International Journal of Advances in Nursing Management

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Needle Sticks Injuries (NSIs) and Hepatitis B Vaccination status among Health Care Workers (HCWs) at Asia’s Largest Trauma Care Centre in Bengaluru


Affiliations
1 Professor, Dept. of Microbiology, Trauma and Emergency Care Centre, Bangalore Medical College and Research Institute., India
2 Nursing Officer, Infection Control Nurse, Trauma and Emergency Care Centre, Bangalore Medical College and Research Institute., India
3 Professor and HOD, Dept. of Neuro Surgery, Trauma and Emergency Care Centre, Bangalore Medical College and Research Institute, India
4 Nursing Officer, Infection Control Nurse, Trauma and Emergency Care Centre, Bangalore Medical College and Research Institute, India
     

   Subscribe/Renew Journal


Background: Needle stick injuries (NSIs) are the most common workplace-related health hazards responsible for the transmission of blood-borne pathogens among the HCWs where safety measures have not already been established. Injuries mostly occur during needle recapping, operative procedures, blood sample collection, intravenous line administration and poor waste disposal practices. Following NSIs, more than 20 blood-borne pathogens can be transmitted through body fluids. However, the most common diseases that can be potentiallytransmitted through body fluids are HIV, HBV, and HCV. Moreover, among the three important pathogens transmitted through NSIs, only HBV has an effective vaccine. The HBV vaccination coverage among HCWs has also been generally less, putting them at greater risk for HBV infections. This study aims to analyze the swing of voluntary reporting of NSIs among HCWs and also the HBV vaccination status among those HCWs reporting NSIs in our tertiary health-care center. Materials and Methods: A retrospective study was conducted between January 2018 and March 2020 at Asia’s Largest Trauma Care Centre in Bangalore. A standard proforma was filled by all HCWs reporting NSIs and a record of the same was maintained. Testing for HIV, hepatitis B virus surface antigen (HBsAg) and HCV was provided to the HCWs and also to the sources. HIV testing, HBsAg testing, and HCV testing were done by using rapid standard kits. All the tests were performed and interpreted according to the manufacturer's instructions. The testing for HIV 1 and 2 was done according to the National AIDS Control Organization Guidelines. The HCWs were tracked up to 6 weeks, 3 months, and 6 months for HIV and at 3 months and 6 months for HBV and HCV, consecutively after guidance, counseling and appropriate interventions. Results: A total of 34 incidents of NSIs were reported between January 2018 and March 2020 in that 11 were reported in 2018, 17 and 06 in 2019 and 2020 respectively. Majority of the HCWs 50 % had complete course of HBV vaccination, 41.17% had incomplete (1 or 2 doses) and 8.82% had not taken any course of HBV vaccination. Conclusion: The study disclosed that the collective prevalence of NSI among HCWs was high. The inadequate training of HCWs among the health care facilities might make HCWs more susceptible to injury. Therefore, the current study recommends the following measures to reduce NSIs - adequate training, simulation training to mimic everyday situations of junior staff, compulsory HBV vaccination for all the HCWs, System in place for reporting, adequate first aid facility and provision of safe working environment.

Keywords

Needle sticks Injuries, Hepatitis B Vaccination status, Health Care Workers Largest Trauma Care Centre.
Subscription Login to verify subscription
User
Notifications
Font Size


  • World Health Organization (WHO): Healthcare worker safety: aide-memoire for a strategy to protect health workers from infection with bloodborne viruses. 2013.

  • Prüss-Üstün A, Rapiti E, Hutin Y. Estimation of the global burden of disease attributable to contaminated sharps injuries among health- care workers. Am J Ind Med. 2005; 48:482–90.

  • Centers for Disease Control and Prevention (CDC). The National Institute for Occupational Safety and Health (NIOSH): Preventing Needle Stick injuries in health care settings 1999. Available from: https://www.cdc.gov/niosh/docs/2000108/ default.html. [Last Accessed on 2018 Dec 30].

  • Leigh JP, Markis CA, Iosif AM, Romano PS. California’s nurseto-patient ratio law and occupational injury. Int Arch Occup Environ Health. 2015; 88:477–84.

  • Vose J, Mcadara J. Reducing scalpel injuries in the operating room. AORN J. 2009; 90:867–72.

