Needlestick prevention: new paradigms for research.

نویسنده

  • J L Gerberding
چکیده

The Centers for Disease Control has recommended safe needle disposal practices to prevent percutaneous exposures to bloodborne pathogens for the last decade.1,2 Infection control policies and procedures based on these guidelines have been implemented in most US healthcare facilities, but few have noted an appreciable decline in needlestick incidence. Hospital infection control practitioners have traditionally relied on behavioral interventions to achieve infection control goals. In the case of needle safety, these interventions include glove use, nonrecapping of needles, and prompt needle disposal in punctureresistant containers. Although this strategy has a sound theoretical basis, in practice, many factors appear to reduce compliance with the recommended behaviors. The extent to which knowledge deficits (inadequate training and risk education), motivational prob lems (failure to appreciate risk, unwillingness to change old habits), skills deficits, equipment problems, competing hazards, and administrative issues (e.g., inadequate staffing) interfere with infection control goals has not been entirely elucidated. However, a growing body of evidence indicates that behavioral interventions alone are not adequate to prevent needle injuries and that a more comprehensive approach is needed. Two novel frameworks for evaluating needle injuries are described in this issue. The success of both of these projects indicates that adopting research methods and risk reduction models from disciplines not traditionally applied to infection control may enhance understanding of the determinants of healthcare worker safety. English applies adult learner theories to the needlestick problem.3 In her model, knowledge of correct procedures, provision of safe equipment, and proper management predicted compliance with needle precautions. This approach could easily be expanded to include assessment of other factors considered important in learning new behaviors, such as beliefs and attitudes about the risks associated with the undesired behavior (needle injury), the probability that behavior change (nonrecapping) will lead to the desired outcome, and the ability to successfully accomplish behavior change (self-efficacy).4 Haiduven et al have introduced other important concepts that draw from both learning theory an.d the industrial hygiene model.5 Their program demonstrated that knowledge of needle safety precautions (training), engineering controls (access to safe disposal containers), and motivation (feedback about injury mechanisms) can significantly reduce needle recapping injuries. The new standards promulgated by the Occupational Safety and Health Administration for preventing occupational exposure to bloodborne pathogens emphasize provision of engineering and administrative controls as well as behavioral controls to prevent needle injuries.‘j Although this approach to risk management has been employed in other work sites for many years, adaptation of these control strategies to healthcare institutions is a relatively recent phenomenon. In retrospect, most infection control practitioners overestimated the efficacy of behavioral interventions and were slow to apply established principles of industrial hazard control to healthcare environments.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

The impact of the Needlestick Safety and Prevention Act on home care and hospice organizations.

Administrators, managers, and clinicians need to be up-to-date on all aspects of the new Needlestick Safety and Prevention Act recently passed into law. This article gives the background and foundation needed to implement policies, procedures, and actions that will assure compliance with the law and increased worker safety.

متن کامل

A new approach to needlestick injuries among health care workers.

Reducing needlestick injuries has become an important topic of discussion for health care workers, politicians, employers, researchers, and government agencies. Demand for action has evoked strong responses from multiple players, and subsequently, greater public awareness. Speci® cally, the safety of health care workers has been emphasized; as a preventable occupational health hazard, needlesti...

متن کامل

Needlestick injuries in dentists and their assistants in Kerman, Iran: Prevalence, knowledge, and practice

BACKGROUND AND AIM: Needlestick (NS) injuries are one of the most important subjects in the dental field which can cause so many dangerous blood-borne diseases. The aim of this study was to evaluate the prevalence, knowledge, and practice of dentists and their assistants about exposure to sharp contaminated instruments in Kerman, Iran, in 2012. METHODS: In this cross-sectional study, self-admin...

متن کامل

Using of health belief model on needlestick injuries and bloodborne pathogens among nurses

Needle Stick Injury (NSI) is one of the spread abroad and dangerous risks in nurse job that HIV, HCV and HBV are the most common infection which were transferred by blood. The aim of this study was evaluation of the education effect basis of the health belief model of knowledge and behavioral prevention of NSI. This study was a quasi-experimental that 165 nurses were selected incidentally from ...

متن کامل

Risk Factors of Needlestick and Sharps Injuries among Healthcare Workers

Background and Objectives: Exposure to contaminated needlesticks and sharp devices is an important occupational hazard among healthcare workers. The objective of this study was to gain further insight into prevalence and risk factors of needlestick and sharps injuries among healthcare workers. Methods: A cross-sectional survey was carried out among 384 healthcare workers of two hospitals in N...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Infection control and hospital epidemiology

دوره 13 5  شماره 

صفحات  -

تاریخ انتشار 1992