Sharps injuries – a major OHS hazard

Study shows more sharps injuries occur in remote areas, and many are caused because nurses recap needles.

Results from a major collaborative study into Sharps Including Needlestick (SIN) injury suggest that remote area nurses are more likely to sustain a sharps injury than their metropolitan colleagues, and indicate that one third of nurses continue to recap needles after drawing up medication.

The study was conducted by researchers from the University of Newcastle and the NSWNA following evidence that nursing is the occupation at highest risk of SIN injuries. Over 1,300 NSWNA members participated in the study (giving a response rate of 17%) and results show that needlestick injury remains a significant OHS issue for nurses, especially in rural and remote areas. While the generalisability of the findings is limited, it is nevertheless clinically relevant.

‘The reported 12-month period prevalence of SIN injury was 6.5%, with a significantly higher rate of 16.4% in remote areas,’ said Newcastle University academics and co-authors of the study Dr Ashley Kable and Maya Guest. Some clinical areas, including the Emergency Department and operating theatres, appeared to have a higher risk for SIN injury (up to 12%).

Of the 84 respondents who experienced SIN injuries, 86% reported the injury at their workplace and 35% believed they were at risk of contracting a blood-borne disease. The main reasons for reporting SIN injury were the fear of acquiring hepatitis B, C, and HIV, the need to have the workplace assessed for risk, and the desire to be informed about blood test results. Only 39% of nurses reported that SIN injury data were routinely provided to staff. The study further found that only 32% of nurses attended sharps training when it was offered.

Many of the results from the study were encouraging, however, with the majority of nurses reporting practices that are consistent with NSW Health policy directives. Compliance with hepatitis B vaccinations was reported by 95% of nurses, 90% reported the use of point-of-use sharps containers and 95% stated a preference for Safety Engineered Devices (SEDs), with 55% of nurses active in the selection and evaluation processes of the SEDs in their workplaces.

‘These results are good, but there is room for improvement. Of most concern is the finding that 33% of our members continue to recap after drawing up medications, and that 5% recap after administering medications or obtaining blood samples. Given that these results go against long-established infection control policies and procedures it is important to find out why some nurses continue to recap. The study recommends initiatives to address the  issue,’ said study project manager and NSWNA Professional Officer Mary McLeod.

‘Another finding that deserves further study is the higher prevalence of SIN injury in remote area nursing. We need to assess the causes of this disparity: Is there a lack of safety engineered devices or disposal equipment? Do remote area nurses undertake work in the field more often? Are there gaps in training, or could it be related to culture?  Further research into this anomaly may assist in the development of future prevention strategies,’ said Mary.

The study report is available on the NSWNA’s website and the results are published in the CSIROs Health Care Infection journal.

This research was funded under the WorkCover NSW WorkCover Assist Program. The research conclusions are those of the authors and any views expressed are not necessarily those of WorkCover NSW.

The Statistics

The study shows that:

  • 6.5% of nurses surveyed in NSW reported experiencing SIN injuries in the previous 12 months with 16.4% reported in remote areas.
  • 33% of nurses surveyed recap after drawing up medications.
  • 5% of nurses surveyed recap after administering medications or obtaining blood samples.
  • 86% of nurses surveyed officially reported SIN injuries.
  • 73% of nurses surveyed reported that SIN incidents are managed according to NSW Health policy.
  • 95% of nurses surveyed prefer the use of Safety Engineered Devices (SEDs).
  • 90% of nurses surveyed use point-of-use sharps containers.