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Epidemiology of sharp object injuries in a children's hospital
L L Pettit1, S Q Gee, R E Begue
1Department of Pediatrics, Louisiana State University School of Medicine, New Orleans, USA.
Insights
Sharp object injuries (SOIs) are frequent in pediatric facilities, with nurses and physicians most affected. Prompt disposal and careful handling can reduce these occupational hazards.
Area of Science:
- Occupational Health
- Infectious Disease Epidemiology
- Pediatric Healthcare Safety
Background:
- Limited data exist on the frequency, circumstances, and management of sharp object injuries (SOIs) in pediatric healthcare settings.
- Understanding these incidents is crucial for improving healthcare worker safety and patient outcomes.
Purpose of the Study:
- To determine the frequency, circumstances, and management of sharp object injuries (SOIs) in a large pediatric hospital.
- To identify high-risk groups and situations for SOIs to inform targeted prevention strategies.
Main Methods:
- Retrospective review of all reported SOIs at a children's hospital over a two-year period.
- Analysis of injury data including demographics, injury circumstances, device types, contamination, and post-exposure management.
Main Results:
- 113 SOIs reported, averaging 6 per 100 employees annually. Nurses and physicians sustained the most injuries, while phlebotomists had the highest injury rate.
- Needles were the most common source (71%), with injuries occurring during use (48%) or disposal (42%). Most objects were contaminated with blood or body fluid.
- No employees contracted HIV, Hepatitis B, or Hepatitis C post-injury; most received post-exposure prophylaxis or vaccinations.
Conclusions:
- Sharp object injuries (SOIs) are a significant occupational hazard for pediatric healthcare workers.
- Implementing strategies like minimizing sharps use, ensuring patient restraint, and prompt disposal can reduce SOI frequency.
- Effective post-exposure management protocols are vital for preventing bloodborne pathogen transmission.
Background:
Limited data exist on the frequency, circumstances and management of sharp object injuries (SOIs) in pediatric facilities.
Method:
SOIs reported at a large children's hospital during a 2-year period were reviewed.
Results:
One hundred thirteen SOIs were reported for an average of 6 injuries per 100 employees per year. The greatest number of injuries occurred among nurses (46%) and physicians (23%), but phlebotomists experienced the highest rate (25.5 injuries per 100 full time equivalent employees per year). Most common locations were the patient room (27%), operating room (25%) and intensive care units (17%). Needles accounted for 71% of injuries and procedural devices accounted for 22%. Forty-eight percent of injuries occurred during use of the item, 42% after use or during disposal and 7% after disposal. Twenty percent were associated with loose sharps and 15% with inadvertent patient movement. Only 2 injuries were associated with recapping. Eighty-eight percent of the objects were contaminated with blood or body fluid. Of 88 known source patients 1 tested positive for hepatitis B surface antigen, 2 for hepatitis C virus and none for HIV. One hundred four employees sought treatment: 36 received tetanus vaccine; 14 received hepatitis B vaccine; 9 received hepatitis B immunoglobulin; and 12 received zidovudine. No employee subsequently tested positive for HIV, hepatitis B virus, or hepatitis C virus.
Conclusions:
SOIs represent a frequent occurrence among pediatric health care workers. Minimizing the use of sharps, appropriately restraining patients during procedures and promptly disposing of sharp items after use might decrease the frequency of SOIs.