Lesión por pinchazo de aguja en trabajadores de salud / Needle-stick injury in healthcare workers

Introducción: Los trabajadores de salud, especialmente enfermeras y enfermeros, laboratoristas y paramédicos tienen mayor riesgo de exposición a lesiones por pinchazo de aguja, en ocasiones, por un inadecuado manejo y almacenamiento de desechos hospitalarios. Objetivo: Describir las causas de lesión por pinchazo de aguja y las medidas de prevención tomadas por los trabajadores de salud. Métodos: Se realizó un estudio de corte transversal utilizando una encuesta en línea; participaron 74 trabajadores de salud del Hospital Nacional Almanzor Aguinaga Asenjo y el Hospital Regional Lambayeque; los datos están presentados como estadística descriptiva; para el análisis estadístico se utilizó InfoStat 2019. Resultados: La edad media de los encuestados fue de 28,9 años (rango de 17-48); la mayoría fueron mujeres (56,8 %), y el 43,2 %, varones. Del total de encuestados (42, 56,8 %), alguna vez tuvo una lesión por pinchazo de aguja, mientras, el 43,2 % no ha recibido lesiones. La severidad del pinchazo de aguja fue leve en 51,4 % de los casos, 6,8 % fue moderada y 41,9 % no tuvo lesión. Conclusiones: Las principales modalidades causantes de pinchazo de aguja encontradas en este estudio fueron: reencapuchar la aguja, extracción de sangre venosa, el movimiento repentino del paciente durante una inyección o una sutura. Una capacitación continua, el uso de equipos de protección personal y seguir las pautas de eliminación adecuada de los objetos cortopunzantes, ayudarían a prevenir este tipo de lesiones en trabajadores de salud y por ende, evitar la transmisión de infecciones a través de sangre percutánea.

Introduction: healthcare workers, especially nurses, laboratory workers and paramedics have a higher risk of exposure to needle-stick injuries, which is sometimes due to inadequate handling and hospital waste storage. Objective: to describe causes of needle-stick injury and preventive measures taken by healthcare workers. Methods: a cross-sectional study was conducted using an online survey; 74 healthcare workers from the Almanzor Aguinaga Asenjo National Hospital and the Lambayeque Regional Hospital participated; data are presented as descriptive statistics; InfoStat 2019 was used for the statistical analysis. Results: the mean age of the respondents was 28.9 years (range 17-48); the majority were female (56.8%), and 43.2%, male. The 56.8% from the total number of respondents (42) had ever had a needle-stick injury, while 43.2% had not received injuries. The severity of the needle stick was mild in 51.4% of the cases, 6.8% was moderate and 41.9% had no injury. Conclusions: needle recapping, venous blood withdrawal and patients' sudden movement during an injection or a suture were the main causes of needle stick found in this study. A continuous training, the use of personal protective equipment, and following the proper disposal guidelines for sharp objects would help health workers to prevent this type of injury, and thus to avoid the transmission of infections through percutaneous blood.

Sharps Accidents: Occurrence and Knowledge Level among Brazilian Dental Students

ABSTRACT Objective: To evaluate the prevalence of sharps accidents among dental students in southwest Goiás state, Brazil, and further survey their knowledge of biosafety and post-injury management. Material and Methods: A cross-sectional analytical observational study was carried out in 2018 following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The study population included dental students in the 4th and 10th course semester. A pre-formulated self-administered questionnaire containing 14 objective questions was used for data collection. Mean and standard deviation values were calculated. Results: A total of 308 responses were obtained. Overall, 15.9% of the respondents reported having previously experienced accidents with sharps. Most dental students who claimed to know the biological risks to which they are exposed were in the 5th and 8th course semesters, and 67.2% of them reported knowing how to proceed in the event of a sharp accident. Conclusion: A low prevalence of sharps accidents has been reported, and dental students are considered to have a good knowledge of biosafety.

Primer caso de transmisión de mpox mediante toma de muestra por desteche en Chile

Mpox es una zoonosis vírica que causa síntomas similares a la viruela, aunque menos graves. La infección fue descrita inicialmente en África central y occidental. Luego del brote multinacional ocurrido el año 2022, ya no es considerada una emergencia de salud pública de importancia internacional. El mecanismo de transmisión es por contacto físico estrecho o directo con lesiones cutáneas de individuos infectados. Presentamos el caso clínico de una enfermera que se infectó por mpox tras un accidente cortopunzante durante la toma de muestra de una lesión por desteche con bisturí en un paciente con VIH. La transmisión percutánea tuvo un período de incubación corto, seguido de una lesión cutánea y síntomas sistémicos. Aunque infrecuente, se destaca el riesgo de transmisión ocupacional de mpox en la atención clínica. Es importante que el personal sanitario adhiera estrictamente a las medidas de prevención, como el uso de equipo de protección personal y la práctica segura en la toma de muestra.

