Hostname: page-component-76fb5796d-9pm4c Total loading time: 0 Render date: 2024-04-25T14:08:43.425Z Has data issue: false hasContentIssue false
  • English
  • Français

Needlestick Injury Rates According to Different Types of Safety-Engineered Devices: Results of a French Multicenter Study

Published online by Cambridge University Press:  02 January 2015

William Tosini ,
Céline Ciotti ,
Floriane Goyer ,
Isabelle Lolom ,
François L'Hériteau ,
Dominique Abiteboul ,
Gerard Pellissier  and
Elisabeth Bouvet
William Tosini
Affiliation:
Department of Infectious Diseases, Paris, France Bichat University Hospital, the Group for the Prevention of Occupational Infections in Healthcare Workers, Xavier Bichat Faculty of Medicine, Paris, France
Céline Ciotti
Affiliation:
Bichat University Hospital, the Group for the Prevention of Occupational Infections in Healthcare Workers, Xavier Bichat Faculty of Medicine, Paris, France
Floriane Goyer
Affiliation:
Bichat University Hospital, the Group for the Prevention of Occupational Infections in Healthcare Workers, Xavier Bichat Faculty of Medicine, Paris, France
Isabelle Lolom
Affiliation:
Bichat University Hospital, the Group for the Prevention of Occupational Infections in Healthcare Workers, Xavier Bichat Faculty of Medicine, Paris, France
François L'Hériteau
Affiliation:
Centre de Coordination de la Lutte contre les Infections Nosocomiales (CCLIN) Paris Nord, Paris, France
Dominique Abiteboul
Affiliation:
Department of Occupational Medicine, Paris, France Bichat University Hospital, the Group for the Prevention of Occupational Infections in Healthcare Workers, Xavier Bichat Faculty of Medicine, Paris, France
Gerard Pellissier*
Affiliation:
Bichat University Hospital, the Group for the Prevention of Occupational Infections in Healthcare Workers, Xavier Bichat Faculty of Medicine, Paris, France
Elisabeth Bouvet
Affiliation:
Department of Infectious Diseases, Paris, France Bichat University Hospital, the Group for the Prevention of Occupational Infections in Healthcare Workers, Xavier Bichat Faculty of Medicine, Paris, France
*
UFR de Medecine Bichat, GERES, 16 rue Henri Huchard, F-75018 Paris, France
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives.

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.

Design.

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.

Results.

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, x2 test). The same gradient of SED efficacy was observed when the type of healthcare procedure was taken into account.

Conclusions.

