Ippolito G, De Carli G, Puro V, Petrosillo N, Arici C, Bertucci R, Bianciardi L, Bonazzi L, Cestrone A, Daglio M
Lazzaro Spallanzani Hospital for Infectious Diseases, Rome, Italy.
JAMA. 1994;272(8):607-10.
To identify the types of medical devices causing needlestick injuries among Italian health care workers, to document the device-specific injury rates and time trends for different hollow-bore needles, and to compare injury rates from these devices with those reported in the United States.
Longitudinal survey.
Twelve Italian acute care public hospitals.
Data were obtained from a multihospital surveillance database on the number of total injuries reported in each device category. Hospitals provided the corresponding number of devices used annually for each needle type.
Number of needlestick injuries by type of hollow-bore needle per 100,000 devices used per year.
A total of 2524 injuries from hollow-bore needles were reported. Disposable syringes/hypodermic needles accounted for 59.3% of injuries, followed by winged steel needles (33.1%), intravenous catheter stylets (5.4%), and vacuum-tube phlebotomy needles (2.2%). Intravenous catheter stylets had the highest needlestick injury rate (15.7/100,000 devices used), and disposable syringes had the lowest needlestick injury rate (3.8/100,000). In contrast to the other devices, the injury rate from winged steel needles increased from 6.2 per 100,000 in 1990 to 13.9 per 100,000 in 1992.
The device-specific needlestick injury rates in Italy are similar to those reported in the United States, suggesting similar exposure experience in two countries. However, in contrast to the United States, needleless intravenous access is standard practice in Italy and thus eliminates one potential risk to Italian health workers. Implementation of safer equipment, such as shielded or retracting needles, and continuing training programs are needed to further reduce the hazards that health care workers face.
确定导致意大利医护人员发生针刺伤的医疗设备类型，记录不同空心针的特定设备损伤率和时间趋势，并将这些设备的损伤率与美国报告的损伤率进行比较。
纵向调查。
意大利12家急性护理公立医院。
数据来自多医院监测数据库中每个设备类别报告的总损伤数量。医院提供了每年每种针型使用的相应设备数量。
每年每100,000使用设备中空心针类型的针刺伤数量。
共报告了2524例空心针损伤。一次性注射器/皮下注射针占损伤的59.3%，其次是翼形钢针（33.1%）、静脉导管芯（5.4%）和真空管采血针（2.2%）。静脉导管芯的针刺伤率最高（每100,000使用设备中有15.7例），一次性注射器的针刺伤率最低（每100,000中有3.8例）。与其他设备不同，翼形钢针的损伤率从1990年的每100,000中有6.2例增加到1992年的每100,000中有13.9例。
意大利特定设备的针刺伤率与美国报告的相似，表明两国的暴露经历相似。然而，与美国不同的是，无针静脉通路在意大利是标准做法，因此消除了对意大利医护人员的一个潜在风险。需要实施更安全的设备，如带防护装置或可回缩的针头，并持续开展培训项目，以进一步降低医护人员面临的风险。
