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Gao H, Liu M, Su Y, Li Y, Tian L. Analysis of factors associated with needlestick injuries of clinical nurses by applying a human factor analysis and classification system: A nationwide cross-sectional survey. J Clin Nurs 2024; 33:2178-2189. [PMID: 38439173 DOI: 10.1111/jocn.16959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 11/13/2023] [Accepted: 11/27/2023] [Indexed: 03/06/2024]
Abstract
AIMS This study aims to investigate the current situation of needlestick injuries (NSIs) of clinical nurses and identify associated factors by using the theoretical framework of the human factors analysis and classification system (HFACS). DESIGN A nationwide cross-sectional survey was conducted. METHODS Multi-stage sampling was used to investigate 3336 nurses in 14 Chinese hospitals. Descriptive statistics and univariate and multivariate logistic regression were employed to reveal the rate of NSIs and their associated factors. RESULTS A total of 970 nurses (29.1%) reported having experienced at least one NSI in the past year. The multivariate logistic regression analysis showed that good hospital safety climate and clinical nurses in intensive care unit (ICU) and emergency department had protective effects against NSIs compared with nurses in internal medicine department. The nurse, senior nurse, and nurse in charge have significantly increased the risk for NSIs compared with the associate chief nurse or above. Patients with poor vision but wearing glasses and poor vision but not wearing glasses were more prone to have NSIs. Working in the operating room compared with internal medicine, average weekly working time of >45 h compared with ≤40 h and poor general health led to increased risk of NSIs. CONCLUSION The rate of NSIs in clinical nurses was high in China. Individual factors including professional title, department, visual acuity and general mental health and organisational factors including weekly working hours and hospital safety atmosphere were significantly correlated with the occurrence of NSIs. RELEVANCE TO CLINICAL PRACTICE Nursing managers should focused on physical and psychological conditions of clinical nurses, and organisational support is required to enhance the hospital safety atmosphere. NO PATIENT OR PUBLIC CONTRIBUTION Contributions from patients or the public are irrelevant because this study aims to explore current situation and factors associated with NSIs in clinical nurses.
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Affiliation(s)
- Huimin Gao
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, China
| | - Mengyuan Liu
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yanan Su
- Reproductive Center, Reproductive and Genetic Hospital of Citic-Xiangya, Changsha, China
| | - Yinglan Li
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center of Geriatric Disorder, Xiangya Hospital , Central South University, Changsha, China
| | - Lingyun Tian
- Department of Nursing, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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Serafin A, Ryk A, Fendler W. Safe and effective use of a passive safety needle by healthcare professionals in a simulated environment, including perceptions and preferences. Expert Rev Med Devices 2023; 20:963-971. [PMID: 37697473 DOI: 10.1080/17434440.2023.2254680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/26/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Needlestick injuries (NSIs) may potentially expose healthcare professionals (HCPs) to bloodborne pathogens. Safety needles are designed to protect against NSIs. We evaluated whether a new fully passive safety needle could be used safely by HCPs. RESEARCH DESIGN AND METHODS The passive safety needle was tested by physicians, nurses, and pharmacists in subcutaneous or intramuscular injection scenarios in simulation studies (1-3). Data collected included successes, close calls, difficulties, use errors, and failures. In study 4, HCPs rated the device safety (21-item questionnaire). RESULTS Overall, 104 participants completed 4772 simulated tasks, including 932 injections. 915 injections (98.18%) were performed successfully and no NSIs (0%) were observed in any of the studies. Studies 1 & 2: 84.15% tasks and 96.06% injections were completed successfully, but use errors occurred, mostly arising from the participants' mental model. There were no failures in Study 3. In Study 4, >98% of participants responded positively to every question, while all felt that the passive safety feature could eliminate NSIs and would better protect against bloodborne pathogens than other existing devices with active or semi-passive safety mechanisms. CONCLUSIONS The passive safety needle was used successfully by HCPs, did not lead to any NSIs, and was rated as the safest compared to similar devices.
