A needlestick injury is defined by the Center for Disease Control (CDC) as a percutaneous injury due to accidental handling of a sharp. The CDC estimates that approximately 400,000 needlestick incidences occur each year in United States healthcare facilities, and reports from other developed countries, such as the United Kingdom and Spain, share similar frequencies. Further, the World Health Organization (WHO) estimates two million international healthcare workers are exposed annually to infectious disease as a consequence of a needlestick event, resulting in 37.6% and 39% of hepatitis B and hepatitis C cases, respectively. In the United States, federal and state legislation have greatly reduced incidence rates since the late 1980s, providing education, better protocols and effective post-exposure management. Additionally, the introduction of national surveillance databases led to stronger epidemiological support for the causation of needlestick injury and consequently, a stronger national awareness. In an effort to better protect healthcare workers, corporations such as DuPont and BD have further reduced needlestick incidences in the United States by designing products ranging from safety-engineered syringes to adhesive strips surrounded in strong synthetic materials such as Kevlar® and Lycra®. These devices are instrumental in minimizing the needlestick problem in both the clinic and in the operating room. As part of the current United States legislation, healthcare organizations are mandated to implement and utilize these safety-engineered syringes and needles. Despite the rise in protective equipment, national database surveillance and federal/state legislature, the incidence rate remains high as hundreds of thousands of injuries persist each year. We sought to find other solutions for better protecting healthcare workers through the implementation of golden orb weaver spider silk in personal protective equipment. This silk, gathered from the Nephila clavipes, is one of the strongest and toughest biomaterials in known existence. Its characteristically high energy absorption makes it an ideal material for reinforcing gloves and other protective equipment for healthcare workers. We believe that products made from this silk would serve as strong barriers against needlestick injury and bloodborne pathogen exposure. We are in the process of designing and fabricating such a glove and completed preliminary strength testing to ensure the superiority of our material. Tensile testing conducted at Tufts' Department of Biomedical Engineering suggests that our silk possesses the same mechanical profile as N. clavipes silk found in published literature. We plan on utilizing Fourier-transform infrared (DSC-FTIR) microspectroscopy to study the protein structure and possibly conducting enzyme degradation assays to assess the property changes under unique conditions. This information combined with our patented extraction and reinforcing methodology will provide the groundwork for partnering with industry leaders to make this product a reality and help eliminate the incidence of needlestick injury.

Thesis (MBA)--Stellenbosch University, 2001. / ENGLISH ABSTRACT: Daily more than 300 000 health care workers in South Africa are to a lesser or greater extent exposed to the risk of deadly viruses which can be transferred through neediestick injuries. It is estimated that currently 9,8 million people in South Africa are HIV positive. This high incidence of HIV has a great impact on the danger of infection from neediestick injuries. It is estimated that 44 000 neediestick injuries takes place annually in South Africa. Despite such a high risk there are currently few safety regulations or official efforts to prevent or determine the true impact and incidence of needlesticks in South Africa. This study project investigated the number of neediestick injuries that could potentially be prevented by the use of needles with safety features and estimated the ranges of benefits and costs of using such safety devices. With the financial constraints that are imposed on South African hospitals, infection control through the use of safety syringes makes economic sense. Prevention of infections is clearly far cheaper than cure. / AFRIKAANSE OPSOMMING: Daagliks word meer as 300 000 gesondheids personeel in Suid Afrika in 'n mindere of meerdere mate blootgestel aan die risiko van lewens gevaarlike viruse wat deur middel van naaldprik ongelukke oorgedra kan word. Hierdie risiko word spesifiek in Suid Afrika verhoog deur die hoë insidensie van HIV. Dit word beraam dat daar tans 9,8 miljoen mense in Suid Afrika is wat HIV positief is. Daar word beraam dat daar tans 44 000 naaldprik ongelukke per jaar in Suid Afrika plaasvind. Ten spyte van die hierdie hoë risko is daar tans min veiligheids regulasies of amptelike pogings om die omvang en voorkoming van naaldprik insidente te bepaal nie. Hierdie studie het die getal naaldprikke wat voorkom kan word deur die gebruik van veiligheids inspuitnaalde ondersoek en het die voordele en kostes van sulke veiligheidsmaatreëls beraam. Gegewe die finasiële druk wat ons tans in Suid Afrikaanse hospitale ondervind, is bewys dat die gebruik van veiligheids inspuitnaalde ekonomiese sin maak. Voorkoming op hierdie manier is bewys as 'n ver goedkoper opsie as nasorg.

