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Comprehensive programme reduces needlestick injuries


Clinical bottom line

The introduction of a comprehensive programme to reduce needlestick injuries led to a reduction of more than 60% over four years in a US hospital.


AB Zafar et al. Effect of a comprehensive program to reduce needlestick injuries. Infection Control and Hospital Epidemiology 1997 18: 712-715.


This study was of a pre-post design in a 350-bed acute hospital in the USA, with 1,500 healthcare workers with doctors in addition. In 1991 a needlestick prevention committee was formed. It was multidisciplinary and instituted the following actions in 1991:

In 1991/2 safe needle devices were evaluated and implementation begun.

There was intensive education on prevention, coupled with an active awareness programme whenever a new device was introduced to assist staff with changes. Compliance was monitored and corrective action taken in the case of noncompliance. Progressive disciplinary action was taken in the case of continued noncompliance.

An infection control coordinator and employee health nurse reviewed all needlestick injury report from 1989 to 1995.


In the three years before the programme the number of needlestick injuries reported was 103-112 per year. In the fourth year after the start of the programme it was 22 (Figure 1). Dramatic falls were seen in some scenarios, like recapping needles, or from overfilled sharps boxes.

Figure 1: Needlestick injuries before and after a prevention programme (red before, blue after programme began)


The authors comment that their results may be even better than they look. While needlestick injuries may previously have been under-reported, one result of the programme may have been to reduce under-reporting. In any event, this is a stellar performance, and a superb report of a how to make improvements using a multifactorial approach to needlestick injury prevention.