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Affiliation(s)
- Anna Serafin
- Regulatory Affairs Department, HTL-STREFA S.A, Ozorkow, Poland
| | - Aleksandra Ryk
- Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz, Poland
| | - Wojciech Fendler
- Department of Biostatistics and Translational Medicine and Clinical Trials Unit, Medical University of Lodz, Lodz, Poland
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Tejada-Pérez JJ, Herrera-Burgos MR, Parrón-Carreño T, Alarcón-Rodríguez R. Biohazard Accidents, Harmful Elements to the Wellness of Healthcare Workers, and Their Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13214. [PMID: 36293794 PMCID: PMC9603502 DOI: 10.3390/ijerph192013214] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND For healthcare personnel, biohazard accidents pose a significant risk to their health. These exposures can enable the transmission of pathogens such as Hepatitis B, Hepatitis C, and human immunodeficiency virus (HIV). OBJECTIVE To indicate and quantify the risk associated with higher threatening situations, such as biohazard accidents on repeated occasions or incorrect notifications to injured healthcare professionals. METHODS A cross-sectional study was conducted at the Poniente Hospital in Almeria (Spain). In total, 592 participants reported 1062 accidents and their characteristics and notifications were analyzed. RESULTS It was found that women (OR = 1.29) working in the surgical area (OR = 2.92), those on indefinite contracts (OR = 1.67), and those with high work experience (OR = 1.14) were the main risk factors for multiple biohazard accidents. Concerning the incorrect notification of these accidents, the main risk factors were work performance during the afternoon shift (OR = 1.72) and the fact that the accident was caused by the injured worker himself (OR = 1.53). CONCLUSIONS This study outlined the main factors that can contribute to healthcare professionals suffering these accidents. As a result, corrective measures must be taken against these risk factors to improve safety for healthcare workers in the future.
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Affiliation(s)
- Juan José Tejada-Pérez
- Faculty of Health Sciences, University of Almeria, Ctra. Sacramento, s/n, 04120 La Cañada, Spain
- Occupational Health Service, Poniente Hospital Entrepreneurial Public Health Agency, Ctra. Almerimar, 31, 04700 El Ejido, Spain
| | - María Renée Herrera-Burgos
- Occupational Health Service, Poniente Hospital Entrepreneurial Public Health Agency, Ctra. Almerimar, 31, 04700 El Ejido, Spain
| | - Tesifón Parrón-Carreño
- Faculty of Health Sciences, University of Almeria, Ctra. Sacramento, s/n, 04120 La Cañada, Spain
| | - Raquel Alarcón-Rodríguez
- Faculty of Health Sciences, University of Almeria, Ctra. Sacramento, s/n, 04120 La Cañada, Spain
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Garus-Pakowska A, Górajski M, Sakowski P. Non-Safety and Safety Device Sharp Injuries-Risk of Incidents, SEDs Availability, Attitudes and Perceptions of Nurses According to Cross-Sectional Survey in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11315. [PMID: 36141587 PMCID: PMC9517290 DOI: 10.3390/ijerph191811315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
Sharp injuries are a serious issue among healthcare workers (HCWs). The aim of the study was to examine the frequency of sharps injuries among nurses (who have the most frequent contact with infectious material) when using devices with and without safety features, then to analyse the factors associated with such injuries and to compare the risk of injuries with safety engineered devices (SEDs) and non-safety engineered devices (non-SEDs). An online cross-sectional survey was completed between October 2021 and March 2022 by 280 nurses. The incidence of exposure to sharp injury during their professional life was 51.4%. The percentage of nurses experiencing a sharp injury in the year preceding the study was 29% and 9.6% for superficially and deep injury, respectively. Ampoules and conventional hollow-bore needles caused the most injuries (25.92% and 22.64% of nurses in the last year). Factors including sex (males), age and seniority (elderly), education (higher), work exhaustion and being left-handed were associated with the occurrence of conventional hollow-bore needle injuries. In the case of SEDs: age, seniority and right/left-handed were the most frequent risk factors associated with the occurrence of sharp injuries. SEDs injuries were much less frequent than non-SEDs. There was a significant difference between the risk of injuries with safety and non-safety needles, central cannulas and ampoules. Fisher's exact test (p-value = 0.000) and positive Spearman's rho statistics (0.2319, p-value = 0.0001) confirmed that in accredited hospitals, the availability of safety needles was higher. Almost half of the nurses (n = 115, 41.07%) stated that staff had little influence on the type of medical sharp instruments supplied. To reduce the risk of nurse injuries, access to medical devices with safe protection mechanisms should be ensured, the use of sharp instruments should be limited where possible, managers should consult nurses regarding the choice of safe devices, and training programs on the proper use of SEDs should be available.
