Zarei Omid, Zeraatpishe Fatemeh, Beygi Najimeh, Moghadam Maryam Talebi, Mousavi Shahraki Seyede Fatemeh, Naghizadeh Mohammad Mehdi, Bijani Mostafa
Department of Anesthesiology, School of Allied Medical Sciences, Fasa University of Medical Sciences, Fasa, Iran.
Instructor of Operating Room, School of Allied Medical Sciences, Fasa University of Medical Sciences, Fasa, Iran.
BMC Nurs. 2025 Mar 3;24(1):236. doi: 10.1186/s12912-025-02839-x.
Needle-stick injuries (NSIs) pose a substantial occupational hazard, exposing healthcare professionals to potentially infectious diseases. Nurses' clinical competence plays a crucial role in preventing and mitigating the incidence of NSIs. This study aimed to investigate the relationship between clinical competence and the incidence of NSIs, as well as the factors contributing to these injuries, among nurses in Fars Province, southern Iran, from March 2023 to May 2023.
This descriptive cross-sectional study included 264 nurses selected through convenience sampling. All participants were employed in various departments of teaching hospitals in Fasa city, southern Iran, during the study period. Data were collected using a demographic questionnaire and a clinical competence questionnaire specifically developed for nurses. The demographic questionnaire captured variables such as age, gender, marital status, educational background, departmental assignment, work experience, and weekly working hours. The clinical competence questionnaire consisted of 55 items assessing seven dimensions: clinical care, leadership, legal and ethical performance, professional development, interpersonal relationships, education and coaching, and critical thinking and research aptitude. Statistical analyses were performed using SPSS software (version 16), employing the Chi-square test, Kruskal-Wallis test, and multiple logistic regression analysis. A significance level of p < 0.05 was applied to all tests.
The findings revealed that 39.4% of the participating nurses exhibited high clinical competence, 51.5% demonstrated moderate competence, and 9.1% were classified as having low competence. Statistical analysis indicated a significant association between clinical competence levels and needle-stick status (P = 0.002). Moreover, a significant difference was identified between clinical competence levels and the frequency of NSIs (P = 0.001). A logistic regression model was employed to assess the likelihood of NSIs based on demographic variables. The results showed that 178 participants (67.42%) had experienced needle-stick or sharp injuries within the preceding year. Among these, 63 males (35.3%) and 115 females (64.6%) reported such incidents. The highest incidence of needle-stick and sharp injuries occurred in the Operating Room (91.7%), followed by Dialysis (88.9%), Pediatrics (80%), Surgical Intensive Care (76.5%), Emergency (74.3%), Women's Surgery (70%), Post-Cardiac Intensive Care (69.2%), Oncology (63.6%), Internal Medicine (59.1%), Surgery and Infectious Diseases (54.5%), Laboratory and Cardiac Intensive Care (52.9%), Men's Surgery (50%), and the Psychiatric Ward (41.2%).
Considering that the majority of nurses working in hospitals exhibited moderate to low levels of clinical competence, it is recommended that hospitals implement an annual clinical competence assessment for nurses. Regular evaluations and targeted training programs can enhance nurses' competence levels, thereby improving patient care quality and reducing the incidence of NSIs among healthcare providers. Additionally, specific strategies should be developed and implemented in medical centers and hospitals to mitigate the risk of NSIs across all hospital departments, particularly in high-risk areas such as operating rooms and dialysis units, where the prevalence of NSIs is significantly higher.
Not applicable.
针刺伤对医护人员构成重大职业危害，使其面临感染潜在传染病的风险。护士的临床能力在预防和降低针刺伤发生率方面起着关键作用。本研究旨在调查2023年3月至2023年5月伊朗南部法尔斯省护士的临床能力与针刺伤发生率之间的关系，以及导致这些伤害的因素。
本描述性横断面研究通过便利抽样选取了264名护士。在研究期间，所有参与者均受雇于伊朗南部法萨市教学医院的各个科室。数据通过一份人口统计学问卷和一份专门为护士编制的临床能力问卷收集。人口统计学问卷获取了年龄、性别、婚姻状况、教育背景、科室分配、工作经验和每周工作时长等变量。临床能力问卷由55个项目组成，评估七个维度：临床护理、领导力、法律和道德表现、专业发展、人际关系、教育与指导以及批判性思维和研究能力。使用SPSS软件（版本16）进行统计分析，采用卡方检验、Kruskal-Wallis检验和多元逻辑回归分析。所有检验的显著性水平设定为p < 0.05。
研究结果显示，39.4%的参与护士表现出高临床能力，51.5%表现出中等能力，9.1%被归类为低能力。统计分析表明临床能力水平与针刺伤状况之间存在显著关联（P = 0.002）。此外，临床能力水平与针刺伤频率之间也存在显著差异（P = 0.001）。采用逻辑回归模型根据人口统计学变量评估针刺伤的可能性。结果显示，178名参与者（67.42%）在过去一年中曾经历针刺或锐器伤。其中，63名男性（35.3%）和115名女性（64.6%）报告了此类事件。针刺和锐器伤发生率最高的科室是手术室（91.7%），其次是透析科（88.9%）、儿科（80%）、外科重症监护室（76.5%）、急诊科（74.3%）、妇科手术（70%）、心脏重症监护后病房（69.2%）、肿瘤科（63.6%）、内科（59.1%）、外科和传染病科（54.5%）、实验室和心脏重症监护室（52.9%）、男科手术（50%）以及精神科病房（41.2%）。
鉴于大多数在医院工作的护士临床能力水平为中等至低等，建议医院对护士进行年度临床能力评估。定期评估和针对性培训项目可以提高护士的能力水平，从而改善患者护理质量并降低医护人员针刺伤的发生率。此外，应在医疗中心和医院制定并实施具体策略，以降低所有医院科室针刺伤的风险，特别是在针刺伤发生率显著较高的高风险区域，如手术室和透析科室。
不适用。
