Safety-engineered device implementation: does it introduce bias in percutaneous injury reporting?
OBJECTIVE
To examine whether implementation of safety-engineered devices in 2001 had an effect on rates of percutaneous injury (PI) reported by HCWs.


METHODS
Before-and-after intervention trial comparing 3-year preintervention (1998--2001) and 2-year postintervention (2001--2002) periods. PI data from anonymous, self-administered surveys were prospectively entered into CDC NaSH software.


METHODS
A 427-bed, tertiary-care hospital in Manhattan.


METHODS
HCWs who attended state-mandated training sessions and completed the survey (1,132 preintervention; 821 postintervention).


METHODS
Implementation of a "safer-needle system" composed of various safety-engineered devices for needle-safe IV delivery-insertion, blood collection, and intramuscular-subcutaneous injection.


RESULTS
Preintervention, the overall annual rate of PIs self-reported on the survey was 36.5 per 100 respondents, compared with 13.9 per 100 respondents postintervention (P < .01). The annual rate of formally reported PIs decreased from 8.3 to 3.1 per 100 respondents (P < .01). Report rates varied by occupational group (P < or = .02). The overall rate did not change between study periods (22.7% to 22.3%), although reporting improved among nurses (23.6% to 44.4%, P = .03) and worsened among building services staff (90.5% to 50%, P = .03). HCWs with greater numbers of PIs self-reported on the survey were less likely to formally report injuries (P < .01). The two most common reasons for nonreport (ie, thought injury was low risk or believed patient was low risk for blood-borne disease) did not vary from preintervention to postintervention.


CONCLUSIONS
Safety-engineered device implementation decreased rates of PIs formally reported and self-reported on the survey. However, this intervention, with concomitant intensive education, had varying effects on reporting behavior by occupation and a minimal effect on overall reporting rates.
Department of Medicine, Infectious Disease Service, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
SeJean
S
Sohn
Janet
J
Eagan
Kent A
KA
Sepkowitz
D015982:Bias; D004867:Equipment Design; D019538:Health Care Surveys; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000706:statistics & numerical data; D016602:Needlestick Injuries / Q000453:epidemiology* / Q000517:prevention & control; D009519:New York City; D009784:Occupational Diseases / Q000453:epidemiology* / Q000517:prevention & control; D016273:Occupational Exposure / Q000517:prevention & control / Q000706:statistics & numerical data*; D010043:Outcome and Process Assessment, Health Care; D012308:Risk Management / Q000379:methods*