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Affiliation(s)
- Anna Garus-Pakowska
- Department of Nutrition and Epidemiology, Medical University of Łódź, 90-752 Łódź, Poland
| | - Mariusz Górajski
- Faculty of Economics and Sociology, Department of Econometrics, University of Łódź, 90-214 Łódź, Poland
| | - Piotr Sakowski
- IKM Pro Sakowska, Michałowska, Łyszkiewicz sp.j., 90-132 Łódź, Poland
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De Carli G, Agresta A, Lecce MG, Marchegiano P, Micheloni G, Sossai D, Campo G, Tomao P, Vonesch N, Leone S, Puro V. Prevention from Sharp Injuries in the Hospital Sector: An Italian National Observatory on the Implementation of the Council Directive 2010/32/EU before and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11144. [PMID: 36078860 PMCID: PMC9518081 DOI: 10.3390/ijerph191711144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/26/2022] [Accepted: 09/02/2022] [Indexed: 06/15/2023]
Abstract
Sharp injuries, determining the risk of bloodborne infections and psychological distress in healthcare workers, may be prevented by a set of strategies, legally enforced in Europe through the Directive 2010/32/EU. To assess its level of implementation in Italy, a national survey was conducted in 2017 and again in 2021, evaluating the progress and possible drawbacks of the COVID-19 pandemic. Altogether, 285 safety managers and 330 nurses from a representative sample of 97 and 117 public hospitals were interviewed using a standardized questionnaire. Knowledge of the Directive requirements decreased significantly, with <60% of participants answering correctly in 2021, and nurses' attendance in specific courses dropped to 25% in 2021 compared to 54% in 2017. Over 75% of hospitals introduced multiple safety-engineered devices (SED), though total replacement occurred in <50% of cases; routine SED availability increased for blood collection (89%) and venous access devices (83%). Incorrect behaviors in handling sharps decreased significantly over time. Nurses' HBV vaccination coverage was high (89% in both surveys); in the last year, 97% were vaccinated against COVID, and 47% against influenza. Average annual injuries per hospital did not increase significantly (32 in 2021 vs. 26 in 2017). In 2017, nurses' perceived safety barriers were working in emergency situations (49%) and lack of resources (40%); in 2021, understaffing (73%), physical fatigue (62%), and handling difficulties while wearing full protective equipment (59%). Safety measures were implemented in Italian hospitals, and although the average injuries per hospital did not show a decrease, these measures could have helped protect healthcare workers during the pandemic, mitigating its potential impact on the increase in situations at risk of injury.
