Occupational Needlestick-Sharp Injuries during Clinical Practice Training and Status of Hepatitis B Immunization in Nursing and Midwifery Students

Abstract

Objective: The aims of this study were to identify the frequency of needlestick/sharps injuries NSISIs in nursing/midwifery students and the rate of Hepatitis B vaccination. Method: This descriptive survey was done on a sample of nursing and midwifery students using selfadministered questionnaire. The frequency and mechanism of needlestick and sharp injuries NSISIs and the prevalence of hepatitis B immunisation were determined retrospectively by surveying a nursing and midwifery school in a university. In May and June 2011. 325 84.5% students were questioned about NSISIs on whether they had experienced during their clinical practice and about their hepatitis B immunisation histories. The data were represented as percentages and analysed using Pearson χ2 -values. Results: 50.8% of the students reported NSISIs in clinical practice. 54.5% of injured students had been injured during or after a procedure. 50.3% of injured students said they hadn’t reported their injury. 27.5% of them reported that the injury occurred when recapping a needle. Overall 77.5% of all respondents had completed their series of vaccinations against hepatitis B. Conclusion: This study showed that students frequently sustain NSISIs and that the hepatitis B immunisation rate was low. The nursing and midwifery students should be trained about ocuppational risk to increase their awareness of and compliance their Universal Precaution and instituting policies so that they are fully immunised againist hepatitis B before begining clinical practice.

Keywords

• Needlestick-sharp injuries,nursing and midwifery students,Hepatitis B immunisation

Hemşirelik ve Ebelik Öğrencilerinin Klinik Uygulama Eğitimleri Sırasında Mesleki Delici-Kesici Yaralanmalar ve Hepatit B Aşılı Olma Durumları

Abstract

Amaç: Bu çalışma hemşirelik ve ebelik öğrencilerinde mesleki delici-kesici yaralanmaların sıklığı ve hepatit B bağışıklanma durumlarını belirlemek amacıyla yapıldı. Metod: Tanımlayıcı olarak yapılan bu çalışmada hemşirelik ve ebelik öğrencilerinin kendilerinin doldurdurduğu bir anket uygulandı. Çalışmada bir üniversitenin hemşirelik ve ebelik bölümünde okuyan öğrencilerde delicikesici yaralanmaların sıklığı ve Hepatit B aşılı olma durumları geriye dönük olarak belirlendi. Mayıs–Haziran 2011 tarihlerinde 325 %84,5 öğrenci klinik uygulamalı eğitimleri sırasında delici-kesici yaralanma maruziyeti ve Hepatit B aşılı olma durumları bakımından tarandı. Araştırmanın verileri yüzdelik ve Pearson Ki-Kare kullanılarak değerlendirildi. Bulgular: Öğrencilerin %50,8’i klinik uygulma sırasında delici-kesici yaralanma olduğunu bildirdi. Yaralanan öğrencilerin %54,5’i işlem sırasında ya da işlem sonrasında yaralandığını belirtti. Yaralanmış olan öğrencilerin %50,3’ü yaralanmayı rapor etmediğini söyledi. Bunların %27,5’i iğneyi kılıfına geçirirken yaralandığını bildirdi. Öğrencilerin %77,5’inin Hepatit B’ye karşı aşılanma serisini tamamladığı belirlendi. Sonuç: Bu çalışma öğrencilerde delici-kesici yaralanmaların sıklığının yüksek, hepatit B’ye karşı aşılı olma sıklığının düşük olduğunu dösterdi. Bu nedenle, hemşirelik ve ebelik öğrencilerine Uluslararası Önlemler ile ilgili farkındalıklarını arttırmak ve klinik uygulamaya başlamadan önce hepatit B’ye karşı tam bağışıklama için kurumun işleyişine uyumlarını sağlamak için eğitim yapılmalıdır

Keywords

• Delici-kesici yaralanmalar,hemşirelik ve ebelik öğrencileri,Hepatit B immünizasyonu