  • Leow JJ, Groen RS, Bae JY, Adisa CA, Kingham TP, Kushner AL. Scarcity of healthcare worker protection in eight low- and middle-income countries: surgery and the risk of HIV and other bloodborne pathogens. Trop Med Int Health. 2012; 17:397–401.

  • US Public Health Service. Guidelines for management of occupational exposure to HBV, HCV, and HIV and recommendations for post-exposure prophylaxis. MMWR Recomm Rep. 2001; 50:1–52.

  • Adib-Hajbaghery M, Lotfi MS. Behavior of healthcare workers after injuries from sharp instruments. Trauma Mon. 2013; 18:75– 80.

  • Rodrigues C. Needlestick injuries & the health care worker. Indian J Med Res.2010; 131:384–6.

  • Cui Z, Zhu J, Zhang X, Wang B, Li X. Sharp injuries: a crosssectional study among health care workers in a provincial teaching hospital in China. Environ Health Prev Med. 2018; 23:2.

  • Baghcheghi N, Koohestani H, Abedi A. Prevalence needlestick/sharps injuries among nursing student and related factor. Iran Occup Health J. 2011; 7:31–9.

  • Adefolalu AO. Needle stick injuries and health workers: a preventable menace. Ann Med Health Sci Res. 2014; 4:159.

  • WHO health care working safety 2014 who. available from https://www.who.int/water_sanitation_health/publications/wastem anag/en/ and answer injection safety.

  • Tadesse M, Tadesse T. Epidemiology of needlestick injuries among healthcare workers in Awassa City, Southern Ethiopia. Trop Doct. 2010; 40:111–3.

  • Lee R. Occupational transmission of bloodborne diseases to healthcare workers in developing countries: meeting the challenges. J Hosp Infect Home. 2009; 72:285–91.

  • Wilburn SQ, Eijkemans G. Preventing needlestick injuries among healthcare workers: a WHO–ICN collaboration. Int J Occup Environ Health. 2004; 10:451–6.

  • Gerberding JL. Management of occupational exposures to bloodborne viruses. N Engl J. 1995; 332:444–51.

  • Gebriel YG, Tesfaye FF. Assessment of the safety of injections and related medical practices in health institutions at Sidama Zone, SNNPRS. J Clin Virol.2006;36:217.

  • Walsh SS, Pierce AM, Hart CA. Drug abuse: a new problem. Br Med J. 1987; 295:526–7.

  • Adamu G, Abdullahi A. Common occupational health hazards amongst health care workers in a tertiary health institution in Bida, North-central Nigeria. Int J Biomed Res. 2017; 8:01–6.

  • Geravandi S, Alavi SM, Yari AR, Yousefi F, Hosseini SA, Kamaei S, et al. Epidemiological aspects of needlestick injuries among health care workersin Razi Hospital Ahvaz, Iran. Arch Hyg Sci. 2016; 5:85–91.

  • Sharma R, Rasania SK, Verma A, Singh S. Study of prevalence and response to needlestick injuries among health care workers in a tertiary care hospital in Delhi, India. Indian J Community Med. 2010; 35:74.

  • Muralidhar S, Singh PK, Jain RK, Malhotra M, Bala M. Needle stick injuries among health care workers in a tertiary care hospital of India. Indian J Med Res 2010; 131:405 10.

  • Khatony A, Abdi A, Jafari F, Vafaei K. Prevalence and reporting of needle stick injuries: A survey of surgery team members in Kermanshah university of medical sciences in 2012. Glob J Health Sci 2015; 8:245 51.

  • Thomas WJ, Murray JR. The incidence and reporting rates of needle-stick injury amongst UK surgeons. Ann R Coll Surg Engl 2009; 91:12 7.

  • Garus Pakowska A, Górajski M. Epidemiology of needlestick and sharp injuries among health care workers based on records from 252 hospitals for the period 2010 2014, Poland. BMC Public Health 2019; 19:634.

  • Kumar HN, Nambiar RP, Mohapatra S, Khanna A, Praveen R, Sai Bhawana D. A cross sectional study on hepatitis B Vaccination status and post exposure prophylaxis practices among health care workers in teaching hospitals of Mangalore. Ann Glob Health 2015; 81:664 8.

  • Aaron D, Nagu TJ, Rwegasha J, Komba E. Hepatitis B vaccination coverage among healthcare workers at national hospital in Tanzania: How much, who and why? BMC Infect Dis 2017; 17:786.

