Factors Affecting the Completion of Sharps Injury Clearance at Belau National Hospital, Palau, 2013 to 2024

Sharps injury is an occupational hazard to health care workers with risk of exposure to bloodborne infectious diseases. The Belau (Palau) National Hospital (BNH) Infection Prevention and Control (IPC) Protocol recommends initial blood work on the day of injury, followed by 4 follow-up appointments after 1, 2, 3, and 6 months, and clearance blood work after 12 months. Health care workers with 12-month blood work that indicates no new infection are considered to have completed clearance from exposure to bloodborne diseases. The objective of this research study was to examine factors affecting completion of sharps injury clearance at BNH from 2013 to 2024. Data were collected from the IPC program and the electronic health record sharps injury registry. From 2013 to 2024, 88 health care workers sharp injuries were included in the study and 30 (34%) completed clearance. The proportion of health care workers that completed clearance was similar across demographic characteristics, length of employment, and whether they had previously reported a sharps injury. Among health care workers who attended all 4 follow-up appointments, 100% (n=8) completed clearance. Among health care workers who missed at least 1 of their follow-up visits, 28% (n=22) completed clearance. Health care workers who attended the 6-month appointment had higher odds of completing clearance (OR 5.6, 95% CI [1.9, 16.2]) than those who did not attend the 6-month appointment. These findings indicate the need to strengthen IPC program efforts by providing appointment reminders to all health care workers who sustain sharps injuries, and educating new and existing staff about the IPC sharps injury clearance protocol.