Organizational climate, staffing, and safety equipment as predictors of needlestick injuries and near-misses in hospital nurses.
BACKGROUND
Recently passed federal legislation requires institutions to adopt safety equipment to prevent needlesticks, but there is little empirical evidence of the effectiveness of specific types of safety devices or the contribution of safety devices to reducing needlesticks relative to the contributions of staffing, organizational climate, and clinicians' experience.


METHODS
In 1998, 2287 medical-surgical unit nurses in 22 US hospitals were surveyed in regard to staffing and organizational climate in their hospitals and about patient and nurse outcomes, including needlestick injuries. Hospitals provided information about available protective devices at the time of the survey. Relationships between nurse and hospital characteristics and protective equipment and the likelihood of needlestick injuries and near-miss incidents were examined.


RESULTS
Poor organizational climate and high workloads were associated with 50% to 2-fold increases in the likelihood of needlestick injuries and near-misses to hospital nurses. Capless-valve secondary intravenous set systems and use of any type of protective equipment for IV starts or blood draws were associated with 20% to 30% lowered risks of both event types.


CONCLUSIONS
Nurse staffing and organizational climate are key determinants of needlestick risk and must be considered with the adoption of safety equipment to effectively reduce sharps injuries.
Clarke
Sean P
SP
Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, 420 Guardian Drive, Philadelphia, PA 19104, USA.
Rockett
Joan L
JL
Sloane
Douglas M
DM
Aiken
Linda H
LH
D000062:Accidents, Occupational / Q000517:prevention & control*; D000328:Adult; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D016013:Likelihood Functions; D016602:Needlestick Injuries / Q000209:etiology* / Q000517:prevention & control*; D009741:Nursing Staff, Hospital / Q000706:statistics & numerical data*; D016273:Occupational Exposure; D015279:Organizational Culture; D011482:Protective Devices; D012307:Risk Factors; D014481:United States; D016526:Workload