27.09.2006

Effectiveness of measures to prevent needlestick injuries among employees in health professions

The pathogens of greatest concern that may be transmitted by a needlestick
injury (NSI) are hepatitis B (HBV), hepatitis C (HCV), and human
immunodeficiency virus (HIV). The objective of the study was to critically
review and summarize the published literature on NSI, with the main focus on
studies evaluating the effectiveness and cost aspects of the implementation of
safer devices and other preventive measures in hospitals.

A comprehensive literature search on MEDLINE identified more than 2,300
publications. A multi-stage selection process was used to identify those
studies appropriate for inclusion in the Quality Based Critical Review (QBCR),
which finally included 61 publications on intervention studies. These studies
were evaluated and rated according to quality indicators. Additionally, papers
discussing the costs and benefits of the introduction of safer device have been
analyzed.

Those with the most patient contact, nurses and physicians, were the most
likely to report NSI, and NSI were most likely to occur in patient and
operating rooms. However, underreporting presents a serious problem for the
development of accurate risk estimates. The majority of the intervention
programs, despite large differences in methodological quality, showed in
general that engineering controls, especially the introduction of
safety-designed devices, were effective in reducing the number of reported NSI.
There are only few studies investigating the cost-effectiveness of this
introduction and their results are suggesting that a complete substitution
currently might not be cost neutral for a hospital. However, these studies
showed little methodological consistency and therefore do not allow to draw
firm conclusions. Societal as well as intangible costs and benefits should be
considered in an overall assessment.

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AplusA-online.de - Source: European Agency for Safety and Health at Work