Monkeypox is a viral zoonosis that causes symptoms similar to smallpox, but less severe. The infection was initially described primarily in central and western Africa. After multi-country outbreak in 2022; it is currently no longer a public health emergency of international concern. The main mode of transmission is through close or direct contact with the skin lesions of an infected individual. We report a case of a nurse was infected with mpox after a needlestick injury during a skin sample collection from an HIV-positive patient. Percutaneous transmission resulted in a short incubation period, followed by a skin lesion and systemic symptoms. This case highlights the risk of occupational transmission of mpox in healthcare settings. It is important for healthcare workers to take rigorous prevention measures, such as the use of appropriate personal protective equipment and safe sample collection practices.

Perfil e fatores associados aos acidentes com perfurocortantes entre a equipe de enfermagem / Profile of sharps accidents among nursing teams and related factors / Perfil y factores asociados a los accidentes con cortopunzantes en el equipo de enfermería

Objetivo: analisar o perfil dos acidentes ocorridos com materiais perfurocortantes entre a equipe de enfermagem notificados em dois hospitais. Métodos: estudo documental e descritivo realizado em um hospital de ensino e um filantrópico do interior paulista. Os dados foram coletados em fichas de notificação de acidentes com material biológico envolvendo profissionais da enfermagem entre 2016 e 2020, e analisados por meio de estatística descritiva. Protocolo de pesquisa aprovada pelo comitê de Ética em Pesquisa da instituição envolvida. Resultados: foram identificados 208 acidentes: 187 (89,9%) no hospital filantrópico e 21 (10,1%) no hospital de ensino. No hospital filantrópico e no hospital universitário foram notificados, respectivamente, 119 (63,64%) e 35 (18,71%) acidentes entre os técnicos de enfermagem; sendo 51 (27,27%) e 8 (38,1%) durante descarte de perfurocortante. Agulhas causaram 166 (79,8%) acidentes. Conclusão: os acidentes nos dois hospitais ocorreram majoritariamente por agulhas, no momento de descarte de perfurocortante, acometendo principalmente os técnicos em enfermagem.

Objective: to analyse the accidents with sharps profile among the nursing staff reported at two hospitals. Methods: this descriptive, documentary study was conducted at a teaching hospital and a philanthropic hospital in the interior of São Paulo State. Data were collected from accident notification forms involving biological material and nursing personnel between 2016 and 2020, and analyzed using descriptive statistics. The research protocol was approved by the research ethics committee. Results: 208 accidents were identified: 187 (89.9%) at the philanthropic hospital and 21 (10.1%) at the university hospital; respectively, 119 (63.64%) and 35 (18.71%) among nursing technicians, and 51 (27.27%) and 8 (38.1%), during sharps disposal. Needles caused 166 (79.8%) accidents. Conclusion: at both hospitals, most accidents involved needles, at the time of sharps disposal, and mainly affected nursing technicians.

Objetivo: analizar el perfil de los accidentes con objetos cortopunzantes entre el personal de enfermería notificados en dos hospitales. Métodos: estudio documental y descriptivo realizado en un hospital universitario y un hospital filantrópico del interior de São Paulo. Los datos se recolectaron en fichas de notificación de accidentes con material biológico involucrando profesionales de enfermería entre 2016 y 2020 y se analizaron mediante estadística descriptiva. Investigación aprobada por el comité de ética en investigación de la institución involucrada. Resultados: se identificaron 208 accidentes: 187 (89,9%) en el hospital filantrópico y 21 (10,1%) en el hospital universitario. En el hospital filantrópico y en el hospital universitario fueron relatados 119 (63,64%) y 35 (18,71%) accidentes, respectivamente, entre técnicos de enfermería; siendo 51 (27,27%) y 8 (38,1%) durante la eliminación de objetos cortopunzantes. Las agujas provocaron 166 (79,8%) accidentes. Conclusión: los accidentes en ambos hospitales ocurrieron en su mayoría por agujas, en el momento de la eliminación de objetos cortopunzantes, afectando principalmente a los técnicos de enfermería.

Factors related to tissue complications resulting from insulin therapy: a cross-sectional study / Factores relacionados con las complicaciones tisulares derivadas de la terapia con insulina: estudio transversal / Fatores relacionados a complicações teciduais decorrentes da insulinoterapia: estudo transversal

Abstract Objective: To identify factors related to tissue complications resulting from insulin therapy. Method: This is a descriptive, cross-sectional study carried out in a capital of northeastern Brazil. A semi-structured form and an observation guide were applied to assess the performance of insulin preparation and administration techniques. Descriptive statistics, association test, and multivariate logistic regression were used for data analysis. Results: Most participants were female (74.2%), aged between 51 and 70 years (50.0%), and had nine to eleven years of education (36.7%). The presence of some type of local complication in 73.5% of the participants and the failure to rotate the injection sites in 82.3% are highlighted. Being single/widowed and not rotating insulin application sites were related to local complications and increased the chances of their occurrence by 3.51 and 6.70 times, respectively. Conclusion: Marital status and nonrotation of injection site were related to the increased chances of tissue complications resulting from insulin therapy.