References

1. Sagoe-Moses C, Pearson RD, Perry J, Jagger J. Risks to health care workers in developing countries. N Engl J Med 2001; 345(7):538-541.
2. Tarantola A, Koumare A, Rachline A, Sow PS, Diallo MB, Doumbia S, Aca C. Grouped’Etude des Risquesd’Exposition des Soignants aux agents infectieux (GERES). A descriptive, retrospective study of 567 accidental blood exposures in healthcare workers in three West African countries. J Hosp Infect 2005; 60(3):276-282.
3. Prüss-Ustün A, Rapiti E, Huntin Y. Estimation of the global burden of disease attributable to contaminated sharps injuries among health-care workers. Am J Ind Med 2005; 48(6):482-490.
4. MacCannell T, Laramie AK, Gomaa A,Perz JF. Occupational exposure of health care personnel to Hepatitis B and Hepatitis C: Prevention and surveillance strategies. Clin Liver Dis 2010; 14(1):23-36.
5. Yang YH, Wu MT, Ho CK, Chuang HY., Chen L, Yang CY, Wu TN. Needlestick/sharp injuries among vocational school nursing students in southern Taiwan. Am J Infect Control2004;32(8):431-443.
6. Askarian M,Malekmakan L. The prevalence of needle stick injuries in medical, dental, nursing and midwifery students at the university teaching hospitals of Shiraz, Iran. Indian J Med Sci 2006; 60(6):227-232.
7. 7.Rampal L, Zakaria R, Sook LW, Zain AM. Needle stick and sharps injuries and factors associated among health care workers in a Malasian Hospital. Eur J Med Sci 2010; 13(3):354-362.
8. Patterson JMM, Novak CB, Mackinnon SE, Ellis RA. Needlestick injuries among medical students. Am J Infect Control 2003; 31(4):226-230.