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.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 31 , Issue 4 , April 2010 , pp. 402 - 407
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Sohn, SJ, Eagan, J, Sepkowitz, KA, Zuccotti, G. Effect of implementing safety-engineered devices on percutaneous injury epidemiology. Infect Control Hosp Epidemiol 2004;25:536–542.Google Scholar
2. Circulaire DGS/DH n_98/249 du20/4/1998 relative à la prévention de la transmission d'agents infectieux véhiculés par le sang ou les liquides biologiques lors des soins dans les établissements de santé. Paris: Ministère de l'Emploi et de la Solidarité, 1998. http://www.sante.gouv.fr/htm/pointsur/contamination/98_249t.htm. Accessed February 8, 2010.Google Scholar
3. Tuma, SJ, Sepkowitz, KA. Efficacy of safety-engineered device implementation in the prevention of percutaneous injuries: a review of published studies. Clin Infect Dis 2006;42:1159–1170.CrossRefGoogle ScholarPubMed
4. Elder, A, Paterson, C. Sharps injuries in UK health care: a review of injury rates, viral transmission and potential efficacy of safety devices. Occup Med (Lond) 2006;56:566–574.CrossRefGoogle ScholarPubMed
5. Adams, D, Elliott, TSJ. Impact of safety needle devices on occupationally acquired needlestick injuries: a four-year prospective study. J Hosp Infect 2006;64:50–55.CrossRefGoogle ScholarPubMed
6. Whitby, M, McLaws, ML, Slater, K. Needlestick injuries in a major teaching hospital: the worthwhile effect of hospital-wide replacement of conventional hollow-bore needles. Am J Infect Control 2008;36:180–186.CrossRefGoogle Scholar
7. Jagger, J, Perry, J, Gomaa, A, Kornblatt Phillips, E. The impact of US policies to protect healthcare workers from bloodborne pathogens: the critical role of safety-engineered devices. J Infect Public Health 2008;1:62–67.CrossRefGoogle ScholarPubMed
8. Lamontagne, F, Abiteboul, D, Lolom, I, et al. Role of safety-engineered devices in preventing needlestick injuries in 32 French hospitals. Infect Control Hosp Epidemiol 2007;28:18:23.Google Scholar
9. Chiarello, LA. Selection of needlestick prevention devices: a conceptual framework for approaching product evaluation. Am J Infect Control 1995;23:386–395.Google Scholar
10. Alvarado-Ramy, F, Beltramy, EM, Short, LJ, et al. Comprehensive approach to percutaneous injury prevention during phlebotomy: results of a multicenter study, 1993-1995. Infect Control Hosp Epidemiol 2003;24:97–104.CrossRefGoogle ScholarPubMed
11. Iinuma, Y, Igawa, J, Takeshita, M, et al. Passive safety devices are more effective at reducing needlestick injuries. J Hosp Infect 2005;61:360–361.CrossRefGoogle ScholarPubMed
12. Tarantola, A, Golliot, F, Astagneau, P, et al. Occupational blood and body fluids exposures in healthcare workers: four-year surveillance from the Northern France Network. Am J Infect Control 2003;31:357–363.Google Scholar
13. L'Hériteau, F, Tarantola, A, Olivier, M, et al. Variation in blood and body fluids exposure when small-gauge needles or peripheral venous catheters were implicated: results of a 4-year surveillance in France. Am J Infect Control 2006;34:215–217.Google Scholar
14. Venier, AF, Vincent, A, L'Hériteau, F, et al. Surveillance of occupational blood and body fluid exposures among French healthcare workers in 2004. Infect Control Hosp Epidemiol 2007;28:1196–1201.CrossRefGoogle ScholarPubMed
15. Groupe d'Etude sur le Risque d'Exposition des Soignants aux Agents Infectieux. Guide des matériels de sécurité. Paris: Ministère de la Santé, 2004. http://www.sante.gouv.fr/htm/pointsur/nosoco/guide_matsecu.pdf. Accessed February 8, 2010.Google Scholar
16. De Carli, G, Puro, V, Jagger, J. Needlestick-prevention devices: we should already be there. J Hosp Infect 2009;71:183–184.CrossRefGoogle Scholar
17. Patel, N, Tignor, G. Device-specific sharps injury and usage rates: an analysis by hospital department. Am J Infect Control 1997;25:77–84.Google Scholar
18. Ippolito, G, DeCarli, G, Puro, V, et al. Device-specific risk of needlestick injury in Italian health care workers. JAMA 1994;272:607–610.Google Scholar
19. Mendelson, MH, BY, Lin-Chen, Solomon, R, et al. Evaluation of a safety resheathable winged steel needle for prevention of percutaneous injuries associated with intravascular-access procedures among healthcare workers. Infect Control Hosp Epidemiol 2003;24:105–112.Google Scholar
20. Peate, WE Preventing needlesticks in emergency medical system workers. J Occup Environ Med 2001;43:554–557.Google Scholar
21. Weinbren, MJ, Hardwick, A, Perinpanayagam, RM, Thayalan, AS. Lancets as a source of sharps injuries. J Hosp Infect 1998;38:235–236.CrossRefGoogle ScholarPubMed
22. Coté, CJ, Roth, AG, Wheeler, M, et al. Traditional versus new needle retractable IV catheters in children: are they really safer, and whom are they protecting? Anesth Analg 2003;96:387–391.Google Scholar
23. Prunet, B, Meaudre, E, Montcriol, A, et al. A prospective randomized trial of two safety peripheral intravenous catheters. Anesth Analg 2008;107: 155–158.Google Scholar
24. Haiduven, D, Applegarth, S, Shroff, M. An experimental method for detecting blood splatter from retractable phlebotomy and intravascular devices. Am J Infect Control 2009;37:127–130.Google Scholar
25. Puglieses, G, Germanson, TP, Barthley, J, et al. Evaluating sharps safety devices: meeting OSHA's intent. Infect Control Hosp Epidemiol 2001;22: 456-458.Google Scholar
26. Isaya, NT, Barger, LK, Cade, BE, et al. Extended work duration and the risk of self-reported percutaneous injuries in interns. JAMA 2006;296: 1055–1062.Google Scholar
27. De Graaf, R, Van Zessen, G. Occupational risk of HIV infection among Western healthcare professionals posted in AIDS endemic areas. AIDS Care 1998;10:441–452.Google Scholar
28. Fisman, DN, Harris, AD, Rubin, M, Sorock, GS, Mittleman, MA. Fatigue increased the risk of injury from sharp devices in medical trainees: results of a case-crossover study. Infect Control Hosp Epidemiol 2007;28:10–17.Google Scholar