RESUMEN Objetivo: Identificar factores relacionados con la aparición de complicaciones tisulares resultantes de la terapia con insulina. Método: Estudio descriptivo, transversal, realizado en la capital del noreste de Brasil. Se aplicó un formulario semiestructurado y un guión de observación para evaluar el desempeño de las técnicas de preparación y administración de insulina. Para el análisis de los datos se utilizó estadística descriptiva, prueba de asociación y regresión logística multivariante. Resultados: La mayoría de los participantes eran mujeres (74,2%), con edades comprendidas entre 51 y 70 años (50,0%) y con nueve a once años de escolaridad (36,7%). Se destaca la presencia de algún tipo de complicación local en el 73,5% de los participantes y mala rotación de los sitios de inyección en el 82,3%. Ser soltero/viudo y no rotar los sitios de aplicación de insulina se relacionaron con complicaciones locales y aumentaron la posibilidade de su ocurrencia en 3,51 y 6,70 veces, respectivamente. Conclusión: Se demostró que el estado civil y la mala rotación de los sitios de aplicación estaban relacionados con el aumento de las posibilidades de complicaciones tisulares como resultado de la terapia con insulina.

RESUMO Objetivo: Identificar os fatores relacionados à ocorrência de complicações teciduais decorrentes da insulinoterapia. Método: Estudo descritivo, transversal, realizado em capital do nordeste brasileiro. Aplicaram-se formulário semiestruturado e roteiro de observação para avaliação do desempenho das técnicas de preparo e administração de insulina. Estatística descritiva, teste de associação e regressão logística multivariada foram utilizadas para análise dos dados. Resultados: A maioria dos participantes era do sexo feminino (74,2%), com idades entre 51 e 70 anos (50,0%), e nove a onze anos de estudo (36,7%). Destaca-se a presença de algum tipo de complicação local em 73,5% dos participantes e a não realização do rodízio dos locais de injeção em 82,3%. Estar solteiro/viúvo e não realizar rodízio dos locais de aplicação da insulina relacionaram-se às complicações locais e aumentaram as chances de ocorrência destas em 3,51 e 6,70 vezes, respectivamente. Conclusão: O estado civil e a não realização de rodízio dos locais de aplicação mostraram-se relacionados ao aumento das chances de complicações teciduais decorrentes da insulinoterapia.

Temporal trend of accidents due to percutaneous exposure in a public hospital in Brazil, 2007-2019 / Tendencia temporal de los accidentes por exposición percutánea en un hospital público en Brasil, 2007-2019 / Tendência temporal dos acidentes por exposição percutânea em um hospital público no Brasil, 2007-2019

ABSTRACT Objectives: to analyze the temporal trend of accidents due to percutaneous exposure in a public hospital in Brazil, between 2007 and 2019, according to sociodemographic and professional characteristics. Methods: analysis of time series of accidents due to percutaneous exposure that occurred in health workers. Sociodemographic and professional variables, accident profile, post-accident behavior and accident incidence rates were evaluated. The Prais Winsten regression was used for trend analysis and calculation of the annual percentage change, with a significance level of 5%. Results: 761 occupational accidents were recorded. There was a downward trend in the rate of percutaneous injuries among female workers (-0.012%; p=0.009), who had secondary education (-0.011%; p=0.035) and among all health professional categories (-0.010%; p =0.019). There was an increasing trend (0.018%; p= 0.050) among workers with ≥ 61 months of professional experience. Conclusions: the analysis showed a decreasing incidence of percutaneous accidents, which can be explained by multiple factors.

RESUMEN Objetivos: analizar tendencia temporal de accidentes por exposición percutánea en un hospital público brasileño, entre 2007 y 2019, segundo características sociodemográficas y profesionales. Métodos: análisis de series temporales de los accidentes por exposición percutánea ocurridos en trabajadores de salud. Fueron evaluadas las variables sociodemográficas, profesionales, perfil de los accidentes, conductas post-accidentes y tasas de incidencia de los accidentes. La regresión de Prais-Winsten fue empleada para análisis de tendencia y cálculo de la variación porcentual anual, con nivel de significación de 5%. Resultados: fueron registrados 761 accidentes ocupacionales. Hubo tendencia decreciente de la tasa de accidente percutáneo en trabajadores del sexo femenino (-0,012%; p=0,009), que poseían enseñanza media (-0,011%; p=0,035) y entre todas categorías profesionales de salud (-0,010%; p=0,019). Observado tendencia creciente (0,018%; p= 0,050) entre trabajadores con tiempo ≥ 61 meses de experiencia profesional. Conclusiones: el análisis evidenció incidencia decreciente de accidentes percutáneos, que puede ser explicada por múltiples factores.

RESUMO Objetivos: analisar a tendência temporal dos acidentes por exposição percutânea em um hospital público no Brasil, entre 2007 e 2019, segundo características sociodemográficas e profissionais. Métodos: análise de séries temporais dos acidentes por exposição percutânea ocorridos em trabalhadores de saúde. Foram avaliadas as variáveis sociodemográficas, profissionais, perfil dos acidentes, condutas pós-acidentes e as taxas de incidência dos acidentes. A regressão de Prais Winsten foi empregada para análise de tendência e cálculo da variação percentual anual, com nível de significância de 5%. Resultados: foram registrados 761 acidentes ocupacionais. Houve tendência decrescente da taxa de acidente percutâneo nos trabalhadores do sexo feminino (-0,012%; p=0,009), que possuíam ensino médio (-0,011%; p=0,035) e entre todas as categorias profissionais de saúde (-0,010%; p=0,019). Observou-se tendência crescente (0,018%; p= 0,050) entre trabalhadores com tempo ≥ 61 meses de experiência profissional. Conclusões: a análise evidenciou incidência decrescente de acidentes percutâneos, que pode ser explicada por múltiplos fatores.

