title: Needlestick injury in acute care nurses caring for patients with diabetes mellitus: a retrospective study.
abstract: OBJECTIVE
  To quantify the incidence and assess the risk of needlestick injury (NI) in nurses caring for patients with diabetes mellitus.
  
  
  METHODS
  A total of 400 nurses caring for patients with diabetes in 381 different hospitals throughout the United States over a period of at least 1 year voluntarily completed an Internet-based data collection instrument. The nurses self-reported comprehensive data on their experience with NI, focusing on those occurring within the past year. If respondents experienced multiple NI during this period, detailed data were collected on the most recent event.
  
  
  RESULTS
  Of the 400 nurses, 313 (78.3%) reported experiencing at least one NI, 110 (27.5%) reported at least one NI within the last 12 months, and 44 (40% of 110) reported multiple NI. Nearly two-thirds of these injuries (n = 73/110; 66.4%) were punctures that drew blood, resulting in one case of contracted hepatitis C. The cumulative annual incidence of NI events was 448 NI per 1000 nurses. Nurses reported the injury in adherence with existing regulations and policies in only 21.8% of the cases. Disposable syringes were involved in 88 (80%) of the NI events. In half of the injuries (n = 55), the needled device was equipped with a safety feature that was ineffective, primarily because it was not fully activated (n = 47/55; 85.5%) or it malfunctioned (n = 2-5; 3.6-9.1%). NI most commonly occurred while nurses were injecting insulin (n = 33; 30%). In the 2 weeks following their NI, 60.1% of nurses noted that they were more afraid of needled devices than before the injury and 41.8% felt anxious, depressed, or stressed. As a direct result of the NI, nurses missed 77 days of work.
  
  
  CONCLUSIONS
  This study is the first to show the relatively high risk both of NI and of NI that draws blood among nurses injecting insulin with a disposable syringe and confirms previous incidence estimates of NI among nurses. Additionally, this study reveals significant post-NI emotional distress, suggests significant under-reporting of NI to hospital officials, and demonstrates the need for a more effective needle safety device.
authors.affiliation: HERQuLES-Abt Associates Inc., Lexington, MA 02421, USA.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Lee
authors.forename: Marc F
authors.initials: MF
authors.lastname: Botteman
authors.forename: Lars
authors.initials: L
authors.lastname: Nicklasson
authors.forename: David
authors.initials: D
authors.lastname: Cobden
authors.forename: Chris L
authors.initials: CL
authors.lastname: Pashos
mesh_terms: D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000328:Adult; D003920:Diabetes Mellitus / Q000451:nursing*; D004209:Disposable Equipment; D004867:Equipment Design; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016602:Needlestick Injuries / Q000453:epidemiology*; D009741:Nursing Staff, Hospital / Q000523:psychology / Q000706:statistics & numerical data*; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012308:Risk Management; D013315:Stress, Psychological; D014481:United States / Q000453:epidemiology