9. Stewardson DA, Palenik CJ, McHugh ES, Burke FJT. Occupational exposures occurring in students in a UK dental school. Eur J Dent Edu 2002;6(3):104-113.
10. 10.Petrucci C, Alvaro R, Cicolini G, Cerone MP, Lancia L. Percutaneous and mucocutaneous exposures in nursing students: An Italian observational study. Nursing Scholarship 2009; 41(4):337-343.
11. 11.Shiao JSC, McLaws ML, Huang KY,Guo YL. Student nurses in Taiwan at high risk for needlestick injuries. AnnEpidemiol2002; 12(3):197-201.
12. Liddell MJ, Davidson SK, Taub H,Whitecross LE. Evaluation of procedural skills training in an undergraduate curriculum. Medical Education 2002; 36(11): 1035-1041.
13. Irmak Z,Baybuga MS. Needlestick and sharps injuries among Turkish students: A cross-sectional study. Int J NursPrac2011; 17(2):151-157.
14. 14.Yamazhan T, Durusoy R, Tasbakan MI, Tokem Y, Pullukcu H, Sipahi OR, Ulusoy S, Turkish Nursing Hepatitis Group. Nursing students’ immunisation status and knowledge about viral hepatitis in Turkey: a multi-centre cross- sectional study. IntNurs Rev 2011; 58(2):181-185.
15. 15.Ilhan MN, Durukan E, Aras E, Turkcuoglu S, Aygun R. Long working hours increase the risk of sharp and needlestick injury in nurses: the need for new policy implication. J AdvNurs 2006; 56(5):563-568.
16. 16.Altiok M, Kuyurtar F, Karacaoglu S, Ersoz G, Erdogan S. Healthcare workers experiences with sharps and needlestick injuries and precautions they took when injuring. (In Turkish). Journal of Maltepe University Nursing Science and Art 2009; 2(3):71-79.
17. 17.Omac M, Egri M,Karaoglu L. Evaluation of occupational needlestick-sharp injuries and status of hepatitis B immunization on nurses working at Malatya Province Hospitals (in Turkish). Journal of Inonu University Faculty of Med 2010; 17(1):19-25.
18. 18.Camacho-Ortiz A, Díaz-Rodríguez X, Rodríguez-López JM, Martínez-Palomares M, Palomares-De la Rosa A,Garza-Gonzalez E. A 5-year surveillance of occupational exposure to boodborne pathogens in a university teaching hospital in Monterrey, Mexico. Int. J Med Students 2015, 3(1):24-28.
19. 19.Karadag M. Occupational exposure to blood and body fluids among a group of Turkish nursing and midwifery students during clinical practice training: Frequency of needlestick and sharps injuries. JpnJ NursSci 2010; 7(2):129- 135.
20. 20.Kursun S, Arslan S. Needlestick and sharp injuries among nursing and midwifery students. Int J Caring Sci 2014; 7(2):661-669.
21. 21.Samarkos M, Veini F, Kostourou S, Dokoutsidou E, Baraboutis I,Skoutelis A. Percutaneous exposures among health care workers in a Greek tertiary hospital. Archives of Hellenic Med 2014; 31(6): 718-724.
22. 22.Talas MS. Occupational exposure to blood and body fluids among Turkish nursing students during clinical practice training: frequency of needlestick/sharp injuries and hepatitis B immunisation. J ClinNurs 2009; 18(10):1394- 1403.
23. Kuyurtar F,Altiok M. Medical and nursing student’s experiences with sharps and needle stick injuries and preventive measures (in Turkish). Journal of Firat Health Services 2009; 4(12):67-84.
24. 24.Nsubuga FM,Jaakola MS. Needlestick injuries among nurses in sub-Saharan Africa. Trop Med Int Health 2005; 10(8):773-781.
25. 25.Muralidhar S, Singh PK, Jain RK, Malhotra M,Bala M. Needlestick injuries among health care workers in a tertiary care hospital of India. Indian Journal of Med Res 2010; 131:405-410.
26. 26.FitzSimons D, François G, De Carli D, Shouval D, Pruss-Ustun A, Puro V, Van Damme P. Hepatitis B virus, hepatitis C virus and other bloo-borne infections in healthcare workers: guidelines for prevention and management in industrialised countries. Occup Environ Med 2008; 65(7):446-451.
27. 27.Kisioglu AN, Ozturk M, Uskun E,Kirbiyik S. Epidemiology of needlestick injuries and attitudes and behaviour for prevention in healthcare personals working a university hospital (in Turkish). J Med Sci 2002; 22(4):390-396.
28. Wang H, Fennie K, He G, Burgess J, Williams AB. A training programme for prevention of occupational exposure to bloodborne pathogens: impact on knowledge, behaviour and incidence of needle stick injuries among student nurses in Changsha, People’s Republic of China. J Adv Nurs2003; 41(2):187-194.
29. Bennet G, Mansell I. Universal precautions: a survey of community nurses’ experience and practice. JClinNurs2004; 13(4):413–421.
30. 30.Krikorian R, Lozach-Perlant A, Ferrier-Rembert A, Hoerner P, Sonntagg P, Garin D,Grance CM. Standardization of needlestick injury and evaluation of a novel virus-inhibiting protective glove. J Hosp Infect 2007; 66(4):339-345.
31. Rabaud C, Zanea A, Mur JM, Blech MF, Dazy D, May T, Guillemin F. Occupational exposure to blood: search for a relation between personality and behavior. Infect Control HospEpidemiol 2000; 21(9):564-574.
32. 32.Mischke C, Verbeek JH, Saarto A, Lavoie MC, Pahwa M,Ijaz S. Gloves, extra gloves or special types of gloves for preventing percutaneous exposure injuries in healthcare personnel. Cochrane Database of Systematic Reviews 2014; Mar 7;3: CD009573. doi: 10. 1002/1451858.CD009573.pub2.
33. 33.Makary MA, Al-Attar A, Holzmueller CG, Sexton JB, Syin D, Gilson MMSulkowski MS, Pronovost PJ. Needlestick injuries among surgeons in training. N Engl J Med 2007; 356(26):2693-2699.
34. Centers for Disease Control and Preventive (CDC). Recommendations for prevention of HIV transmission in health care settings. The Morbidity and Mortality Weekly Report 1987, 36 (suppl no.2S). Available from: http://www.cdc.gov/mmwr/preview/mmwrhtml/00023587.htm, (Accessed 2012 August 8).
35. Kaya Ş, Baysal B, Eşkazan AE, Çolak H. Elavation of sharp object injuries in the health care personnel working in the Diyarbakır training and research hospital. J ViralHepat2012; 18(3):107-110.
36. Rivers DL, Aday LA, Frankowski RF, Felknor S, White D, Nichols B. Predictors of nurses’ acceptance of an intravenous catheter safety device. Nursing Research 2003; 52(4):249-255.
37. Adams D, Elliott TSJ. Impact of safety needle devices on occupationally acquired needlestick injuries: a four-year prospective study. J HospInfect2006; 64(1):50-55.
38. 38.Korkmaz M (2008). Needlestick and sharp injuries in health care workers (in Turkish). Journal of Fırat Health Services, 3(9), 17-37. 39. The Needlestick Safety and Prevention http://history.nih.gov/research/downloads/PL106-430.pdf, (Accessed 2012 October 24). Act (the Act) (Pub. L. 106-430. Available from
39. Republic of Turkey Ministry of Health, 2006. The extended immunization program curricular, data 30.12.2006 and number 8607-2006/120 (In Turkish). Available from: http://www.rsm.gov.tr/sbbulhast/mevzuat/gbd/pdf, (Accessed 2012 October 24).
40. Matson K. States begin passing sharps and needle-stick legislation to protect health care workers. AORN 2000; 72(4):699–705.
41. McCarthy GM & Britton JE. A survey of final-year dental, medical and nursing students: Occupational injuries and infection control. J Can DentAssoc 2000; 66(10):561-565. 43. Facchin LT, Gir E, Pazin-Filho, Hayashido M, da Silva Canini SR. Under-repoting of
42. accidentsinvolvingbiologicalmaterialbynursing Professional at a Brazialianemergencyhospital. Int J Occup Saf Ergon 2013; 19(4):623-629.