Thesis (Dr. P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 1994. / Typescript. Includes bibliographical references (leaves 167-172).

Medical trainees (medical students and resident physicians) are at high risk of sharps injury (needlestick injury). High rates of sharps injury in this population and the risk incurred by exposure to bloodborne pathogens poses a threat both to medical trainees who are at risk for bloodborne pathogen exposure and to training institutions for legal and financial reasons. This study examines the prevalence of sharps injuries in medical trainees at the University of South Florida and compares that to data on sharps injuries in US medical trainees. Data from the present study was compared to previously collected USF medical trainee sharps injury data. Results from this study demonstrated that residents had higher rates of sharps injury than medical students. A prior USF study of similar data from academic years 2002-2008 had similar findings. This study demonstrated a peak in sharps injury rate in first year residents, similar to the prior USF study. Resident rates remained highest in Surgery and lowest for Psychiatry and Pediatrics. This information can be used to focus hazard analysis and risk reduction efforts at USF Health. This data can also be combined with the known efficacy of simulated training experience should encourage increased use of USF’s center for advanced medical simulation (CAMLS) to increased procedural experience in medical students and junior residents and decrease their exposure to bloodborne pathogens by increasing knowledge and procedural safety.

Needlestick injuries (NSIs) are a recognized risk for occupationally-related transmission of bloodborne pathogens (BBP). The occurrence of NSIs and BBP exposures among firefighters (FFs) and emergency medical services (EMS) personnel has been documented. The purposes of this study were: 1) to define the problem of NSI among FFs and EMS personnel in a suburban fire department (FD) and identify practices and factors that influence sharps use and safety; 2) design and implement and intervention to promote safer sharps device usage; and 3) to measure the effectiveness of the intervention among FFs and EMS personnel. A multi-phase, mixed methods approach was used that included a diagnosis phase that utilized a mixed methods exploratory design, an intervention period, and a quantitative evaluation phase that used a before and after evaluation design. In the diagnosis phase, data regarding sharps device practices were obtained through a count of discarded sharps devices. Qualitative data regarding sharps practices and factors which influenced those practice were obtained via focus groups. The PRECEDE/PROCEED model (PPM) was used as the theoretical framework for assessment, planning, implementation, and evaluation of an intervention to increase the occurrence of safer sharps device behaviors and decrease the frequency of riskier sharps device behaviors. The evaluation phase included a post-intervention sharps count and a post-intervention survey to assess changes in sharps practices and the impact of the intervention. During the baseline sharps count, 2743 sharps devices were counted and classified according to pre-established categories of safer or risky behaviors for NSI. Altered safety devices on IV stylets were the highest count for unsafe behaviors (n=105), followed by recapped traditional needles (n= 53). A statistically significant increase in risky behaviors was observed in discarded sharps from engines, as opposed to ambulances, among all sharps devices combined (p=0.000) and IV stylets (p=0.000). When comparing advanced life support (ALS) medications to all other medications, a statistically significant increase in unsafe behaviors occurred among all sharps devices combined (p=0.000) and prefilled syringes (p=0.000). Input from eight focus groups of firefighters allowed for identification of multiple themes which guided the development of an intervention. The intervention included distribution of a hands-on training kit and booklet, expansion of an existing required BBP training, and posters to increase awareness regarding NSI prevention. In the evaluation phase, a total of 2178 sharps devices were counted and classified in a post-intervention sharps count. Altered safety devices on IV stylets were the highest count of unsafe behaviors (n=50). Recapped traditional needles were the second highest count of unsafe behaviors (n=27), but experienced an 18.7% drop in frequency when compared to baseline. When comparing riskier behaviors to the pre-intervention baseline sharps count, statistically significant decreases in risky behaviors were observed in all sharps devices combined ( 2=25.71, p=0.000), IV stylets (2=16.87, p=0.000), and traditional needles (=5.07, p=0.024). A post-intervention survey, consisting of 15 Likert scale questions, was returned by 165 out of 383 active field personnel (41.3%). Results indicated high frequencies of strongly agree and somewhat agree responses regarding risk perception; the importance of using safer needle devices; the impact of the intervention on safer needle practices and sharps safety awareness. Critical predisposing, reinforcing, enabling, and environmental factors which influenced sharps device practices were identified. This study identified factors and practices which influenced unsafe sharps device behaviors. Due to the statistically significant decreases in risky behavior in the post-intervention sharps count and the positive responses in the post-intervention survey, it can be concluded that the intervention did positively impact sharps device behavior and reduced the risk of NSI. The implications of the study are numerous and include a need to explore these practices and factors at other fire departments and EMS agencies, address gaps in regulations; promote research targeting FFs and EMS personnel in regard to NSI, and promote a nationwide effort to prevent NSI among emergency responders.

