departments of Infectious Diseases, Bichat University Hospital, Xavier Bichat Faculty of Medicine, Paris, France.
Infect Control Hosp Epidemiol. 2010 Apr;31(4):402-7. doi: 10.1086/651301.
To evaluate the incidence of needlestick injuries (NSIs) among different models of safety-engineered devices (SEDs) (automatic, semiautomatic, and manually activated safety) in healthcare settings.
This multicenter survey, conducted from January 2005 through December 2006, examined all prospectively documented SED-related NSIs reported by healthcare workers to their occupational medicine departments. Participating hospitals were asked retrospectively to report the types, brands, and number of SEDs purchased, in order to estimate SED-specific rates of NSI. Setting. Sixty-one hospitals in France.
More than 22 million SEDs were purchased during the study period, and a total of 453 SED-related NSIs were documented. The mean overall frequency of NSIs was 2.05 injuries per 100,000 SEDs purchased. Device-specific NSI rates were compared using Poisson approximation. The 95% confidence interval was used to define statistical significance. Passive (fully automatic) devices were associated with the lowest NSI incidence rate. Among active devices, those with a semiautomatic safety feature were significantly more effective than those with a manually activated toppling shield, which in turn were significantly more effective than those with a manually activated sliding shield (P < .001, chi(2) test). The same gradient of SED efficacy was observed when the type of healthcare procedure was taken into account.
Passive SEDs are most effective for NSI prevention. Further studies are needed to determine whether their higher cost may be offset by savings related to fewer NSIs and to a reduced need for user training.
评估不同安全工程设备（SED）（自动、半自动和手动激活安全）模型在医疗保健环境中发生针刺伤（NSI）的发生率。
这项多中心调查于 2005 年 1 月至 2006 年 12 月进行，调查了医疗保健工作者向其职业医学部门报告的所有前瞻性记录的与 SED 相关的 NSI。要求参与医院回顾性报告所购买的 SED 类型、品牌和数量，以便估计特定 SED 的 NSI 率。地点：法国 61 家医院。
在研究期间，共购买了超过 2200 万支 SED，共记录了 453 例与 SED 相关的 NSI。NSI 的总平均发生率为每 100 万支 SED 购买 2.05 例。使用泊松逼近比较设备特定的 NSI 率。95%置信区间用于定义统计学意义。被动（全自动）设备与最低的 NSI 发生率相关。在主动设备中，具有半自动安全功能的设备明显比具有手动激活翻转保护装置的设备更有效，而具有手动激活滑动保护装置的设备又明显比具有手动激活滑动保护装置的设备更有效（P<0.001，卡方检验）。当考虑到医疗程序的类型时，也观察到 SED 效果的相同梯度。
被动 SED 最能有效预防 NSI。需要进一步研究以确定其较高的成本是否可以通过减少 NSI 和减少用户培训需求相关的节省来抵消。
