Lamontagne F, Abiteboul D, Lolom I, Pellissier G, Tarantola A, Descamps J M, Bouvet E
Department of Infectious Diseases, Tenon University Hospital, Paris, France.
Infect Control Hosp Epidemiol. 2007 Jan;28(1):18-23. doi: 10.1086/510814. Epub 2006 Dec 18.
To evaluate safety-engineered devices (SEDs) with respect to their effectiveness in preventing needlestick injuries (NSIs) in healthcare settings and their importance among other preventive measures.
Multicenter prospective survey with a 1-year follow-up period during which all incident NSIs and their circumstances were reported. Data were prospectively collected during a 12-month period from April 1999 through March 2000. The procedures for which the risk of NSI was high were also reported 1 week per quarter to estimate procedure-specific NSI rates. Device types were documented. Because SEDs were not in use when a similar survey was conducted in 1990, their impact was also evaluated by comparing findings from the recent and previous surveys.
A total of 102 medical units from 32 hospitals in France.
A total of 1,506 nurses in medical or intensive care units.
A total of 110 NSIs occurring during at-risk procedures performed by nurses were documented. According to data from the 2000 survey, use of SEDs during phlebotomy procedures was associated with a 74% lower risk (P<.01). The mean NSI rate for all relevant nursing procedures was estimated to be 4.72 cases per 100,000 procedures, for a 75% decrease since 1990 (P<.01); however, the decrease in NSI rates varied considerably according to procedure type. Between 1990 and 2000, decreases in the NSI rates for each procedure were strongly correlated with increases in the frequency of SED use (r=0.88; P<.02).
In this French hospital network, the use of SEDs was associated with a significantly lower NSI rate and was probably the most important preventive factor.
评估安全工程设备（SEDs）在医疗环境中预防针刺伤（NSIs）的有效性及其在其他预防措施中的重要性。
多中心前瞻性调查，随访期为1年，在此期间报告所有针刺伤事件及其发生情况。数据于1999年4月至2000年3月的12个月期间前瞻性收集。每季度有1周报告针刺伤风险高的操作，以估计特定操作的针刺伤发生率。记录设备类型。由于1990年进行类似调查时SEDs尚未使用，因此还通过比较近期和先前调查的结果来评估其影响。
法国32家医院的102个医疗单位。
医疗或重症监护病房的1506名护士。
记录了护士在高危操作过程中发生的110起针刺伤事件。根据2000年调查数据，在静脉穿刺操作中使用SEDs可使风险降低74%（P<0.01）。所有相关护理操作的平均针刺伤发生率估计为每100,000次操作4.72例，自1990年以来下降了75%（P<0.01）；然而，针刺伤发生率的下降因操作类型而异。1990年至2000年期间，每种操作的针刺伤发生率下降与SEDs使用频率增加密切相关（r=0.88；P<0.02）。
在这个法国医院网络中，SEDs的使用与显著降低的针刺伤发生率相关，可能是最重要的预防因素。
