Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-12-02T19:46:24.445Z Has data issue: false hasContentIssue false
  • English
  • Français

Installing Needle Disposal Boxes Closer to the Bedside Reduces Needle-Recapping Rates in Hospital Units

Published online by Cambridge University Press:  21 June 2016

David Makofsky  and
James E. Cone
David Makofsky
Affiliation:
Center for Occupational and Environmental Health, University of California, San Francisco, California
James E. Cone*
Affiliation:
Center for Occupational and Environmental Health, University of California, San Francisco, California
*
2241 Channing Way, Berkeley, CA 94704
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To compare the proportion of recapped needles, an injury surrogate measure, in disposal boxes on two different types of hospital units, both before and after an intervention.

Design:

Prospective nonrandomized intervention trial.

Setting:

A major public teaching hospital.

Participants:

Specific hospital units. We selected two types of hospital units for study: the first type of hospital unit (medical-surgical ward) had existing mounted in-bathroom needle disposal boxes, and the second type of hospital unit (intensive care unit) had unmounted needle disposal boxes in the room but not necessarily near the patient's bedside.

Intervention:

The installation, in the medical-surgical wards only, of mounted needle disposal boxes on the wall near the patient's bed. The box location in the intensive care units remained the same. In both types of unit, a new mailbox-slot disposal box (SAGE) also was substituted for the previous round-top container.

Results:

The baseline proportion of recapped needles in the first medical-surgical unit was 32.6% (±3.8%) and in the second medical-surgical unit it was 27.4% (± 4.0%) in the bathroom needle disposal boxes, which was similar to the observed proportion (34.7 ± 6.4%) in the intensive care unit boxes. Following the intervention, the proportion of recapped needles was significantly reduced in the disposal containers adjacent to the bedside in medical-surgical units, to 27% (a difference of 2.9 standard errors of the baseline distribution) in the first unit and 18.2% (a difference of 4.6 standard errors) in the second. In the intensive care unit, where boxes were not moved but new mailbox-types were simply substituted, no significant change was noted (36.6%, a difference of 0.59 standard errors). A statistically significant reduction was observed in the proportion of needles recapped in both wards combined following the intervention (30.2% to 26.2%, a difference of 2.9 standard errors).

Conclusion:

Environmental changes alone are an effective means of altering the risk to healthcare workers from sharp instruments. The use of needle-box counts provides a sensitive and stable instrument to measure injury surrogates and, indirectly, behavioral change in hospital workers.

Type
Orginal Articles
Information
Infection Control & Hospital Epidemiology , Volume 14 , Issue 3 , March 1993 , pp. 140 - 144
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1993

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. McCormick, RD, Maki, DG. Epidemiology of needlestick injuries in hospital personnel. Am J Med. 1981;70:928–932.CrossRefGoogle Scholar
2. Jagger, J, Hunt, E, Brand-Elnaggar, R, Pearson, R. Rates of needlestick injury caused by various devices in a university hospital. N Engl J Med. 1988;319:282–288.CrossRefGoogle Scholar
3. Jagger, J, Hunt, E, Pearson, R. Sharp objects injury in the hospital: causes and strategies for prevention. Am J Infect Control. 1990;18:227–231.CrossRefGoogle ScholarPubMed
4. Ribner, BS, Landry, M, Gholson, G, Linden, L. Impact of a rigid, puncture resistant container system upon needlestick injuries. Infect Control. 1987;8:63–66.CrossRefGoogle ScholarPubMed
5. Edmond, M, Khakoo, R, McTaggart, B, Solomon, R. Effect of bedside needle disposal units on needle recapping frequency and needlestick injury, Infect Control Hosp Epidemiol. 1988;9:114–116.CrossRefGoogle ScholarPubMed
6. Krasinski, K, LaCouture, R, Holzman, R, Effect of changing needle disposal systems upon needle puncture injuries. Infect Control. 1987;8:59–62.CrossRefGoogle ScholarPubMed
7. Ribner, BS, Ribner, BS. An effective educational program to reduce the frequency of needle recapping. Infect Control Hosp Epidemiol. 1990;11:635–638.CrossRefGoogle ScholarPubMed
8. 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.CrossRefGoogle ScholarPubMed
9. Zar, JH. Biostatistical Analysis. 2nd ed. Englewood Cliffs, NJ: Prentice Hall; 1984.Google Scholar
10. Mangione, CM, Gerberding, JL, Cummings, SR Occupational exposure to LUV and rates of underreporting of percutaneous and mucocutaneous exposures by medical housestaff. Am J Med. 1991;90:85–90.CrossRefGoogle Scholar