Una nueva alternativa para la localización y la recuperación de agujas fracturadas durante la anestesia odontológica. Presentación de técnica y caso clínico / A new alternative for locating and removing a needle fractured during dental anesthesia. Technique and case report

Objetivo: Describir en un caso clínico una nueva técni- ca para la localización y la remoción de agujas fracturadas du- rante la anestesia odontológica mediante planificación virtual. Caso clínico: Una paciente de género femenino de 52 años de edad concurre a la Cátedra de Cirugía y Traumatolo- gía Bucomaxilofacial I de la Facultad de Odontología de la Universidad de Buenos Aires y relata que dos meses atrás, durante la atención odontológica, se produjo la fractura de la aguja durante la anestesia troncular mandibular. Se realiza diagnóstico y planificación virtual para conocer la ubicación exacta de la aguja y se confecciona un modelo estereolito- gráfico y una guía quirúrgica individualizada para removerla. El uso de una guía quirúrgica individualizada y confeccio- nada mediante planificación virtual permitió ubicar la aguja tridimensionalmente y con mayor precisión en espacios pro- fundos y disminuir tiempos operatorios (AU)

Aim: To describe in a clinical case a new virtual plan- ning technique for locating and removing a fractured dental anesthetic needle. Clinical case: A 52-year-old patient visited the De- partment of Oral and Maxillofacial Surgery I (School of Dentistry, University of Buenos Aires) with a retained den- tal needle in the pterygomandibular space. The needle had fractured during inferior alveolar nerve block two months previously. Virtual diagnosis and planning were performed to locate the needle and a stereolithographic model and a customized surgical guide were prepared. The use of cus- tomized surgical guides prepared by virtual planning ena- bled precise location of the dental needle in deep spaces and reduced operating times (AU)

Epidemiology and risk factors of needlestick injuries among healthcare workers in Iran: a systematic reviews and meta-analysis

BACKGROUND@#Occupational contact with blood and body fluids poses a significant risk to healthcare workers. The aim of this systematic review is to investigate the epidemiology and risk factors affecting needlestick injuries (NSI) in healthcare personnel in Iran.@*METHODS@#In March 2020, researchers studied six international databases such as Medline/PubMed, ProQuest, ISI/WOS, Scopus, Embase, and Google Scholar for English papers and two Iranian databases (MagIran and SID) for Persian papers. Joanna Briggs Institute (JBI) Critical Appraisal Checklist was used to assess quality of studies. The method of reporting was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement.@*RESULTS@#A total of 43 articles were included in the analysis. Results showed that females (OR = 1.30, 95 % CI 1.06-1.58, P value = 0.009), younger age (OR = 2.75, 95 % CI 2.27-3.33, P value < 0.001, rotated shift workers (OR = 2.16, 95 % CI 1.47-3.15, P value < 0.001), not attending training courses (OR = 1.30, 95 % CI 1.07-1.56, P value = 0.006), working in the surgery ward (OR = 1.83, 95 % CI 1.33-2.50, P value < 0.001), less work experience (OR = 1.43, 95 % CI 1.04-1.95, P value = 0.025) apposed a greater risk factors for NSI among healthcare workers.@*CONCLUSION@#Based on the results of this review, factors such as young age, less work experience, work shift, and female gender are considered as strong risk factors for NSI injury in Iran. Preventive measures including education programs can reduce the burden of NSI among healthcare personnel.

Prevalence of needle stick injuries and utilization of post exposure prophylaxis among resident doctors in a tertiary hospital in Port Harcourt, Nigeria ­ a cross-sectional analytical study

Background:Needlestick injuries (NSIs) are percutaneous injuries sustained during delivery of medical care. They are occupational hazards faced by health workers and are a source of transmission of bloodborne pathogens.This study was aimed at determining the prevalence, utilization of post-exposure prophylaxis(PEP) and assessed the association between the sociodemographic, occupational factors, knowledge and attitude towards NSIs to its occurrence among the residents in a Tertiary hospital in Port Harcourt Nigeria.Methods: Descriptive cross-sectional analytical study design Results: The study found a 53.8% prevalence of NSIs. Annual prevalence was 50.9%. The prevalence was significantly higher among senior residents (65.1%) (p=0.006), residents in Paediatrics (75.6%) (p<0.001), and among residents who had worked three years or more (65.7%) (p<0.001). The most frequently reported factors that predisposed to NSIs were excess workload (77.9%), insufficient consumables (72.6%) and long working hours (70.2%). 77.4% of residents recapped needles, 66.1% did not report NSIs. Only 8.9% of the residents utilized PEP after injury. In 51.8% of cases, the needle had been used on a patient prior to the injury. In 25.9% of these cases, the injury involved a high-risk patient (HIV, Hepatitis B or C infected). This study found a risk of transmission of HIV following a needle stick injury to be 0.48%. Conclusion: Needlestick injuries are common among resident doctors. A large number of these injuries go unreported. The attitude toward preventive measures and use of PEP services is sub-optimal necessitating a need for more attention to be drawn to occupational health and safety in the region