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Affiliation(s)
- Gabriella De Carli
- UOC Infezioni Emergenti e Riemergenti e CRAIDS, Dipartimento di Epidemiologia, Ricerca Preclinica e Diagnostica Avanzata, INMI L. Spallanzani-IRCCS, 00149 Rome, Italy
| | - Alessandro Agresta
- UOC Infezioni Emergenti e Riemergenti e CRAIDS, Dipartimento di Epidemiologia, Ricerca Preclinica e Diagnostica Avanzata, INMI L. Spallanzani-IRCCS, 00149 Rome, Italy
| | - Maria Giuseppina Lecce
- Ufficio IV—Direzione Generale della Prevenzione del Ministero della Salute, 00144 Rome, Italy
| | - Patrizia Marchegiano
- SC Servizio Prevenzione e Protezione Aziendale, Azienda Ospedaliero-Universitaria di Modena, 41124 Modena, Italy
| | - Gianpaolo Micheloni
- Servizio Medicina del Lavoro, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy
| | - Dimitri Sossai
- U.O. Servizio Prevenzione e Protezione, Ospedale Policlinico San Martino, 16132 Genova, Italy
| | - Giuseppe Campo
- INAIL—Sezione Sistemi di Sorveglianza e Gestione Integrata del Rischio, Dipartimento di Medicina, Epidemiologia, Igiene del Lavoro ed Ambientale, 00144 Rome, Italy
| | - Paola Tomao
- INAIL—Laboratorio Rischio Agenti Biologici, Dipartimento di Medicina, Epidemiologia, Igiene del Lavoro ed Ambientale, 00078 Monte Porzio Catone, Italy
| | - Nicoletta Vonesch
- INAIL—Laboratorio Rischio Agenti Biologici, Dipartimento di Medicina, Epidemiologia, Igiene del Lavoro ed Ambientale, 00078 Monte Porzio Catone, Italy
| | - Sara Leone
- UOC Epidemiologia Clinica, Dipartimento di Epidemiologia, Ricerca Preclinica e Diagnostica Avanzata, INMI L. Spallanzani-IRCCS, 00149 Rome, Italy
| | - Vincenzo Puro
- UOC Infezioni Emergenti e Riemergenti e CRAIDS, Dipartimento di Epidemiologia, Ricerca Preclinica e Diagnostica Avanzata, INMI L. Spallanzani-IRCCS, 00149 Rome, Italy
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Friel BA, Sieradzan R, Jones C, Katz RA, Smith CM, Trenery A, Gee J. Leveraging Partnerships to Reduce Insulin Needlestick Injuries: Nurse-Led System-Wide Quality Improvement Project. J Nurs Care Qual 2022; 37:14-20. [PMID: 34446664 PMCID: PMC8608009 DOI: 10.1097/ncq.0000000000000592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Percutaneous injuries from needlesticks are a major occupational hazard for nurses. LOCAL PROBLEM Reducing subcutaneous insulin-related needlestick injuries was part of a nurse-led comprehensive sharps injury-reduction program at an integrated, not-for-profit health system. METHODS The incident rate of needlestick injuries was compared between 1 year before and 1 year after introducing this quality improvement project. INTERVENTIONS A system-wide educational program instituting changes in subcutaneous insulin administration practices was combined with supply chain standardization using a single type of safety-engineered insulin syringe. RESULTS The average monthly incidence of needlestick injuries per 10 000 subcutaneous insulin injections fell significantly from year to year (incidence rate ratio, 0.49; 95% CI, 0.30-0.80; Poisson regression P = .004). One-year cost savings for supplies totaled $3500; additional annual median savings were $24 875 (2019 US dollars) in estimated costs of needlestick injuries averted. CONCLUSIONS The effectiveness of this multifaceted project provides a practical template to reduce subcutaneous insulin-related needlestick injuries.
