Hollow-bore needlestick injuries in a tertiary teaching hospital: epidemiology, education and engineering.
OBJECTIVE
To describe the frequency, cause and potential cost of prevention of hollow-bore dirty needlestick injury (NSI) sustained by healthcare workers.


METHODS
Ten-year prospective surveillance study, 1990-1999, with triennial anonymous questionnaire surveys of nursing staff.


METHODS
800-bed university tertiary referral hospital in Brisbane, Australia.


METHODS
Rates and circumstances of NSI in medical, nursing and non-clinical staff; knowledge of NSI consequences in nurses; and minimum costs of safety devices.


RESULTS
Between 1990 and 1999, there was a significant increase (P < 0.001) in the trend of the reported rate of NSI. Of the 1836 "dirty" NSIs reported, most were sustained in nursing (66.2%) and medical (16.8%) staff, with 62.7% sustained before disposal. Hollow-bore injuries from hypodermic needles (83.3%) and winged butterfly needles (9.8%) were over-represented. Knowledge among nursing staff of some of the risks and outcomes of NSI improved over the decade. A trend (chi(2 )= 9.89; df = 9; P = 0.0016) with increasing rate of reported injuries in this group was detected. The estimated cost of consumables only, associated with the introduction of self-retracting safety syringes with concomitant elimination of butterfly needles, where practicable, would be about $365 000 per year.


CONCLUSIONS
More than one NSI occurs for every two days of hospital operation. Introduction of self-retracting safety syringes and elimination of butterfly needles should reduce the current hollow-bore NSI by more than 70% and almost halve the total incidence of NSI.
Whitby
R Michael
RM
Infection Management Services, Princess Alexandra Hospital, Ipswich Road, Wolloongabba, QLD 4102, Australia. whitbym@health.qld.gov.au
McLaws
Mary-Louise
ML
D001698:Biomedical Engineering; D004867:Equipment Design; D006784:Hospitals, Teaching; D006801:Humans; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data*; D016602:Needlestick Injuries / Q000453:epidemiology* / Q000517:prevention & control; D009741:Nursing Staff, Hospital / Q000706:statistics & numerical data*; D011159:Population Surveillance; D011446:Prospective Studies; D011482:Protective Devices / Q000191:economics; D011793:Queensland / Q000453:epidemiology; D011795:Surveys and Questionnaires