Inoculation injuries in hospitals in Trinidad and Tobago

This paper reviews the frequency of inoculation injuries, which occurred in hospitals in Trinidad and Tobago from 1991 to 1997, inclusive. A total of 397 cases of inoculation injuries were detected. Significantly more of these injuries occurred during diagnostic or therapeutic procedures (231, or 58.2%; G = 41.2, df 9, p < 0.001) than during disposal of needles and other sharps (136, or 34.3%), certain situations remote from patient care (21, or 5.2%), and 'rogue incidents' related to unsafe disposal with later injury to janitors or others (9, or 2.3%). No statistically significant monthly or seasonal variations occurred in the incidence of reported inoculation injuries. The two institutions that saw the largest number of patients, the Port-of-Spain General and San Fernando General Hospitals, accounted for the largest number of cases of inoculation injury, with 139 (35.0%) and 135 (34.0%), respectively. Interestingly enough, there were 42 reported inoculation incidents at the St. Ann's Hospital for the Mentally Impaired and 23 (52.5%) of these were bites, most of them occurring during attempted procedures. Nurses were the main recipients of inoculation injuries (287 cases, or > 72%), followed by doctors (9.3%), and ward maids (6.2%). The main modes of inoculation were needle sticks (305, or 76.8%). Bites (34, 8.6%), injuries with sharps other than needles (29, or 7.3%), and splashes (29, or 7.3%) were the other types seen. One recipient was found to be infected with HIV following accidental inoculation. The infection control methodologies used in hospitals in Trinidad and Tobago are reviewed and recommendations for preventing injuries are outlined.