title: Use of safety devices and the prevention of percutaneous injuries among healthcare workers.
abstract: OBJECTIVE
  To study the effectiveness of safety devices intended to prevent percutaneous injuries.Design. Quasi-experimental trial with before-and-after intervention evaluation.
  
  
  METHODS
  A 350-bed general hospital that has had an ongoing educational program for the prevention of percutaneous injuries since January 2002.
  
  
  METHODS
  In October 2005, we implemented a program for the use of engineered devices to prevent percutaneous injury in the emergency department and half of the hospital wards during the following procedures: intravascular catheterization, vacuum phlebotomy, blood-gas sampling, finger-stick blood sampling, and intramuscular and subcutaneous injections. The nurses in the wards that participated in the intervention received a 3-hour course on occupationally acquired bloodborne infections, and they had a 2-hour "hands-on" training session with the devices. We studied the percutaneous injury rate and the direct cost during the preintervention period (October 2004 through March 2005) and the intervention period (October 2005 through March 2006).
  
  
  RESULTS
  We observed a 93% reduction in the relative risk of percutaneous injuries in areas where safety devices were used (14 vs 1 percutaneous injury). Specifically, rates decreased from 18.3 injuries (95% confidence interval [CI], 5.9-43.2 injuries) to 0 injuries per 100,000 patients in the emergency department (P=.002) and from 44.0 injuries (95% CI, 20.1-83.6 injuries) to 5.2 injuries (95% CI, 0.1-28.8 injuries) per 100,000 patient-days in hospital wards (P=.007). In the control wards of the hospital (ie, those where the intervention was not implemented), rates remained stable. The direct cost increase was 0.558 euros (US$0.753) per patient in the emergency department and 0.636 euros (US$0.858) per patient-day in the hospital wards.
  
  
  CONCLUSIONS
  Proper use of engineered devices to prevent percutaneous injury is a highly effective measure to prevent these injuries among healthcare workers. However, education and training are the keys to achieving the greatest preventative effect.
authors.affiliation: Servicio de Medicina Preventiva, Hospital Virgen de Salud-Elda, Alicante, Spain. Valls_vic@gva.es
authors.forename: Victoria
authors.initials: V
authors.lastname: Valls
authors.forename: M Salud
authors.initials: MS
authors.lastname: Lozano
authors.forename: Remedios
authors.initials: R
authors.lastname: Yánez
authors.forename: Mária José
authors.initials: MJ
authors.lastname: Martínez
authors.forename: Francisco
authors.initials: F
authors.lastname: Pascual
authors.forename: Joan
authors.initials: J
authors.lastname: Lloret
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Ruiz
mesh_terms: D000062:Accidents, Occupational / Q000517:prevention & control*; D004867:Equipment Design; D004869:Equipment Safety / Q000295:instrumentation*; D006745:Hospital Bed Capacity, 300 to 499; D006769:Hospitals, General; D006801:Humans; D007262:Infusions, Intravenous / Q000295:instrumentation*; D007318:Inservice Training; D016602:Needlestick Injuries / Q000517:prevention & control*; D010564:Personnel, Hospital; D018962:Phlebotomy / Q000295:instrumentation*; D011446:Prospective Studies; D013030:Spain