Prevalence of and risk factors for needlestick and sharps injuries among nursing students in Hong Kong

doi:10.1016/j.ajic.2012.01.023

American Journal of Infection Control

Volume 40, Issue 10, December 2012, Pages 997-1001

https://doi.org/10.1016/j.ajic.2012.01.023 Get rights and content

Background

Although nursing students are at greater risk for needlestick injuries (NSIs) and sharps injuries (SIs) than staff nurses, there is a lack of research on NSIs and SIs in students, especially in different years of study. The purpose of this study was to identify the risk factors for and prevalence of NSIs and SIs among nursing students in different years of study.

Methods

This was a cross-sectional survey study using a questionnaire confirmed to be valid and reliable, with a content validity index of 0.96 and reliability index of 0.82.

Results

A total of 878 nursing students (response rate, 76.61%), participated in the study. NSIs/SIs, NSIs, and SIs were significantly increased by year of study (P < .001) in both the study period and 12-month prevalence. Four predictors for NSIs/SIs were final-year study (odds ratio [OR], 11.9; 95% confidence interval [CI], 3.9-36.7), perception of not receiving prevention training (OR, 2.8; 95% CI, 1.1-7.5), perception of not using a kidney dish to contain used needles and sharps (OR, 4.2; 95% CI, 1.7-10.3), and perception of not immediately discarding used needles and syringes into a sharps box (OR, 2.9; 95% CI, 1.2-7.4).

Conclusions

Preclinical training, reinforcement of kidney dish use, immediate discarding of used needles, and adequate clinical supervision are essential elements in reducing the risk of NSIs and SIs.

Section snippets

Methods

In this cross-sectional survey study, participants were recruited by convenience sampling from a university with the largest number of nursing students among the 4 universities providing nursing education in Hong Kong.¹⁷

Results

A total of 1,146 questionnaires were distributed and 878 were returned, for a response rate of 76.61%. The response rate was 95.57% for first-year students, 87.17% for second- or third-year students, and 58.87% for final-year students. Questionnaires were distributed to students in class on weekdays on their usual study days, except for final-year students. The final-year students had clinical placement during weekdays and were scheduled to attend a 2-hour seminar on one particular Saturday, a

Discussion

This study is the first large-scale survey of the prevalence of NSIs/SIs, NSIs, and SIs and their associated factors among nursing students in Hong Kong. Our finding of year of study as a predictor for NSI and SI are consistent with a report from Australia,¹⁹ but not with findings from Italy⁷ and Turkey.¹⁰ In Australia, the 12-month prevalence of NSIs increased with year of study, from 4.3% in the first year to 11.4% in the second year and then 40.4% in the final year.¹⁹ In contrast, in Italy

Conclusion

This is the first large-scale study investigating NSIs and SIs among nursing students. Our data show that the prevalence of NSIs and SIs varies with year of study. Preclinical training, use of a kidney dish, immediate disposal of used needles, and adequate clinical supervision are essential components to reduce NSIs and SIs. Future research should explore ways to improve injury reporting among nursing students.

References (22)

A. Tarantola et al.
Occupational blood and body fluids exposure in health care workers: four-year surveillance from the northern France network
Am J Infect Control
(2003)
J.S. Shiao et al.
Student nurses in Taiwan at high risk for needlestick injuries
Ann Epidemiol
(2002)
D.R. Smith et al.
Epidemiology of needlestick and sharps injuries among professional Korean nurses
J Prof Nurs
(2006)
Y.H. Yang et al.
Needlestick/sharps injuries among vocational school nursing students in southern Taiwan
J Infect Control
(2004)
W.X. Yao et al.
Needlestick injuries among nursing students in China
Nurse Educ Today
(2010)
M. Askarian et al.
Needlestick injuries among nurses of Fars Province, Iran
Ann Epidemiol
(2007)
Y. Nagao et al.
A long-term study of sharps injuries among health care workers in Japan
Am J Infect Control
(2007)
W. Phipps et al.
Risk of medical sharps injuries among Chinese nurses
Am J Infect Control
(2002)
D.R. Smith et al.
Epidemiology of needlestick and sharps injuries among nurses in a Japanese teaching hospital
J Hosp Infect
(2006)
K. Cheung et al.
Analysis of needlestick injures among nursing students in Hong Kong
Accid Anal Prev
(2010)