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Affiliation(s)
- Beth Ann Friel
- Intermountain Healthcare, Salt Lake City, Utah (Mss Friel and Katz, Messrs Jones and Smith, and Dr Gee); and Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey (Drs Sieradzan and Trenery). Dr Gee is now with the University of Utah College of Nursing, Salt Lake City
| | - Ray Sieradzan
- Intermountain Healthcare, Salt Lake City, Utah (Mss Friel and Katz, Messrs Jones and Smith, and Dr Gee); and Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey (Drs Sieradzan and Trenery). Dr Gee is now with the University of Utah College of Nursing, Salt Lake City
| | - Chris Jones
- Intermountain Healthcare, Salt Lake City, Utah (Mss Friel and Katz, Messrs Jones and Smith, and Dr Gee); and Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey (Drs Sieradzan and Trenery). Dr Gee is now with the University of Utah College of Nursing, Salt Lake City
| | - Rachael A. Katz
- Intermountain Healthcare, Salt Lake City, Utah (Mss Friel and Katz, Messrs Jones and Smith, and Dr Gee); and Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey (Drs Sieradzan and Trenery). Dr Gee is now with the University of Utah College of Nursing, Salt Lake City
| | - Cole M. Smith
- Intermountain Healthcare, Salt Lake City, Utah (Mss Friel and Katz, Messrs Jones and Smith, and Dr Gee); and Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey (Drs Sieradzan and Trenery). Dr Gee is now with the University of Utah College of Nursing, Salt Lake City
| | - Alyssa Trenery
- Intermountain Healthcare, Salt Lake City, Utah (Mss Friel and Katz, Messrs Jones and Smith, and Dr Gee); and Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey (Drs Sieradzan and Trenery). Dr Gee is now with the University of Utah College of Nursing, Salt Lake City
| | - Julie Gee
- Intermountain Healthcare, Salt Lake City, Utah (Mss Friel and Katz, Messrs Jones and Smith, and Dr Gee); and Becton, Dickinson and Company (BD), Franklin Lakes, New Jersey (Drs Sieradzan and Trenery). Dr Gee is now with the University of Utah College of Nursing, Salt Lake City
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Comparing risk changes of needlestick injuries between countries adopted and not adopted the needlestick safety and prevention act: A meta-analysis. Infect Control Hosp Epidemiol 2021; 43:1221-1227. [PMID: 34674781 PMCID: PMC9483715 DOI: 10.1017/ice.2021.372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To determine whether countries that adopted the Needlestick Safety and Prevention Act (NSPA) achieved a reduced risk of needlestick injuries (NSIs). METHOD In this meta-analysis, 3 international databases (Embase, PubMed, and MEDLINE EBSCO) and 1 Chinese database (Airiti Library) were searched using appropriate keywords to retrieve relevant articles, including multiyear NSI incidences that were published after 2010. The Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies was used to evaluate article prevalence. A binary random-effects model was used to estimate risk ratio as summary effect. A log scale was used to evaluate differences in risk ratios of NSIs between countries that adopted versus those that did not adopt the NSPA. RESULTS In total, 11 articles were included in the meta-analysis from 9 countries, and NSI incidence rates were surveyed between 1993 and 2016. The risk ratios of NSIs in countries with and without the NSPA were 0.78 (95% CI, 0.67-0.91) and 0.98 (95% CI, 0.85-1.12), respectively, and the ratio of risk ratios was 0.79 (95% CI, 0.65-0.98). Reduction in NSI incidence was more prominent in nurses than in physicians. CONCLUSIONS Our findings suggest that the mandatory use of safety-engineered medical devices in countries that adopted the NSPA had lower NSI incidence in healthcare workers compared with countries without needlestick safety and prevention regulatory policies. Further studies are needed to develop preventive strategies to protect against NSIs in physicians, which should be incorporated into the standards of care established by national regulatory agencies.
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Wynn M. Understanding the principles of infection prevention and control. Nurs Stand 2021; 36:61-66. [PMID: 33899381 DOI: 10.7748/ns.2021.e11729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 11/09/2022]
Abstract
Nurses have a crucial role in infection prevention and control. The coronavirus disease 2019 (COVID-19) pandemic has emphasised the importance of controlling the spread of infections, while reinforcing the challenges involved in the care of patients who already have an infection. This article discusses important elements of theory and practice related to infection prevention and control. The author also explores various areas that have come to prominence as a result of the COVID-19 pandemic, including measures such as risk assessment, the use of personal protective equipment, the role of surveillance, and outbreak management.
