Effect of implementing safety-engineered devices on percutaneous injury epidemiology.
OBJECTIVE
To assess the effect of implementing safety-engineered devices on percutaneous injury epidemiology, specifically on percutaneous injuries associated with a higher risk of blood-borne pathogen exposure.


METHODS
Before-and-after intervention trial comparing 3-year preintervention (1998--2000) and 1-year postintervention (2001--2002) periods. Percutaneous injury data have been entered prospectively into CDC NaSH software since 1998.


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


METHODS
All employees who reported percutaneous injuries during the study period.


METHODS
A "safer-needle system," composed of a variety of safety-engineered devices to allow for needle-safe IV delivery, blood collection, IV insertion, and intramuscular and subcutaneous injection, was implemented in February 2001.


RESULTS
The mean annual incidence of percutaneous injuries decreased from 34.08 per 1,000 full-time-equivalent employees preintervention to 14.25 postintervention (P < .001). Reductions in the average monthly number of percutaneous injuries resulting from both low-risk (P < .01) and high-risk (P was not significant) activities were observed. Nurses experienced the greatest decrease (74.5%, P < .001), followed by ancillary staff (61.5%, P = .03). Significant rate reductions were observed for the following activities: manipulating patients or sharps (83.5%, P < .001), collisions or contact with sharps (73.0%, P = .01), disposal-related injuries (21.41%, P = .001), and catheter insertions (88.2%, P < .001). Injury rates involving hollow-bore needles also decreased (70.6%, P < .001).


CONCLUSIONS
The implementation of safety-engineered devices reduced percutaneous injury rates across occupations, activities, times of injury, and devices. Moreover, intervention impact was observed when stratified by risk for blood-borne pathogen transmission.
Infectious Disease Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
SeJean
S
Sohn
Janet
J
Eagan
Kent A
KA
Sepkowitz
Gianna
G
Zuccotti
D004867:Equipment Design; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000295:instrumentation* / Q000379:methods*; D009339:Needles; D016602:Needlestick Injuries / Q000453:epidemiology / Q000517:prevention & control*; D009519:New York City / Q000453:epidemiology; 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; D017751:Safety Management / Q000379:methods*