Prevalence of needlestick injury among healthcare workers in Ethiopia: a systematic review and meta-analysis

BACKGROUND@#Health facilities can provide diagnostic, curative, and prognostic services for the community. While providing services, healthcare workers can be exposed to needlestick injuries that can transmit pathogenic organisms through body fluids.@*OBJECTIVE@#The aim was to establish the pooled prevalence of needlestick injuries among healthcare workers in Ethiopia.@*METHODS@#This systematic review and meta-analysis was conducted according to PRISMA guidelines. Articles were searched from Google Scholar, PubMed, Science Direct, and Scopus databases using a combination of keywords and Boolean functions. All the searched articles were imported into the EndNote X9 software, and then, duplicate data files were removed. Article screening and data extraction were done independently by two authors. Data manipulation and analyses were done using STATA version 15.1 software.@*RESULTS@#The analysis of 23 full-text articles showed that the prevalence of the 12-month and lifetime needlestick injuries among the primary studies ranged from 13.2 to 55.1% and 18.6 to 63.6%, respectively. The pooled prevalence of needlestick injuries among the Ethiopian healthcare workers was 28.8% (95% CI 23.0-34.5) and 43.6% (95% CI 35.3-52.0) for the 12 months and lifetime, respectively.@*CONCLUSIONS@#The pooled prevalence of needlestick injuries among Ethiopian healthcare workers was high. Therefore, efforts should be implemented to reduce the occurrence of injuries. Adequate protective equipment and safety-engineered devices should be supplied for the healthcare workers. It could be more effective to reduce the factors contributing to increased exposures through the allocation of adequate numbers of the healthcare workforce and implementing in-service training.

Prevalence and associated factors for needlestick and sharp injuries (NSIs) among dental assistants in Jeddah, Saudi Arabia

BACKGROUND@#Dental personnel are subject to exposure to a number of occupational factors including needlestick and sharp injuries (NSIs). Our study aims to address knowledge gaps on prevalence and associated factors for needlestick and sharp injuries (NSIs) for the first time in Saudi Arabia.@*METHODS@#This cross-sectional study was conducted on a sample of 450 dental assistants recruited from 40 randomly selected private clinics in Jeddah, Saudi Arabia. Data on demographic characteristics, history of NSIs, nature of work, compliance with infection control protocols, and knowledge of infection control procedures and disease transmission were collected using a self-administered questionnaire. Logistic regression analysis was used to assess factors associated with NSIs; unadjusted and adjusted odds ratios (aORs) and their respective 95% confidence intervals (CIs) were computed.@*RESULTS@#About three in ten dental assistants experienced at least one NSI (29.8%, 95% CI 25.6-34.2%) in private dental clinics. Lack of adequate knowledge of infection control procedures and disease transmission, non-compliance with infection control protocol of vaccination against hepatitis B virus, and attending 12 or less number of patients daily were significantly associated with increased risk of NSIs (p ≤ 0.05); adjusted odds ratios (95% CI) were 1.87 (1.18-2.97), 1.89 (1.05-3.41), and 1.63 (1.03-2.56), respectively. In addition, dental assistants working in 45.8% of dental clinics that had no infection control unit were positively associated with higher NSI risk (aOR = 2.28, 95% CI 1.45-3.57).@*CONCLUSION@#Our study reported the prevalent nature of NSIs among dental assistants in Saudi Arabia and identified key factors that could be targeted to mitigate this preventable condition. Dental assistants would benefit from proper training on infection control protocols and procedures.

Analysis of needlestick injuries and depression among the female medical staff in a city district in 2018 / 中华劳动卫生职业病杂志

Objective@#To investigate needlestick injuries and depression among the female medical staff in a city district.@*Methods@#Using cross-sectional survey methods, female medical staff from selected sixteen hospitals voluntarily participated in questionnaire survey on APP of mobile phone. They Data were uploaded assessment platform, saved by Excel, and analysed by SPSS 22.0 statistical software.@*Results@#The lasted year, Incidence of needlestick injuries was 11.28%. Incidence of needlestick injuries was respectively 5.2%, 9.1% and 16.3% in Class-I hospital, Second-class Hospital and three levels of hospitals(χ2=28.900, P<0.01). And 6.3% Resting no more than 10 days of Incidence of needlestick injuries was 12.5%, others was 6.3%.Night shift no more than 5 days of Incidence of needlestick injuries was 8.5%, others was 15.1%. The rate of not less than 14 of BDI was respectively 18.6%, 29.1% and 32.7% in Class-I hospital, Second-class Hospital and three levels of hospitals (χ2=23.843, P<0.01). In recent one year, the rate of medical staff who have taken annual leave less than 10 days and higher than 10 days scoring over 14 in the Beck(Beck depression inventory, BDI) survey are respectively 29.1% and 17.8% (χ2=10.710, P<0.01). In recent one year, the rate of medical staff who worked in night shift less than 5 days and higher than 5 days each month scoring over 14 in the Beck survey are respectively 23.5% and 31.7%(χ2=8.886, P<0.01). In recent one year, the rate of medical staff who had needle injury and non-needle injury scoring over 14 in the Beck survey are respectively 35% and 25%(χ2=4.782, P<0.05).@*Conclusion@#The needle injury rate, high score rate in Beck survey among the medical staff increased when the level of the hospital they worked for increased. Medical staff should improve their method of rest.