No abstract available. / Thesis (MMed)-University of Natal, Durban, 1993.

Thesis (Master of Nursing)--Cape Peninsula University of Technology, 2019 / Background: Like other health care providers, nursing students are unprotected from occupational dangers such as sharp object injuries (SOIs) due to imperfect knowledge and experience. These students face a great risk of exposure to blood borne infections by pathogens such as HIV and the hepatitis B and C viruses while executing their clinical actions in hospitals. SOIs are a significant problem for nursing students, as they increase the risk of contracting blood-borne infections. Purpose: The purpose of this study was to determine nursing students' knowledge and practices related to SOIs and their management at a university in the Western Cape Province. Objectives: The objectives of this study include determining the occurrence of SOIs, and knowledge of risk of SOIs, as well as the reporting and management of SOIs at a university in the Western Cape. Method and sample: A cross-sectional descriptive survey was conducted with nursing students from the second to fourth year of study, registered at a university in the Western Cape Province for the 2017 academic year. Quota sampling was applied to select respondents who, after providing informed consent, then completed and handed the self- administered questionnaires back to the researcher on the same day that they were distributed. Data were obtained from nursing students about whether or not they had experienced an SOI, what they did after the SOI, their perception of the risk, and management of and preventive measures for SOIs. Validity and reliability were ensured, and all ethical principles were adhered to. SPSS was used for the quantitative data analysis. Results: A total of 252 nursing students from the second to fourth years participated in this study. The average age of respondents was 24 years, with a minimum of 19 and maximum of 46 years; 211 (83.7%) of them were females. During their course 63 (25%) respondents experienced SOIs; only 42 (66.67%; N=63) of them reported the occurrence of an SOI, most (25 or 59.52%) reporting it to the professional nurse in charge. The highest occurrence of SOIs was reported by fourth-year students (26 respondents, 41.3%). It was found that 21 (33.3%) of SOIs were not reported, and the main reason for this was because there was little or no perception of associated risk (15, 71.43%). Forty-six (73.02%) respondents experienced a single SOI, while 11 (17.46%) had two SOIs, 4 (6.35%) reported having had three SOIs, and one each (1.59%) had more than four and more than ten SOIs. The activity causing most of the SOIs was administration of medication by injection (48 cases, 76.2%), and in most cases (57, 90.47%) the instruments causing injury were needles or hollow-bore needles. Most of the affected respondents squeezed the puncture site after the SOI (42, 66.7%), followed by washing the area with water and soap (40; 63.5%), and cleaning the site with antiseptic (15, 23.8%). Among those students exposed to SOIs, only 22 (52.4%) had undergone blood tests, and very few of them took post-exposure prophylaxis or treatment (16, 25.40%). The emotion that most of them felt after the SOI was fear (42, 66.7%), and the main reason for not getting treatment was fear of side effects (18, 38.29%). Also, only 61 (24.2%) respondents reported recapping needles after use, while most reported incomplete vaccination against hepatitis B (195, 77.38%). The main reason for not using personal protective equipment (PPE) was noted as the unavailability thereof at the institution (43, 49.4%). Conclusion: This study documented a low rate of reporting SOIs among nursing students. It is plain that there are inadequate levels of knowledge and practice related to SOI management among these students at a university in the Western Cape. One would imagine that because the majority of nursing students had a measure for the practice of universal precautions and used PPE, their management after exposure to SOIs during work training in hospital would be efficient. This was not the instance in this study, where application of these actions in their practical training was poor.

