Safety-engineered device implementation: does it introduce bias in percutaneous injury reporting?

Area of Science:

• Healthcare epidemiology
• Occupational safety
• Medical device innovation

Background:

• Percutaneous injuries (PI) pose a significant risk to healthcare workers (HCWs).
• Previous studies indicate varying rates of PI reporting and underreporting.
• The introduction of safety-engineered devices (SEDs) aims to mitigate these risks.

Purpose of the Study:

• To evaluate the impact of implementing SEDs on reported rates of percutaneous injuries (PI) among healthcare workers (HCWs).
• To assess changes in PI reporting behaviors following the introduction of a safer-needle system.

Main Methods:

• A before-and-after intervention trial was conducted over a 5-year period (1998-2002) at a tertiary-care hospital.
• Data on PI were collected through anonymous, self-administered surveys and entered into CDC NaSH software.
• 1,132 HCWs participated preintervention and 821 postintervention.

Main Results:

• The overall annual rate of self-reported PIs decreased from 36.5 to 13.9 per 100 respondents (P < .01).
• Formally reported PIs also decreased significantly, from 8.3 to 3.1 per 100 respondents (P < .01).
• Reporting rates varied by occupation, with improved reporting among nurses but decreased reporting among building services staff.

Conclusions:

• Implementation of safety-engineered devices effectively reduced both self-reported and formally reported percutaneous injuries.
• The intervention, combined with education, had differential effects on reporting behaviors across occupational groups.
• Overall reporting rates showed minimal change, highlighting challenges in consistent injury documentation.