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Needlesticks and sharps containers

 

Clinical bottom line

A 60% reduction in needlestick injuries was achieved by more sensible use fo sharps containers and education.


Reference

DJ Haiduven et al. A five-year study of needlestick injuries: significant reduction associated with communication, education, and convenient placement of sharps containers. Infection Control and Hospital Epidemiology 1992 13: 265-271.

Study

The setting was a 600-bed county teaching hospital in California with 3,500 employees. During 1987 more needle disposal containers were added to patient care areas and as close to the area of use as possible. The hospital policy was immediate reporting of needlestick injuries or puncture wound.

Infection control personnel reviewed reports of injuries in 1986, and 1988, 1989 and 1990, that is the year before, and three years after the intervention. Only contaminated needlestick injuries are included in the analysis.

Results

There was a significant, prolonged fall in needlestick injuries after the introduction of more, and more convenient, sharps containers in the hospital (Figure 1). In the year before the intervention there were 259 injures. By the third year after the intervention this had fallen to 110 injuries, a reduction of almost 60%.

Figure 1: Needlestick injuries every year (intervention year in yellow)


Most injuries occurred in nurses, and the causes of the injuries were mixed, but usually involved intravenous lines, disposal, and recapping.

Comment

The study in a very useful indication that doing simple things well can make a real difference. There is a useful list of recommendations that are worth reporting:

Recommendations

  1. Place needle disposal containers in all patient care areas. The numbers of disposal containers may need to be increased or location changed.
  2. Analyse the number of needlestick injuries on a consistent basis. Include the number and category of personnel, location, cause, and device.
  3. Communicate the results to staff on an on-going basis. Elicit feedback from managers of strategies to reduce those injuries that do occur.
  4. Educate workers on needle safety on an ongoing basis. Include results of analysis of injuries at educational events.
  5. Conduct pilot studies and evaluation of new products. Purchase only after evaluation by personnel who will use them.
  6. Elicit feedback from departments that find needles improperly disposed (laundry, housekeeping)
  7. Eliminate unnecessary needles from the hospital environment and replace with safe products.