ. The detection, transmission, and outcome of hepatitis C virus infection. Infect Agents Dis 1993;2:155–166.Google ScholarPubMed
12. Skolnick, R, LaRocca, J, Barba, D, Paicius, L, Evaluation and implementation of a needleless intravenous system: making needlesticks a needless problem. Am J Infect Control 1993;21:39–41.Google Scholar
13. Yassi, A, McGill, MLKhokhar, JB. Efficacy and cost-effectiveness of a needleless intravenous access system. Am J Infect Control 1995;23:57–64.Google Scholar
14. Gartner, K. Impact of needleless intravenous systems in a university hospital. Am J Infect Control 1992;20:75–79.Google Scholar
15. Chiarello, LA, Nagin, D, Laufer, F. Report to the Legislature: Pilot Study of Needlestick Prevention Devices. Albany, NY: New York State Department of Health; March 1992.Google Scholar
16. Linnemann, CC Jr, Cannon, C, DeRonde, M, Lanphear, B. Effect of educational programs, rigid sharps containers and Universal Precautions on reported needlestick injuries in healthcare workers. Infect Control Hosp Epidemiol 1991;12:214–219.Google Scholar
17. Ribner, BS, Landry, MN, Gholson, GL, Linden, LA. Impact of a rigid, puncture resistant container system upon needlestick injuries. Infect Control 1987;8:63–66.Google Scholar
18. Wugofski, L, Needlestick prevention devices: a pointed discussion. Infect Control Hosp Epidemiol 1992;13:295–298.Google Scholar
19. Gershon, RR, Vlahov, D, Felknor, SA, Vesley, D, Johnson, PC, Delclos, GLet al. Compliance with Universal Precautions among health care workers at three regional hospitals. Am J Infect Control 1995;23:225–236.Google Scholar
20. Hersey, JC, Martin, LS. Use of infection control guidelines by workers in healthcare facilities to prevent occupational transmission of HBV and HTV: results of a national survey. Infect Control Hosp Epidemiol 1994;15:243–252.Google Scholar
21. Michalsen, A, Delclos, GL, Felknor, SA, Davidson, AL, Johnson, PC, Vesley, D, et al. Compliance with Universal Precautions among physicians. J Occup Environ Med 1997;39:130–137.Google Scholar
22. Gershon, RR, Karkashian, CD, Vlahov, D, Kummer, L, Kasting, C, Green-McKenzie, J, et al. Compliance with Universal Precautions in correctional health care facilities. J Occup Environ Med 1999;41:181–189.Google Scholar
23. Jagger, J, Hunt, EH, Pearson, RD. Sharp object injuries in the hospital: causes and strategies for prevention. Am J Infect Control 1990;18:227–231.CrossRefGoogle ScholarPubMed
24. Lawrence, LW, Delclos, GL, Felknor, SA, Johnson, PC, Frankowski, RF, Cooper, SP, Davidson, A. The effectiveness of a needleless intravenous connection system: an assessment by injury rate and user satisfaction. Infect Control Hosp Epidemiol 1997;18:175–182.CrossRefGoogle ScholarPubMed
25. Weltman, AC, Short, LJ, Mendelson, MH, Lilienfeld, DE, Rodriguez, M. Disposal-related sharps injuries at a New York City Teaching Hospital. Infect Control Hosp Epidemiol 1995;16:268–274.Google Scholar
26. Whitby, M, Stead, P, Najman, JM. Needlestick injury: impact of a recapping device and an associated education program. Infect Control Hosp Epidemiol 1991;12:220–225.Google Scholar
27. US Department of Health and Human Services. Selecting, Evaluating, and Using Sharps Containers. Atlanta, GA: US Department of Health and Human Services; 1998.Google Scholar
28. Becker, MH, Janz, NK, Band, J, Bartley, J, Snyder, MB, Gaynes, RP. Noncompliance with Universal Precautions Policy: why do physicians and nurses recap needles? Am J Infect Control 1990;18:232–239.Google Scholar
29. Owens-Schwab, E, Fraser, VJ. Needleless and needle protection devices: a second look at efficacy and selection. Infect Control Hosp Epidemiol 1993;14:657–660.Google Scholar