  • Akibu M, Nurgi S, Tadese M, Tsega WD. Attitude and vaccination status of healthcare workers against hepatitis B infection in a teaching hospital, Ethiopia. Scientifica (Cairo) 2018; 2018:6705305.

  • Wilburn SQ, Eijkemans G. Preventing needle stick injuries among healthcare workers: A WHO ICN collaboration. Int J Occup Environ Health 2004; 10:451 6.

  • Mannocci A, De Carli G, Di Bari V, Saulle R, Unim B, Nicolotti N, et al. How much do needlestick injuries cost? A systematic review of the economic evaluations of needle stick and sharps injuries among healthcare personnel. Infect Control Hosp Epidemiol 2016; 37:635 46.


Abstract Views: 221

PDF Views: 0




  • Needle Sticks Injuries (NSIs) and Hepatitis B Vaccination status among Health Care Workers (HCWs) at Asia’s Largest Trauma Care Centre in Bengaluru

Abstract Views: 221  |  PDF Views: 0

Authors

Sachina B T
Professor, Dept. of Microbiology, Trauma and Emergency Care Centre, Bangalore Medical College and Research Institute., India
Asima Banu
Nursing Officer, Infection Control Nurse, Trauma and Emergency Care Centre, Bangalore Medical College and Research Institute., India
S. Balaji Pai
Professor and HOD, Dept. of Neuro Surgery, Trauma and Emergency Care Centre, Bangalore Medical College and Research Institute, India
Shahid S
Nursing Officer, Infection Control Nurse, Trauma and Emergency Care Centre, Bangalore Medical College and Research Institute, India
Chidambara V N
Nursing Officer, Infection Control Nurse, Trauma and Emergency Care Centre, Bangalore Medical College and Research Institute, India

Abstract


Background: Needle stick injuries (NSIs) are the most common workplace-related health hazards responsible for the transmission of blood-borne pathogens among the HCWs where safety measures have not already been established. Injuries mostly occur during needle recapping, operative procedures, blood sample collection, intravenous line administration and poor waste disposal practices. Following NSIs, more than 20 blood-borne pathogens can be transmitted through body fluids. However, the most common diseases that can be potentiallytransmitted through body fluids are HIV, HBV, and HCV. Moreover, among the three important pathogens transmitted through NSIs, only HBV has an effective vaccine. The HBV vaccination coverage among HCWs has also been generally less, putting them at greater risk for HBV infections. This study aims to analyze the swing of voluntary reporting of NSIs among HCWs and also the HBV vaccination status among those HCWs reporting NSIs in our tertiary health-care center. Materials and Methods: A retrospective study was conducted between January 2018 and March 2020 at Asia’s Largest Trauma Care Centre in Bangalore. A standard proforma was filled by all HCWs reporting NSIs and a record of the same was maintained. Testing for HIV, hepatitis B virus surface antigen (HBsAg) and HCV was provided to the HCWs and also to the sources. HIV testing, HBsAg testing, and HCV testing were done by using rapid standard kits. All the tests were performed and interpreted according to the manufacturer's instructions. The testing for HIV 1 and 2 was done according to the National AIDS Control Organization Guidelines. The HCWs were tracked up to 6 weeks, 3 months, and 6 months for HIV and at 3 months and 6 months for HBV and HCV, consecutively after guidance, counseling and appropriate interventions. Results: A total of 34 incidents of NSIs were reported between January 2018 and March 2020 in that 11 were reported in 2018, 17 and 06 in 2019 and 2020 respectively. Majority of the HCWs 50 % had complete course of HBV vaccination, 41.17% had incomplete (1 or 2 doses) and 8.82% had not taken any course of HBV vaccination. Conclusion: The study disclosed that the collective prevalence of NSI among HCWs was high. The inadequate training of HCWs among the health care facilities might make HCWs more susceptible to injury. Therefore, the current study recommends the following measures to reduce NSIs - adequate training, simulation training to mimic everyday situations of junior staff, compulsory HBV vaccination for all the HCWs, System in place for reporting, adequate first aid facility and provision of safe working environment.

Keywords


Needle sticks Injuries, Hepatitis B Vaccination status, Health Care Workers Largest Trauma Care Centre.

References