Development of a Safe Syringe Disposal System Moving towards Automated Syringe Data Collection / 대한의료정보학회지

OBJECTIVES: An automatic needle destroyer (ANDY) was developed to prevent needlestick injuries, and usability tests were conducted in several hospitals. The addition of extra features to the ANDY is in progress, such as data collection and automatic identification of used syringes. Thus, this report describes how the ANDY can be used to track the data of used syringes. METHODS: The motor torque required for barrel separation differs according to syringe diameters. By monitoring the electric current which is consumed for the motor torque, the type of syringe can be identified. Twelve prototypes were produced, and five usability tests were conducted in hospitals. RESULTS: After use, a syringe is inserted into the proposed device, and the needle portion is then cut and separated from the syringe body (barrel) and discarded. The needles are collected in a sharps container for hygienic disposal, and the barrel is dropped into a general medical waste container. CONCLUSIONS: The ANDY can be used to track the syringe used for each patient. The barcode can be read while the syringe rotates in the main body of the ANDY with a built-in omnidirectional scanner. Collection of information during syringe disposal can facilitate stock management. This system could also be extended to other types of consumable medical devices, although it would still be a challenge to differentiate each medical device.

Occupational Sharps Injury Among Healthcare Workers In Hospital Melaka 2013 – 2015: A Cross Sectional Study

@#Sharps injury imposed a major threat towards safety and health among healthcare workers (HCWs). Many studies in Malaysia concentrated on prevalence of needle stick injury (NSI), however the prevalence of sharps injury among HCWs based on local guideline was still scarce in Malaysia. This information gap leads us to conduct this study. Our study aimed to determine the prevalence of sharps injury among HCWs in Hospital Melaka and to describe the factors among staff with sharps injury. This cross-sectional study was conducted in Hospital Melaka, Malaysia. 165 reported cases from 2013-2015 were reviewed and secondary data extracted. Data was analyzed using IBM SPSS version 20. Among reported sharps injury cases in this study, 65 (39.4%) were male, while 100 (60.6%) were female. The mean age was 27.41 (SD: 6.06). More than half of the reported sharps injury occurred among doctor, 113 (68.5%) specifically House Officer; 89 (53.9%) followed by paramedic, 26 (15.8%) and others, 26 (15.8%). Mostly occurred in ward, 114 (69.1%). The device which accounted for most of sharps injury cases was hypodermic needle, 67 (40.6%). Many of the sharps injury cases occurred while withdrawing needle from patient, 26 (15.9%). Prevalence of sharps injury among HCWs in this study was 0.8% in year 2013, 1.1% in year 2014 and 0.5% in year 2015. Nearly half from the total number of reported sharps injury cases among HCWs in Hospital Melaka were from Medical Department, 71 (43%). Recommended measures include usage of Safety-engineered devices (SEDs) and emphasize on standard precaution.

Needlesticks with safety devices and accident prevention: an integrative review / Agujas con dispositivos de seguridad y prevención de accidentes: revisión integrativa / Agulhas com dispositivos de segurança e a prevenção de acidentes: revisão integrativa

ABSTRACT Objective: To identify in the literature the efficacy of needlesticks with safety devices to reduce the occurrence of occupational accidents with exposure to biological material among health workers. Method: Integrative literature review, structured in the stages: Guiding question, search, categorization of studies, evaluation, discussion and interpretation of results, and synthesis of knowledge. Search for original articles and systematic reviews on the main bases of the Health area, published from 2000 to 2016 in Portuguese, English and Spanish, with descriptors: needlesticks injuries, exposure to biological agents, needles, protective devices, occupational accidents, accident prevention and health personnel. Results: We selected eleven articles, most characterized the passive safety devices as more effective in reducing the occurrence of injuries by needlesticks. Conclusion: The use of needlesticks with safety devices reduces the occurrence of accidents, bringing greater solvency when combined with the training of workers.

