Awareness and Perspectives of Doctors on Needle Stick Injuries at Port Sudan Teaching Hospital: A Quality Improvement...

Needlestick injuries (NSIs) pose a threat to healthcare workers (HCWs) by exposing them to bloodborne pathogens. Irrespective of safety devices and policies, knowledge, practice, and reporting gaps still exist. This study aimed to audit the knowledge, attitudes, and practices of HCWs regarding NSIs in a tertiary hospital and to determine the effects of educational and system-level interventions.

A two-cycle quality-improvement audit was held at Port Sudan Teaching Hospital. Cycle 1 defined compliance at the baseline level through review of documents, staff surveys, and observation. Interventions were education sessions, practical workshops, quick-reference materials, better access to safety-engineered devices, and promotion of a nonpunitive reporting culture. Repeat measurements were conducted in Cycle 2 using the same standards: safety device use, no recapping, sharps container practices, immediate first aid, reporting, and postexposure prophylaxis (PEP) procedures. A total of 97 HCWs participated (Cycle 1: n = 53; Cycle 2: n = 44).

The interventions produced significant improvements. Recognition of hepatitis B virus as a bloodborne risk increased from 33/53 (62.3%) to 39/44 (88.6%) (p = 0.003). Correct initiation of PEP within 72 hours rose from 18/53 (34.0%) to 34/44 (77.3%) (p < 0.001). Safety behaviors improved markedly: use of safety-engineered devices increased from 17/53 (32.1%) to 35/44 (79.5%) (p < 0.001); needle recapping decreased from 21/53 (39.6%) to 2/44 (4.5%) (p < 0.001); and correct use of sharps boxes (two-thirds full) increased from 15/53 (28.3%) to 34/44 (77.3%) (p < 0.001). Training uptake rose significantly: formal training increased from 6/53 (11.3%) to 21/44 (47.7%) (p < 0.001), and refresher training from 2/53 (3.8%) to 12/44 (27.3%) (p = 0.001). Awareness of a formal reporting system improved from 8/53 (15.1%) to 21/44 (47.7%) (p < 0.001). However, awareness of the hepatitis C virus and human immunodeficiency virus (HIV) as risk factors and some unsafe first-aid practices persisted as areas requiring further strengthening.

An education-based approach, reinforced by practical training, improved device availability, and a favorable reporting culture, led to significant improvements in NSI knowledge and safe practice. Continued refresher education and stronger communication about HCV/HIV risks are required to maintain and extend gains. Limitations include the single-center design, reliance on self-reports, and potential underreporting.