S.P. Clarke

Hospital work environments, nurse characteristics, and sharps injuries

Am J Infect Control

(2007)

Cited by (32)

Is possible to train health professionals in prevention of high-risk pathogens like the Ebola by using the mobile phone?
2019, Telematics and Informatics
Citation Excerpt :
From previous published studies, it is observed that nursing professionals are particularly susceptible to needle pricks, with this being the group with the highest incidence of biological accidents (Dulon et al., 2017). There are numerous factors that may contribute to the possibility of a biological accident, such as lack of experience, skills, or knowledge in handling materials; anxiety; inadequate working conditions, mental fatigue, or exhaustion; and lack of awareness towards oneself or other professionals (Cavalcante et al., 2013; Cheung et al., 2012; Petrucci et al., 2009; Souza-Borges et al., 2014; Tarantola et al., 2003; Yao et al., 2010). According to Olivera and Paiva, in the face of emergencies, health professionals have a higher incidence of biological accidents and a higher prevalence in the absence of the use of standard precautionary measures.
Health professionals are a concerning risk population because of the high prevalence of exposure to biological, especially during training that involves procedures implying direct contact with bodily fluids. Notwithstanding, the considerable advance of information and communication technologies (ICTs) during the last decades has provided with the divergence of new paths of research applied to training in the health field, allowing it integration in the field of biological risk prevention.
The objectives of this study are: firstly, to estimate the level of knowledge about risk situations and the immediate response capacity of future professionals, prepare health professionals before different scenarios that can be presented in health care, and contribute to the appropriate decision making in possible scenarios. Secondly, to design and develop a mobile web application that, in a fast and ever-present manner, allows the healthcare professional, to have a quick response system that is clear and concise; and to evaluate by health students’ and professionals’ opinions the effectiveness of the technology developed.
This study has been structured in two phases: first, to determine the degree of knowledge and compliance of biosecurity measures; and second, to perform a dual evaluation of the application.
The survey of graduating students concerning practices has shown that the knowledge of risk prevention is adequate; meanwhile, a dynamic and efficient platform has been obtained, and its double assessment is satisfactory.
It has been shown that the incidence of biological accidents is in the mean of the results of previous studies. An upgradeable web platform, ubiquitous and capable of being used in any electronic device available in the market, was obtained.
Exposure Survey of Trends in Occupational Practice (EXPO-S.T.O.P.) 2015: A national survey of sharps injuries and mucocutaneous blood exposures among health care workers in US hospitals
2017, American Journal of Infection Control
Citation Excerpt :
Of the hospitals participating in EXPO-S.T.O.P. 2015, 43% were teaching hospitals. The increased SI rate in teaching hospitals over nonteaching hospitals (Table 2) mirrors that of previous EXPO-S.T.O.P.,5-7 EPINet,2 and MADPH4 surveys and is indicative of a teaching hospital's higher procedure intensity with concomitant higher use of sharps15 and their training role for nursing students16 and medical students,17 together with the added SI incidence in research (ie, nonbed) departments in teaching hospitals. In terms of clinical work groups, of the total reported SIs, 45.6% were reported by nurses and 32.8% by doctors.
National blood exposure (BE) surveys are valuable to health care facilities striving to reduce percutaneous sharps injuries (SIs) or mucocutaneous (MC) exposures among their health care workers (HCWs). In the Exposure Survey of Trends in Occupational Practice (EXPO-S.T.O.P.) 2015 we surveyed hospital BE incidence among members of the Association of Occupational Health Professionals in Healthcare.
A 23-item electronic survey requested 2015 data on total SI and MC; SI in nurses, doctors, and surgery; staffed beds; teaching status; full time equivalent staff (FTE), nurse FTE, average daily census (ADC), and adjusted patient days (APD).
One hundred eighty-one hospitals in 34 states reported 9,343 BE (71% SI and 29% MC exposures). SI rates were 25.2/100 ADC (17.5 in nonteaching hospitals and 30.4 in teaching hospitals), 2.1/100 FTE (significantly less than that in 2001), 3.2/100 nurse FTE, 0.36/1,000 APD, and 38% occurred during surgery. MC exposure incidence rates were 10.5/100 ADC (8.6 in nonteaching hospitals and 11.7 in teaching hospitals), 0.86/100 FTE, and 0.14/1000 APD.
BE incidence rates have fallen slowly but significantly since 2001, but the reduction is far less than hoped. Occupied beds (ie, ADC) has become a less-useful denominator. We estimate more than 300,000 HCWs sustain SIs annually in hospital and nonhospital settings. Greater resources are needed for more frequent and correct use of safety devices, training to competency, and root-cause investigation of all SIs.
