Interventions to reduce needle stick injuries at a tertiary care centre.
BACKGROUND
Occupational exposure to blood/body fluids is associated with risk of infection with blood borne pathogens like human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV).


METHODS
We carefully document needle stick injuries (NSI) and implement post-exposure prophylaxis (PEP). We report a four-year continuing surveillance study where 342 healthcare workers (HCWs) sustained NSI. PEP was given to HCWs injured from seropositive sources. If the source was HbsAg positive, HCWs were given a hepatitis B immunization booster. If the HCW was antiHBs negative, both hepatitis B immunoglobulin (HBIG) and hepatitis B vaccine were administered. For HCWs who sustained injuries from HIV positive sources, antiretroviral therapy was started. Follow-up was done after three and six months of exposure. Recent interventions by the infection control committee at our hospital reduced NSI considerably during intravenous line administration and glucose monitoring.


CONCLUSIONS
Of 342 injuries, 254 were from known sources and 88 from unknown sources. From known sources, 37 were seropositive; 13 for HIV, 15 for HCV, nine for HBV. Sixty six sharp injuries were sustained through garbage bags, 43 during IV line administration, 41 during injection administration, 35 during needle recapping, 32 during blood collection, 27 during blood glucose monitoring, 24 from OT instruments, 17 during needle disposal, 16 while using surgical blade, 7 during suturing and 34 from miscellaneous sources.


CONCLUSIONS
No case of seroconversion has taken place, so far, as a result of needle stick injuries at our centre.
Mehta
A
A
Department of Microbiology, P.D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim (West), Mumbai - 400 016, India.
Rodrigues
C
C
Singhal
T
T
Lopes
N
N
D'Souza
N
N
Sathe
K
K
Dastur
F D
FD
D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D015658:HIV Infections / Q000517:prevention & control; D006282:Health Personnel; D006509:Hepatitis B / Q000517:prevention & control; D017325:Hepatitis B Vaccines / Q000627:therapeutic use; D006526:Hepatitis C / Q000517:prevention & control; D006801:Humans; D016602:Needlestick Injuries / Q000453:epidemiology*; D009784:Occupational Diseases / Q000453:epidemiology* / Q000517:prevention & control*; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D056990:Post-Exposure Prophylaxis / Q000379:methods*
D044966:Anti-Retroviral Agents; D017325:Hepatitis B Vaccines