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Affiliation(s)
- Matthew Wynn
- adult nursing, University of Salford, Salford, England
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Causes of Needlestick and Sharps Injuries When Using Devices with and without Safety Features. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238721. [PMID: 33255337 PMCID: PMC7727709 DOI: 10.3390/ijerph17238721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/05/2020] [Accepted: 11/20/2020] [Indexed: 11/17/2022]
Abstract
Safety-engineered devices (SEDs) have been developed to protect healthcare personnel (HCP) from needlestick and sharps injuries (NSIs). The aim of this study was to analyze NSIs associated with SEDs and non-SEDs among HCP in hospitals, medical offices and care facilities. Records from online questionnaires on NSIs were used. Causes of NSIs were compared for SED use and healthcare setting. A sample of 835 files was included. Injuries with SEDs accounted for 35.0% of all NSIs, whereas the proportions were higher in medical offices and lower in care facilities. NSIs in nurses were more often associated with SEDs than NSIs in physicians. NSIs from intravenous needles were associated with SEDs in more than 60% of cases in hospitals and medical offices and in about 30.0% of cases in care facilities. In contrast, suturing was associated with every fourth NSI in hospitals, of which fewer than 10.0% were associated with SEDs. In care facilities, SEDs were involved in 36.1% of NSIs during subcutaneous injections. NSIs during disposal accounted for 29.2% of total NSIs, of which 36.1% were associated with SEDs. Frequent reasons for SED-associated NSIs were technical problems, unexpected patient movement and problems during disposal. Our analysis shows that many NSIs are associated with SEDs. Continuous training is necessary in the handling and disposal of SEDs.
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Complete Blood Count Collected Via Venipuncture Versus Peripherally Inserted Central Catheter in Hematological Patients: A Comparison of 2 Methods. Cancer Nurs 2020; 45:E36-E42. [PMID: 32769376 DOI: 10.1097/ncc.0000000000000873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The use of peripherally inserted central catheters (PICCs) in cancer care is increasing over traditional central venous catheters. Nurses frequently collect blood by venipuncture when a PICC is inserted, as there is no available evidence to confirm the reliability of blood tests collected through PICCs in adults. OBJECTIVE The aim of this study was to assess the reliability of blood samples for complete blood count (CBC) obtained through PICCs as an alternative to venipuncture. METHODS A cross-sectional design was used to recruit adult hematological patients. The blood samples were collected within 5 minutes of each other by a specialist nurse. Hemoglobin, hematocrit, and platelet count were evaluated. To determine method comparison, Passing-Bablok regression, test of linearity, Pearson product-moment correlation coefficient, and Bland-Altman plots were used. RESULTS Thirty paired blood samples were collected in 29 hematological patients with a mean age of 66.8 years. A statistical difference was found for hemoglobin (P = .001) and hematocrit (P = .001) levels, but no clinical difference. The regression models revealed no systematic differences and no proportional differences with a linear relationship between the methods. Bland-Altman plots highlighted a good agreement between methods. CONCLUSION Blood samples for CBC drawn by PICCs are as reliable as those collected via venipuncture. Blood sampling via PICC could be recommended in people with hematological malignancies in needs of frequent blood tests. IMPLICATIONS FOR PRACTICE Sampling through a PICC provides reliable laboratory results for CBC, and it could reduce patients' discomfort and increase the safety of professionals reducing the risk of accidental percutaneous needlestick injuries.
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Bolton CJW, Howells O, Blayney GJ, Eng PF, Birchall JC, Gualeni B, Roberts K, Ashraf H, Guy OJ. Hollow silicon microneedle fabrication using advanced plasma etch technologies for applications in transdermal drug delivery. LAB ON A CHIP 2020; 20:2788-2795. [PMID: 32632424 DOI: 10.1039/d0lc00567c] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
A novel production process flow is presented here for the manufacture of hollow silicon microneedles using deep reactive-ion etching (DRIE) technology. The patent-pending three-step process flow has been developed to produce multiple arrays of sharp-tipped, hollow microneedles, which facilitate easy insertion and controlled fluid injection into excised skin samples. A bevelled tip and vertical sidewalls for the microneedle have been achieved with good uniformity, despite >45% open etch area. Processing steps and etch challenges are discussed, and preliminary skin testing results are presented, showing effective needle insertion and delivery of fluorescent dye into ex vivo skin from human breast tissue.
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