Compliance with standard precautions among baccalaureate nursing students in a Saudi university: A self-report study
2017, Journal of Infection and Public Health
Citation Excerpt :
Direct experience is an invaluable tool in psychomotor skill development and enhancement of decision-making [44]. As nursing students’ studies progress, they gradually get more practice in the nursing procedures that necessitate them to use standard precautions, and their skill competency improves [45]. In addition, students who had longer clinical exposure are more familiar with the hospital's guidelines and protocols regarding infection control and prevention, thus increasing their practice in observance of standard precautions.
Meticulous observance of standard infection control precautions by health care providers is strongly recommended for every patient encounter. Assessment of nursing students’ compliance should be carried out regularly in order to ensure adherence to protocols. Thus, this study was conducted to assess self-reported compliance with standard precautions among baccalaureates in nursing students in a Saudi university. A convenience sample of 236 nursing students was surveyed in this cross-sectional, self-reported study, using the Compliance with Standard Precaution Scale Arabic version (CSPS-A). Independent t-test and one-way analyses of variance (ANOVA) were performed to examine the differences on compliance. A multiple regression analysis was performed to identify the factors affecting compliance. The overall compliance rate was 61.0%. The students reported highest compliance in disposing used sharp instruments and other sharp objects into sharps-only boxes, while the lowest compliance rate in using water only for hand washing. Significant differences in compliance were observed when respondents were grouped according to their demographic characteristics. Cultivating a supportive culture of adherence to infection control precautions among nursing students is of paramount importance. The clinical environment should be supportive of a culture where strict compliance with the control and prevention of infection is of prime importance.
Predictors for compliance of standard precautions among nursing students
2015, American Journal of Infection Control
Citation Excerpt :
Their ages ranged from 18-29 years, with a mean age of 21.02 ± 1.46 years. The sex distribution of the study sample (female/male = 3:1) was similar to the sex ratio of students enrolled in the programs.19 More than 70% (n = 486) of NSs had attended SPs training.
We aimed to investigate the frequency of standard precautions (SPs) compliance and the factors affecting the compliance among nursing students (NSs).
A cross-sectional survey study guided by the health belief model was conducted in 2009. The study questionnaire is valid (content validity index, 0.81) and reliable (Cronbach α range, 0.65-0.94).
There were 678 questionnaires analyzed, with a response rate of 68.9%. The mean frequency score of SPs compliance was 4.38 ± 0.40 out of 5. Tukey honest significant difference post hoc test indicated that year 2 and year 4 students had better SPs compliance than year 3 students. Further analysis using a univariate general linear model identified an interaction effect of perceived influence of nursing staff and year of study (F_1,593 = 3.72; P < .05). The 5 following predictors for SPs compliance were identified: knowledge of SPs, perceived barriers, adequacy of training, management support, and influence of nursing staff.
Although the SPs compliance among NSs was high, the compliance varied by year of study and was affected by the nursing staff. Furthermore, SPs compliance among NSs can be enhanced by increasing SPs knowledge, providing more SPs training, promoting management support, reducing identified SPs barriers, and improving nursing staff compliance to SPs.
Sharps injuries within the healthcare student population: A narrative review
2023, British Journal of Nursing
Determination and prioritization of factors affecting the occurrence of needle stick injuries among healthcare workers using techniques of Delphi and fuzzy analytical hierarchy process (FAHP)
2023, BMC Public Health

View all citing articles on Scopus

: Funding for this study was provided by The Hong Kong Polytechnic University.

: Conflict of interest: None to report.

View full text

Major articlePrevalence of and risk factors for needlestick and sharps injuries among nursing students in Hong Kong

Background

Methods

Results

Conclusions

Section snippets

Methods

Results

Discussion

Conclusion

Am J Infect Control

Ann Epidemiol

J Prof Nurs

J Infect Control

Nurse Educ Today

Ann Epidemiol

Am J Infect Control

Am J Infect Control

J Hosp Infect

Accid Anal Prev

Am J Infect Control

Major article
Prevalence of and risk factors for needlestick and sharps injuries among nursing students in Hong Kong