RESUMEN Objetivo: Identificar en la literatura la eficacia del uso de agujas con dispositivos de seguridad para reducir la ocurrencia de accidentes del trabajo con exposición a material biológico entre trabajadores de la salud. Método: Revisión integrativa de la literatura, estructurada en las etapas: Cuestión orientadora, búsqueda, categorización de los estudios, evaluación, discusión e interpretación de los resultados, y síntesis del conocimiento. Busca artículos originales y revisiones sistemáticas en las principales bases del área de la salud, publicados desde 2000 hasta 2016 en Portugués, Inglés y Español, con descriptores: lesiones por pinchazo de agujas, exposición a agentes biológicos, agujas, equipos de seguridad, accidentes de trabajo, prevención de accidentes y personal de salud. Resultados: Se han seleccionado once artículos, la mayoría caracterizó los dispositivos de seguridad pasivos como más efectivos en la disminución de la ocurrencia de lesiones por agujas. Conclusión: La utilización de agujas con dispositivos de seguridad reduce la ocurrencia de los accidentes, trayendo mayor resolutividad cuando aliada a la capacitación de los trabajadores.

RESUMO Objetivo: Identificar na literatura a eficácia do uso de agulhas com dispositivos de segurança para reduzir ocorrência de acidentes de trabalho com exposição a material biológico entre trabalhadores de saúde. Método: Revisão integrativa da literatura, estruturada nas etapas: Questão norteadora, busca, categorização dos estudos, avaliação, discussão e interpretação dos resultados, e síntese do conhecimento. Busca a artigos originais e revisões sistemáticas nas principais bases da área da Saúde, publicados de 2000 a 2016 em português, inglês e espanhol, com descritores: ferimentos penetrantes produzidos por agulhas, exposição a agentes biológicos, agulhas, equipamentos de proteção, acidentes de trabalho, prevenção de acidentes e pessoal de saúde. Resultados: Foram selecionados onze artigos, a maioria caracterizou os dispositivos de segurança passivos como mais efetivos na diminuição da ocorrência de lesões por agulhas. Conclusão: A utilização de agulhas com dispositivos de segurança reduz a ocorrência dos acidentes, trazendo maior resolutividade quando aliada à capacitação dos trabalhadores.

Cutaneous manifestations of anti retroviral therapy used for post-exposure prophylaxis

Health care workers are at increased risk of needle stick injuries. Blood borne diseases that could be transmitted by such an injury include HIV, Hepatitis B, HCV and many others. Post exposure prophylaxis should be immediately started within 72 hours and should be continued for 28 days. Currently two Nucleoside Reverse Transcriptase Inhibitors (NRTIs) are given along with one NNRTI (Non- Nucleoside reverse Transcriptase Inhibitor) including Efavirenz or Nevirapine. Multiple adverse effects have been reported with all the Anti- Retroviral Therapies including various cutaneous manifestations. A 22-year-old intern doctor studying in tertiary hospital of Ahmedabad had a needle stick injury with a needle contaminated with blood of HIV positive patient. Post Exposure prophylaxis was started within 72 hours consisting of fixed dose regimen of Tenofovir disprodoxil sulphate, Efavirenz and lamivudine. He was started with the drug within 2 hours and was prescribed one drug per day for next 27 days. On 22nd day he started having rash on his body which started on palms and soles. On 23rd day he saw severe facial edema along with edema on lips and rash spreading to other parts of the body. He was diagnosed with Hypersensitivity reaction and angioedema due to ART drug therapy. He was instructed to stop ART medications and was given antihistaminic for the symptoms. Patient's angioedema was relieved in 2-3 days and rash disappeared after 4-5 days. As he had already finished 23 days of therapy he was instructed to discontinue the drugs. No recurrence of rash or angioedema was noted. This case points out the severity of side effects in the normal healthy people taking ART as Post Exposure Prophylaxis. Apart from cutaneous manifestations, angioedema is a very grievous condition which doctors should always have lower threshold for diagnosis. Early diagnosis can prevent further complications. ART drugs have many complications and these patients should have intensive regular monitoring while on treatment. Also, proper education is required for needle cut injuries in health care workers.

Exposure of a patient with systemic lupus erythematosus, under immunosuppression therapy, to human immunodeficiency virus by accidental needlestick contamination / Exposição de um paciente com lúpus eritematoso sistêmico, sob imunossupressão, ao vírus HIV por contaminação acidental por agulha

Introduction: Systemic lupus erythematosus and infection by the human immunodeficiency virus are diseases that affect the immune system. There are few reported cases of the concomitance of both pathologies. Objective: To describe a clinical case of lupus who had a needlestick injury and had also HIV exposure. Method: Case report description. Results: A patient with lupus had a needlestick injury from an HIV positive patient. This person had several intolerances or side effects to retroviral prophylaxis, lupus flare was also observed; however, in the end of 24 weeks his serology was negative and viral load was also undetectable. Conclusion: This is the first case report of a patient diagnosed with SLE, using an immunosuppressive, exposed to HIV through a needlestick accident while working.

Introdução: O lúpus eritematoso sistêmico e a infecção pelo vírus da imunodeficiência humana são doenças que afetam o sistema imunológico. Existem poucos casos relatados da concomitância de ambas as patologias. Objetivo: Descrever um relato de caso de uma paciente com lúpus que teve um ferimento penetrante produzido por agulha e foi exposta ao vírus HIV. Método: relato de caso. Resultado: Um paciente com lúpus teve um ferimento penetrante produzido por agulha proveniente de um paciente com HIV positivo. Esta pessoa teve várias intolerâncias ou efeitos colaterais na profilaxia retroviral, também foi observado a atividade do lúpus; no entanto, no final de 24 semanas, sua sorologia foi negativa e a carga viral também não era detectável. Conclusão: Este relato é a primeira descrição de um acidente com lúpus que se contaminou acidentalmente por agulha com o vírus HIV.

