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

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          Abstract

          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.

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          Most cited references67

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          Needle Stick Injuries and their Related Safety Measures among Nurses in a University Hospital, Shiraz, Iran

          Background This study aimed to determine the prevalence and factors related to needle stick injuries (NSIs) and to assess related safety measures among a sample of Iranian nurses. Methods In this cross-sectional study, a random sample of 168 registered active nurses was selected from different wards of one of the hospitals of Shiraz University of Medical Sciences (SUMS). Data were collected by an anonymous questionnaire and a checklist based observational method among the 168 registered active nurses. Results The prevalence of NSIs in the total of work experience and the last year was 76% and 54%, respectively. Hollow-bore needles were the most common devices involved in the injuries (85.5%). The majority of NSIs occurred in the morning shift (57.8%) and the most common activity leading to NSIs was recapping needles (41.4%). The rate of underreporting NSIs was 60.2% and the major reasons for not reporting the NSIs were heavy clinical schedule (46.7%) and perception of low risk of infection (37.7%). A statistically significant relationship was found between the occurrence of NSIs and sex, hours worked/week, and frequency of shifts/month. Conclusion The study showed a high prevalence of NSIs among nurses. Supportive measures such as improving injection practices, modification of working schedule, planning training programs targeted at using personal protective equipment, and providing an adequate number of safety facilities such as puncture resistant disposal containers and engineered safe devices are essential for the effective prevention of NSI incidents among the studied nurses.
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            Standard Precautions: Occupational Exposure and Behavior of Health Care Workers in Ethiopia

            Background Occupational exposure to blood and body fluids is a serious concern for health care workers, and presents a major risk for the transmission of infections such as HIV and hepatitis viruses. The objective of this study was to investigate occupational exposures and behavior of health care workers (HCWs) in eastern Ethiopia. Methods We surveyed 475 HCWs working in 10 hospitals and 20 health centers in eastern Ethiopia using a structured questionnaire with a response rate of 84.4%. Descriptive statistics and multivariate analysis using logistic regression were performed. Results Life time risks of needle stick (30.5%; 95% CI 26.4–34.6%) and sharps injuries (25.7%; 95% CI 21.8–29.6%) were high. The one year prevalence of needle stick and sharps injury were 17.5% (95% CI 14.1–20.9%) and 13.5% (95% CI 10.4–16.6%) respectively. There was a high prevalence of life time (28.8%; 95% CI = 24.7–32.9%) and one year (20.2%; 95% CI = 16.6–23.8%) exposures to blood and body fluids. Two hundred thirteen (44.8%) HCWs reported that they were dissatisfied by the supply of infection prevention materials. HCWs had sub-optimal practices and unfavorable attitudes related to standard precautions such as needle recapping (46.9%) and discriminatory attitudes (30.5%) toward HIV/AIDS patients. Conclusion There was a high level of exposure to blood and body fluids among HCWs. We detected suboptimal practices and behavior that put both patients and HCWs at significant risk of acquiring occupational infections. Health authorities in the study area need to improve the training of HCWs and provision of infection prevention equipment. In addition, regular reporting and assessment of occupational exposures need to be implemented.
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              Study of Prevalence and Response to Needle Stick Injuries among Health Care Workers in a Tertiary Care Hospital in Delhi, India

              Background: Because of the environment in which they work, many health care workers are at an increased risk of accidental needle stick injuries (NSI). Objective: To study prevalence and response to needle stick injuries among health care workers. Materials and Methods: Study Design: Cross-sectional study. Setting: A tertiary care hospital in Delhi. Participants: 322 resident doctors, interns, nursing staff, nursing students, and technicians. Statistical Analysis: Proportions and Chi-square test. Results: A large percentage (79.5%) of HCWs reported having had one or more NSIs in their career. The average number of NSIs ever was found to be 3.85 per HCW (range 0-20). 72 (22.4%) reported having received a NSI within the last month. More than half (50.4%) ascribed fatigue as a cause in their injury. Most of the injuries (34.0%) occurred during recapping. In response to their most recent NSI, 60.9% washed the site of injury with water and soap while 38 (14.8%) did nothing. Only 20 (7.8%) of the HCWs took post-exposure prophylaxis (PEP) against HIV/AIDS after their injury. Conclusions: The occurrence of NSI was found to be quite common. Avoidable practices like recapping of needles were contributing to the injuries. Prevention of NSI is an integral part of prevention programs in the work place, and training of HCWs regarding safety practices indispensably needs to be an ongoing activity at a hospital.
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                Author and article information

                Contributors
                rezaghanei30@yahoo.com
                m.aslani@umsha.ac.ir
                fidannahal@yahoo.com
                S_dalvand91@yahoo.com
                +98 9141473781 , nparizad@gmail.com
                Journal
                Environ Health Prev Med
                Environ Health Prev Med
                Environmental Health and Preventive Medicine
                BioMed Central (London )
                1342-078X
                1347-4715
                7 September 2018
                7 September 2018
                2018
                : 23
                : 44
                Affiliations
                [1 ]ISNI 0000 0004 0417 6812, GRID grid.484406.a, Clinical Care Research Center, , Kurdistan University of Medical Sciences, ; Sanandaj, Iran
                [2 ]ISNI 0000 0004 0611 9280, GRID grid.411950.8, Shahid Beheshti Hospital of Hamadan, , Hamadan University of Medical Sciences, ; Hamadan, Iran
                [3 ]ISNI 0000 0004 0612 774X, GRID grid.472458.8, Department of Nursing, , University of Social Welfare and Rehabilitation Sciences, ; Tehran, Iran
                [4 ]GRID grid.411746.1, MSc of Biostatistics, Health Promotion Research Center, , Iran University of Medical Sciences, ; Tehran, Iran
                [5 ]ISNI 0000 0004 0442 8645, GRID grid.412763.5, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, , Urmia University of Medical Sciences, ; Pardis Nazlou, 11 km of Nazlou Road, Urmia, Iran
                Author information
                http://orcid.org/0000-0001-7393-3010
                Article
                734
                10.1186/s12199-018-0734-z
                6129009
                30193569
                43c48537-e95a-44a3-8067-1b536ec0a318
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 19 April 2018
                : 22 August 2018
                Categories
                Review Article
                Custom metadata
                © The Author(s) 2018

                Occupational & Environmental medicine
                health care workers,iran,meta-analysis,needlestick,prevalence

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