A research project submitted in partial fulfilment of the requirements for the degree of Master’s (Industrial/Organisational Psychology) in the Faculty of Humanities, University of the Witwatersrand, Johannesburg, March 2017 / A South African study, based on a sample of 208 medical personnel working in public and private institutions, was conducted in order to determine whether job demands and job resources led to differences in the propensity to comply with Needlestick Injury (NSI) intervention scores. Three self-report questionnaires were completed by the participants, namely the self-developed demographic questionnaire, the Job Demands-Resources Scale (JDRS) which measured job demands and resources, and thirdly the self-developed Propensity to Comply with Interventions for Needlestick Injuries Scale (PCINS) which measured the propensity to comply with interventions for NSIs. Accidental needle stick, as well as sharp, injuries occur frequently within the medical context and are associated with high risks for blood-borne infections (Adefolalu, 2014). Specifically within South Africa blood-borne infections such as HIV carry heavy significance. Needlestick injuries often go unreported by healthcare professionals, and these injuries are widely prevalent. The researcher aimed to explore the job demands and resources that contribute to and mitigate against these injuries. Therefore support for the analysis of job demands and resources and the propensity to comply with NSI interventions exists. The results of the study suggested that there were mostly no significant differences between Job Demands and Resources and the propensity to comply with NSI Interventions scores. However significant relationships were found between length of shift and the propensity to comply with NSI interventions and growth opportunities and the propensity to comply with NSI interventions. The findings did not follow the proposed hypotheses that job demands would lead to a decrease in the propensity to comply with NSI interventions and job resources would lead to an increase in the propensity to comply with NSI interventions as longer length of shift (job demand) led to an increase in propensity to comply with NSI interventions and an association between high levels of growth opportunity (job resource), and low levels of propensity to comply with NSI interventions, was found. / GR2018