Association of Sleep Disturbance, Fatigue, Job Stress and Exposure to Blood and Body Fluid in Shift-work Nurses

PURPOSE: The purpose of this study was to identify associations among the sleep disturbance, fatigue, job stress, and blood and body fluid (BBF) exposure of shift-work nurses. METHODS: A total of 299 shift-work nurses from two tertiary hospitals were enrolled in this study. We used the Insomnia Severity Index (ISI), and the Fatigue Severity Scale (FSS), and the Korean Occupational Stress Scale-Short Form (KOSS-SF) to evaluate sleep disturbance, fatigue, and job stress, respectively. The data were analyzed using t-test or chi-squared test and Logistic regression analysis using the SPSS 23.0 program. RESULTS: We found that 43.8% of participants reported BBF exposure over the past year. Splash or exposure to broken skin of BBF were most frequent (56.9%), and followed by needlestick injuries (30.4%) and sharp injuries (12.8%). Age, hospital, working period, level of stress, sleep disturbance (ISI≥15), fatigue (FSS score≥4), job demand and organizational climate subset in KOSS-SF were significantly associated with BBF exposure in shift-work nurses. In multivariate analysis after adjusting age and hospital, the risk factors of BBF exposure in shift-work nurses were the level of stress and fatigue (FSS score≥4). CONCLUSION: Fatigue and job stress were related to BBF exposure in shift-work nurses. Our results suggest that management of sleep disturbance, fatigue, and high job stress in shift-work nurses is needed to reduce risk of BBF exposure.

Needlestick Injury Cases And Adherence To The Follow-Up Protocol Among Healthcare Workers In Selangor

@#Needlestick injury (NSI) is a serious occupational hazard against healthcare workers (HCWs) in a hospital setting with multiple implications, thus adherence to post-NSI management including follow-up protocol is crucial.This research was conducted to describe the distribution of NSI cases among HCWs working in Ministry of Health Malaysia (MOH)’s hospital in Selangor and adherence to a follow-up protocol, as well as the factors related to it.This was a cross-sectional quantitative study reviewing retrospectively all notified NSI cases in January-September 2016. Data were taken from Sharps Injury Surveillance (SIS) system and analyzed into descriptive and analytical statistics.There were 143 notified NSI cases. The majority of the cases were female(76.2%), Malay(60.1%), medical doctors(56.6%) and in a medical-based department (44.8%). The median age of NSI cases was 27 years old (IQR:5) and median years of employment was 1.5 (IQR:4.5). Most cases happened in a ward setting (58.7%) involving contaminated (95.8%) hypodermic needle (43.4%), occurred mostly during the procedure of drawing blood (23.1%). Only 86.7% of NSI cases were source-known and some were tested positive with blood borne pathogens. However, no occurrence of seroconversion among the injured HCWs detected. The overall adherence rate to the follow-up protocol was 72.3%. Multiple logistic regression yielded significant association between age, gender, department, device contamination, procedure conducted and source HBV status with adherence to follow-up of post-NSI protocol. Further comprehensive studies involving more determinants such as therapy-related factors and potential interventions are needed to optimize adherence rate to the follow-up protocol post-NSI.

Prevalence of needlestick and sharps injuries in the healthcare workers of Iranian hospitals: an updated meta-analysis

BACKGROUND@#Needlestick and sharps injuries (NSIs) are critical occupational risk among health care workers (HCWs), which is extremely worrying due to the potential risk of transmitting bloodborn pathogens (BBPs). This study was carried out to evaluate the prevalence of NSIs among Iranian HCWs.@*METHODS@#In this systematic review and meta-analysis, the key terms percu* injur*, needle* stick injur*, needlestick* injur*, or sharp* injur* were searched in the Scientific Information Database (SID), MagIran, IranMedex, Google Scholar, Science Direct, PubMed, and Scopus. A prefabricated checklist, including variables: first author, publication year, study population, sample size, gender, total prevalence of needlestick in each gender, type of questionnaire, region, and type of hospitals, was used to extract data from the selected articles included which were published between 2003 and 2016.@*RESULTS@#The analysis showed that the prevalence of NSIs in the Iranian HCWs was 42.5% (95% CI 37-48). Moreover, the prevalence of NSIs was more in women (47%; 95% CI 36-58) compared to men (42%; 95% CI 26-58).@*CONCLUSION@#Given the high prevalence of NSIs, it is necessary to supply safe needles and instruments, hold training programs focused on new methods of using sharp objects safely, observe safety principles and standards, reinforce the practical skills of personnel, and pay more attention to reporting and improving occupational behaviors like avoiding needle recapping in order to reduce the prevalence of NSIs and consequently reduce potential risk of transmission of BBPs.