ABSTRACT
Needle Stick Injuries caused by hypodermic needles, intravenous stylets or other sharps are an occupational hazard as these can lead to transmission of bloodborne pathogens. This study was conducted to understand the pattern of Needle Stick Injuries (NSIs) in our hospital settings.METHODSAn observational retrospective study was conducted in a 600 bedded Tertiary Care Hospital in Kishanganj, Bihar. A total of 87 NSIs were encountered during the study period from April 2018 to March 2019 using NACO guidelines. Data was entered into a computer-based spreadsheet for analysis using SPSS statistical software, version 19. The statistical tests applied included descriptive statistics and Chi-square tests to observe the association, if any.RESULTSDirect HCWs like Nursing Professionals and Doctors sustained more NSIs. Staff with >2 years of experience sustained less NSIs. Staff who received training on awareness and prevention of NSIs within the last 6 months sustained less NSIs. Introduction of engineered safety devices brought about an overall reduction in the NSI rate per 100 occupied beds from 7.83% to 6.67%, a reduction by 14.81%. This reduction in NSI rate was statistically significant (p value=0.003).CONCLUSIONSThere is a definite role of experienced staff and frequent trainings in reducing NSIs. This study brought out another very significant observation not reviewed previously in Indian settings, the use of engineered safety devices in bringing down NSIs. Certain policy recommendations at the National Level to strengthen monitoring and surveillance to safeguard HCWs from occupational exposure to bloodborne pathogens is also felt.
ABSTRACT
Introduction: “Code blue” (CB) is common emergency code,used by hospitals to alert trained emergency response teamof any cardiac arrest. The factors affecting the outcome ofresuscitative services are inherent to the patient and also tothe functioning of the Code Blue System (CBS). The primaryobjective was to assess the success of ‘Code Blue’ in terms ofsurvival. The other objective was to identify the patient andsystem variables associated with a favorable outcome.Material and methods: This was a cross sectionalretrospective study done in a multispecialty teaching hospitalin Bihar during the period from April 2018 to March 2019.The study was conducted after approval from the InstitutionalEthics Committee. Data was gathered from the Code BlueReport Form and further details of individual patients weretracked from their medical records. Data was entered in anExcel Spreadsheet and analyzed using descriptive statistics,Chi-square test and logistic regression analysis using SPSSVersion 21 software.Results: A total of 111 CB calls were initiated during theperiod. Code Blue activated for cardiac arrest situations onlywere considered in the study. Emergency response calls forphysiologically acute changes in the patients were excluded.Immediate success of resuscitation services for Code Bluecalls was 63.06%, beyond 24 hours this was 27.03% and atdischarge this was just 9.01%. Factors such as age, time ofCode Blue during or outside routine hospital working hours,associated comorbidities, procedures like dialysis, operationor chemotherapy done in the last 24 hours preceding the CodeBlue and duration of CPR were found to have a significanteffect on the success rate.Conclusion: We conclude, that formal training of all thehealthcare providers on BLS is of paramount importance.Further in depth analysis is required to find out the root causeof the problems that are associated with the ‘Code Blue’process which is affecting the success rates beyond routinehospital working hours.