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Needlestick safety in a hospital


Clinical bottom line

Introduction of an education programme and safety devices reduced the incidence of needlestick injuries in a hospital.


SG Reddy, RJ Emery. Assessing the effect of long-term availability of engineering controls on needlestick injuries among health care workers: a 3-year preimplementation and postimplementation comparison. American Journal of Infection Control 2001 29: 425-427.


Am 800-bed hospital serving a major metropolitan area in Texas was the study site. In 1995 it implemented an extensive in-service educational programme to inform all hospital employees on the importance of needlestick safety and bloodborne pathogens. Over six months in 1997 it implemented hospital-wide use of safety syringes and needleless intravenous system in all departments, except in cases where the use of traditional needles was unavoidable.

Retrospectively injury reports to an occupational health clinic between 1994 and 1999 were examined. Results from physicians were excluded for legal reasons. Results were reported on the basis of needlestick injuries per 100 full time employees (all types and grades), and over the period the number of full time employees rose from 945 to 1508.


There were 550 injuries, and excluding physicians 533 remained for analysis. Of these, 474 (89%) were from needle-related devices, but what proportion that might have been from traditional or safety devices had not been recorded.

Over the six years there was a fall from an incidence rate of over 10% to just 4% (Figure 1). The absolute number per year fell from about 100 in each of the first two years to 63 in 1999.

Figure 1: Change in incidence of needlestick injuries over a six year period.


This ecological study does not clearly relate the fall in needlestick injury to any particular intervention. It might be seen as being important for educational interventions and for the introduction of safety devices. Following both there was a fall in needlestick incidence.

The largest confounder was the large increase in full time equivalents over the same period, though the absolute number of needlestick injuries also fell. So there are limitations to the study because of the limitations in data collection not allowing, for instance, analysis by job description, department, or device.

Despite this, the overall message is positive.