Effect of Educational Programs, Rigid Sharps Containers, and Universal Precautions on Reported Needlestick Injuries in Healthcare Workers

TLDR

The University of Cincinnati Hospital, a 700‑bed teaching facility, maintained a five‑year surveillance of all reported needlestick injuries (1985‑1989) to monitor injury trends among its staff. The study aimed to evaluate the impact of three infection control programs on reported needlestick injuries in a general hospital. Data on individual workers were collected monthly and reviewed continuously, and the hospital sequentially implemented an educational program (1986), rigid sharps disposal containers (1987), and universal precautions with intensive in‑service (1988) to assess their effects on injury rates. Despite a total of 1,602 needlestick injuries (320 per year) during the study, the educational program increased reporting, the rigid sharps containers reduced recapping injuries by 50% (from 63 to 30 per year) mainly among nurses, and universal precautions only slightly raised total injuries while maintaining the reduced recapping rate; overall, none of the programs achieved a major reduction in reported injuries, indicating a need for new strategies.

Abstract

To evaluate the effect of infection control programs on reported needlestick injuries in a general hospital.Surveillance of all reported needlestick injuries at the University of Cincinnati Hospital was maintained by the infection control department for five years, from 1985 through 1989. Data on individual workers were collected, tabulated on a monthly basis, and reviewed continually to monitor trends in injuries. During this time, the effects of each of three new infection control programs on reported injuries were evaluated sequentially.A 700-bed general hospital that serves as the main teaching hospital of the University of Cincinnati.All employees of University Hospital who reported to personnel health for management of needlestick injuries.In 1986, an educational program to prevent injuries was initiated and continued throughout the surveillance period. In 1987, rigid sharps disposal containers were placed in all hospital rooms. In 1988, universal precautions were introduced with an intensive inservice.Surveillance identified 1,602 needlestick injuries (320/year) or 104/1,000/year. After the educational program began, reported injuries increased rather than decreased, and this was attributed to increased reporting. Subsequently, after installation of the new disposal containers, reported injuries returned to the levels seen prior to the educational program, but recapping injuries showed a significant decrease from 63/year to 30, or 20/1,000/year to 10. This decrease was observed in nurses but not in other healthcare workers. After universal precautions were instituted, total injuries increased slightly, but recapping injuries remained at 50% of the levels reported prior to the use of rigid sharps disposal containers.The three infection control programs failed to produce a major reduction in reported needlestick injuries, except for a decrease in recapping injuries associated with the placement of rigid sharps disposal containers in all patient rooms. These observations indicate that new approaches are needed to reduce needlestick injuries.