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Safety-Engineered Device Implementation: Does It Introduce Bias in Percutaneous Injury Reporting?

Published online by Cambridge University Press:  02 January 2015

SeJean Sohn ,
Janet Eagan  and
Kent A. Sepkowitz
SeJean Sohn
Affiliation:
Department of Medicine, Infectious Disease Service, Memorial Sloan-Kettering Cancer Center, New York
Janet Eagan
Affiliation:
Department of Medicine, Infectious Disease Service, Memorial Sloan-Kettering Cancer Center, New York
Kent A. Sepkowitz*
Affiliation:
Department of Medicine, Infectious Disease Service, Memorial Sloan-Kettering Cancer Center, New York
*
Infectious Disease Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021
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Abstract

Objective:

To examine whether implementation of safety-engineered devices in 2001 had an effect on rates of percutaneous injury (PI) reported by HCWs.

Design:

Before-and-after intervention trial comparing 3-year preintervention (1998–2001) and 2-year postintervention (2001–2002) periods. PI data from anonymous, self-administered surveys were prospectively entered into CDC NaSH software.

Setting:

A 427-bed, tertiary-care hospital in Manhattan.

Participants:

HCWs who attended state-mandated training sessions and completed the survey (1,132 preintervention; 821 postintervention).

Intervention:

Implementation of a “safer-needle system” composed of various safety-engineered devices for needle-safe TV delivery-insertion, blood collection, and intramuscular-subcutaneous injection.

Results:

Preintervention, the overall annual rate of PIs self-reported on the survey was 36.5 per 100 respondents, compared with 13.9 per 100 respondents postintervention (P < .01). The annual rate of formally reported PIs decreased from 8.3 to 3.1 per 100 respondents (P < .01). Report rates varied by occupational group (P ≤ .02). The overall rate did not change between study periods (22.7% to 22.3%), although reporting improved among nurses (23.6% to 44.4%, P = .03) and worsened among building services staff (90.5% to 50%, P = .03). HCWs with greater numbers of Pis self-reported on the survey were less likely to formally report injuries (P < .01). The two most common reasons for nonreport (ie, thought injury was low risk or believed patient was low risk for blood-borne disease) did not vary from preintervention to postintervention.

Conclusions:

Safety-engineered device implementation decreased rates of Pis formally reported and self-reported on the survey. However, this intervention, with concomitant intensive education, had varying effects on reporting behavior by occupation and a minimal effect on overall reporting rates.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 7 , July 2004 , pp. 543 - 547
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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References

1.Doebbeling, BN. Percutaneous injury: risks and management. In: Schlossberg, D, ed. Current Therapy of Infectious Disease. St. Louis: Mosby; 2000:402–407.Google Scholar
2.U.S. Department of Labor, Bureau of Labor Statistics. Table B-1: employees on nonfarm payrolls by industry. In: U.S. Department of Labor, Bureau of Labor Statistics. The Employment Situation: April 2002. Washington, DC: U.S. Department of Labor; 2002. Available at stats.bls.gov/news.release/empsit.t14.htm. Accessed June 1, 2003.Google Scholar
3.Panlilio, AL, Cardo, DM, Campbell, S, et al.Estimate of the annual number of percutaneous injuries in U.S. health-care workers. Presented at the 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections; March 5-9, 2000; Atlanta, GA.Google Scholar
4.Perry, J. CDC releases national needlestick estimates. Advances in Exposure Prevention 2000;5:19.Google Scholar
5.Alvarado-Ramy, F, Beltrami, EM, Short, LJ, et al.A comprehensive approach to percutaneous injury prevention during phlebotomy: results of a multicenter study, 1993-1995. Infect Control Hosp Epidemiol 2003;24:97–104.Google Scholar
6.Mendelson, MH, Lin-Chen, BY, Solomon, R, et al.Evaluation of a safety resheathable winged steel needle for prevention of percutaneous injuries associated with intravascular-access procedures among healthcare workers. Infect Control Hosp Epidemiol 2003;24:105–112.Google Scholar
7.Harmory, BH. Underreporting of needlestick injuries in a university hospital. Am J Infect Control 1983;11:174–177.Google Scholar
8.Alvarado, F, Panlilio, A, Cardo, D, NaSH Surveillance Group. Percutaneous injury reporting in US hospitals, 1998. Presented at the 4th Decennial International Conference on Nosocomial and Healthcare-Associated Infections; March 5-9, 2000; Atlanta, GA.Google Scholar
9.Gartner, K. Impact of a needleless intravenous system in a university hospital. Am J Infect Control 1992;20:75–79.Google Scholar
10.Gershon, RR, Pearse, L, Grimes, M, Flanagan, PA, Vlahov, D. Impact of multifocused interventions on sharps injury rates at an acute-care hospital. Infect Control Hosp Epidemiol 1999;20:806–811.Google Scholar
11.Tan, L, Hawk, JC 3rdSterling, ML. Report of the Council on Scientific Affairs: preventing needlestick injuries in health care settings. Arch Intern Med 2001;161:929–936.Google Scholar
12.Nguyen, M, Paton, S, Villeneuve, PJ. Surveillance of healthcare workers exposed to blood/body fluids and bloodborne pathogens: 1 April, 2000 to 31 March, 2001. Can Commun Dis Rep 2001;27:201–209.Google Scholar
13.Orenstein, R, Reynolds, L, Karabaic, M, Lamb, A, Markowitz, SM, Wong, ES. DO protective devices prevent needlestick injuries among health care workers? Am J Infect Control 1995;23:344–351.Google Scholar
14.Jagger, J, Bentley, MB. Injuries from vascular access devices: high risk and preventable. Journal of Intravenous Nursing 1997;20(6 suppl):S33–S39.Google Scholar
15.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.Google Scholar
16.Sohn, S, Eagan, J, Sepkowitz, KA, Zuccotti, G. Effect of implementing safety-engineered devices on percutaneous injury epidemiology. Infect Control Hosp Epidemiol 2004;25:536–542.Google Scholar
17.Centers for Disease Control and Prevention. Surveillance: National Surveillance System for Health Care Workers. Atlanta, GA: Centers for Disease Control and Prevention; 2000. Available at www.cdc.gov/ncidod/hip/SURVEILL/nash.htm. Accessed April 1, 2003.Google Scholar
18.Fleiss, JL. Statistical Methods for Rates and Proportions, ed. 2. New York: John Wiley & Sons; 1981.Google Scholar
19.Rothman, KJ, Greenland, S, eds. Modern Epidemiology, ed. 2. New York: Lippincott Williams & Wilkins; 1998.Google Scholar
20.Doebbeling, BN, Vaughn, TE, McCoy, KD, et al.Percutaneous injury, blood exposure, and adherence to standard precautions: are hospital-based health care providers still at risk? Clin Infect Dis 2003;37:1006–1013.Google Scholar
21.Rabaud, C, Zanea, A, Mur, JM. Occupational exposure to blood: search for a relation between personality and behavior. Infect Control Hosp Epidemiol 2000;21:564–574.Google Scholar
22.Haiduven, DJ, Simpkins, SM, Phillips, ES, Stevens, DA. A survey of percutaneous/mucocutaneous injury reporting in a public teaching hospital. J Hosp Infect 1999;41:151–154.Google Scholar
23.Resnic, FS, Noerdlinger, MA. Occupational exposure among medical students and house staff at a New York City Medical Center. Arch Intern Med 1995;155:75–80.Google Scholar
24.Rattner, SL, Norman, SA, Berlin, JA. Percutaneous injuries on the “front line:” a survey of housestaff and nurses. Am J Prev Med 1994;10:372–377.Google Scholar