title: Issues in understanding the impact of the Needlestick Safety and Prevention Act on hospital sharps injuries.
abstract: OBJECTIVE
  Measuring the effect of the Needlestick Safety and Prevention Act (NSPA) is challenging. No agreement exists on a common denominator for calculating injury rates. Does it make a difference? How are the law and safety-engineered devices related? What is the effect on injuries and costs? This study examines those issues in assessing the impact of the legislation on hospital worker percutaneous injuries.
  
  
  METHODS
  Using a historic prospective design, we analyzed injury data from 85 hospitals. Injury rates were calculated per 100 full-time equivalents, 100 staffed beds, and 100 admissions each year from 1995 to 2005. We compared changes for each denominator. We measured the proportion of the injury rate attributed to safety-engineered devices. Finally, we estimated a national change in injuries and associated costs.
  
  
  RESULTS
  For all denominators, a precipitous drop in injury rates of greater than one-third ([Formula: see text]) occurred in 2001, immediately following the legislation. The decrease was sustained through 2005. Concomitant with the decrease in rates, the proportion of injuries from safety-engineered devices nearly tripled ([Formula: see text]) across all denominators. We estimated annual reductions of more than 100,000 sharps injuries at a cost savings of $69-$415 million.
  
  
  CONCLUSIONS
  While the data cannot demonstrate cause and effect, the evidence suggests a reduction in hospital worker injury rates related to the NSPA, regardless of denominator. It also suggests an association between the increase in safety-engineered devices and the reduction in overall injury rates. The decreases observed translate into significant reductions in injuries and associated costs.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Virginia, Charlottesville, Virginia, USA. ekp2e@virginia.edu
authors.forename: Elayne Kornblatt
authors.initials: EK
authors.lastname: Phillips
authors.forename: Mark
authors.initials: M
authors.lastname: Conaway
authors.forename: Ginger
authors.initials: G
authors.lastname: Parker
authors.forename: Jane
authors.initials: J
authors.lastname: Perry
authors.forename: Janine
authors.initials: J
authors.lastname: Jagger
mesh_terms: D004867:Equipment Design / Q000592:standards; D006761:Hospitals / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D062307:Medical Device Legislation; D009339:Needles / Q000592:standards; D016602:Needlestick Injuries / Q000453:epidemiology / Q000517:prevention & control*; D010564:Personnel, Hospital / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D011446:Prospective Studies; D011482:Protective Devices; D012449:Safety / Q000331:legislation & jurisprudence; D014481:United States / Q000453:epidemiology