Artemis Hospital, Sector 51, Gurugram, Haryana 122001, India.
Artemis Hospital, Sector 51, Gurugram, Haryana 122001, India.
J Healthc Qual Res. 2020 May-Jun;35(3):141-148. doi: 10.1016/j.jhqr.2020.03.007. Epub 2020 May 20.
Needle stick injuries are associated with a 0.3-30% risk of transmission of Human Immunodeficiency virus, Hepatitis C virus, and Hepatitis B virus. Despite causing psychological trauma they also involve a huge financial burden. A robust process improvement (RPI) toolkit was introduced in order to effectively manage and reduce needle stick injuries, as well as an attempt to report prevalence, post-exposure management, and associated economic burden.
Prospective Observational Study (2015-2018) has been design in a Corporate Tertiary Care Hospital. The participants included were needle stick injuries exposed staff. RPI toolkit was implemented (2015-2018) focusing on root cause analysis, availability of safety engineered devices, immunization and post-exposure management of needle stick injuries exposed staff. The main outcome measure was needle stick injuries incidence.
A total of 211 needle stick injuries were reported (mean - 52.72/year, needle stick injury incidence - 13.18/year/100 beds). Yearly trends showed a decrease of 21.3% in injuries from 2015 (61) to 2018 (48). Half (106, 50%) of the total injuries were reported among nurses. Use of hypodermic needles was involved in 116 (55%) injuries, with 114 (54%) occurring due to nonadherence to hospital policies. Overall, 204 staff had protective immunity, and 135 (64%) of these had completed their Hepatitis B immunizations. The source was known in 165 (78%) cases, and 113 of these cases had an injury from a source with negative viral markers. A 6-month follow-up was completed in 90 cases. No seroconversion was reported. Overall costs incurred in post-exposure prophylaxis was approximately €30,000 (mean cost €143.50/needle stick injury).
Nurses are most at risk of needle stick injury in healthcare settings. Implementation of RPI toolkit led to a 21.3% reduction in sharps injury incidences. These injuries incur huge financial burden on the hospital. Appropriate immunization strategies saved about €1360 expenditure on post-exposure prophylaxis.
针刺伤的人类免疫缺陷病毒、丙型肝炎病毒和乙型肝炎病毒传播风险为 0.3-30%。尽管造成心理创伤，但也带来了巨大的经济负担。引入了强大的流程改进 (RPI) 工具包，以有效管理和减少针刺伤，并尝试报告患病率、接触后管理和相关的经济负担。
在一家企业三级保健医院进行了前瞻性观察研究（2015-2018 年）。参与者包括暴露于针刺伤的员工。实施了 RPI 工具包（2015-2018 年），重点是根本原因分析、安全工程设备的可用性、暴露于针刺伤的员工的免疫接种和接触后管理。主要观察指标是针刺伤发生率。
共报告了 211 例针刺伤（平均每年 52.72 例，针刺伤发生率每年 13.18/100 张床位）。逐年趋势显示，2015 年（61 例）至 2018 年（48 例）的伤害减少了 21.3%。总伤害的一半（106 例，50%）发生在护士中。使用皮下注射器涉及 116 例（55%）损伤，其中 114 例（54%）是由于不遵守医院政策所致。总体而言，204 名员工具有保护性免疫力，其中 135 名（64%）完成了乙型肝炎免疫接种。在 165 例（78%）病例中已知来源，其中 113 例来源的病毒标志物为阴性。在 90 例中完成了 6 个月的随访。没有报告血清转换。接触后预防的总费用约为 30,000 欧元（平均每例针刺伤 143.50 欧元）。
在医疗保健环境中，护士最容易受到针刺伤的伤害。实施 RPI 工具包使锐器伤发生率降低了 21.3%。这些伤害给医院带来了巨大的经济负担。适当的免疫接种策略节省了大约 1360 欧元的接触后预防支出。