Atualmente, a avaliação do clima organizacional tem sido considerada importante ferramenta de gestão nas instituições de saúde. O objetivo deste estudo foi avaliar o clima organizacional e a sua relação com a ocorrência de acidentes de trabalho com material perfurocortante entre os profissionais de enfermagem em um hospital público de média complexidade do interior do Estado de São Paulo. Trata-se de um estudo de abordagem quantitativa, descritivo e transversal. Para a coleta de dados, foi utilizada a versão validada e adaptada para o contexto brasileiro do Safety Attitudes Questionnaire (SAQ) - Short Form, denominada Questionário de Atitudes de Segurança - QAS. Por meio do QAS foi possível avaliar a percepção dos trabalhadores acerca do clima de trabalho em equipe, clima de segurança, satisfação profissional, percepção do estresse, ações da gerência quanto às questões de segurança e as condições de trabalho. As respostas foram dadas por meio da escala Likert de cinco pontos e o processamento e a análise dos dados foram realizados com o auxílio do programa Statistical Package for Social Science (SPSS), versão 17.0. Para relacionar o clima organizacional com a ocorrência de acidentes de trabalho, inicialmente, foi realizado levantamento junto ao Serviço Especializado de Medicina e Segurança do Trabalho - SESMT dos registros de acidentes de trabalho ocorridos no período 2008-2014 e foram identificados os trabalhadores de enfermagem vítimas desses acidentes. Após este levantamento, foram constituídos dois grupos: Grupo 1 - profissionais de enfermagem que sofreram acidentes de trabalho envolvendo perfurocortantes; Grupo 2 - profissionais de enfermagem que não sofreram acidente de trabalho com perfurocortantes. A análise dos dados foi realizada por meio de estatística descritiva com testes de comparação entre as variáveis dos grupos. A amostra do estudo foi constituída por 116 participantes, técnicos de enfermagem e enfermeiros atuantes em unidades de internação hospitalar, sendo o Grupo 1 composto por 21 participantes e o Grupo 2 composto por 95 participantes. Predominaram participantes do sexo feminino, técnicos de enfermagem e profissionais com cinco a 10 anos de atuação na instituição. A percepção dos participantes quanto ao clima organizacional foi considerada desfavorável; no entanto, foi considerada satisfação no trabalho pela maioria dos participantes. Os resultados não indicaram relação direta entre o clima organizacional e a ocorrência de acidentes com perfurocortante, mas foi possível observar que o grupo que não sofreu acidentes apresentou maior satisfação no trabalho. Considera-se que este estudo permitiu ampliar o conhecimento acerca da percepção de profissionais de enfermagem sobre o clima organizacional, contribuindo para a discussão sobre formas de melhoria da assistência segura, de redução de eventos adversos e sobre a qualidade da assistência de enfermagem / Recently, evaluation of organizational climate has been considered an important management tool in health institutions. The aim of this study was to evaluate the organizational climate and its relationship with the occurrence of accidents with needlestick materials among nursing professionals in a public hospital of medium complexity in the state of São Paulo. It is a study of quantitative, descriptive and cross-sectoral approach. The instrument Safety Attitudes Questionnaire (SAQ) was used - Short Form, 2006, validated and adapted version for the Portuguese language (Safety Attitudes Questionnaire - QAS). Through the areas of QAS was possible to assess attitudes about the working environment in staff, safety climate, job satisfaction, perceived stress, management actions regarding safety issues and working conditions. The answers were given by Likert scale of five points, processing and data analysis was performed with the aid of the Statistical Package for Social Sciences (SPSS) version 17.0. To relate the organizational climate with the occurrence of accidents with sharps survey was carried out by the Specialized Service of Medicine and Safety - SESMT with records of work accidents in the period 2008-2014 and workers were identified nursing victims of these accidents. Constituted two groups: Group 1 - nursing professionals who were victims of work accidents involving sharps; Group 2 - nursing professionals who did not undergo occupational accidents with needlestick during the study period. After conformal groups, the data analysis was performed using descriptive statistics with correlation tests between the variables of the groups in order to analyze possible relationship between accidents and the adoption of safety measures by the professional. The study sample consisted of 116 participants, nursing technicians and nurses working in hospital units. Group 1 consisted of 21 participants and Group 2 consists of 95 participants. Predominated female participants, nursing technicians and professionals with five to 10 years of experience in this institution. The perception of the participants about the organizational climate was considered unfavorable, however it was observed that job satisfaction was evidenced by most of the participants, demonstrating how they feel during the exercise of the profession in this institution. On the relationship between organizational climate and the occurrence of accidents with needlestick materials, the results indicated no direct relationship between organizational climate and the occurrence of such accidents, however it was observed that the group that did not suffer sharps injuries was the group that presented greater job satisfaction. Thus, this study promotes the opportunity to meet the professionals\' perception of the organizational climate and can contribute to improvement of safe care, reduce adverse events and improve the quality of patient care

Les variants viraux impliqués dans la transmission du VHC ont rarement été étudiés en raison des difficultés rencontrées pour recruter des patients au stade de la primo-infection. Pour mener cette étude, nous avons analysé le goulot d’étranglement génétique subit par les quasi-espèces virales au cours de 3 accidents d’exposition au sang impliquant des représentants du personnel soignant contaminés par piqûre d’aiguille. En utilisant la technique d’amplification de génomes uniques nous avons obtenu les gènes codant les glycoprotéines d’enveloppe virales E1E2 des variants viraux présents dans ces quasi-espèces. Ces gènes ont été séquencés et soumis à une analyse phylogénétique. Nous avons ensuite pu étudier les propriétés phénotypiques des glycoprotéines d’enveloppe dérivées de variants qui apparaissent au stade très précoce de l’infection. Pendant cette période, le VHC pourrait être plus vulnérable à l’élimination par des vaccins préventifs ou par des immunothérapies. / Little is known about the transmitted variants responsible for the spread of HCV infection, principally because of the difficulties to recruit patients early enough in infection. To address this issue, we proposed to track the genetic bottleneck event in HCV quasispecies, leading to productive clinical infection in three health care workers accidentally contaminated through needlestick accidents. By using a single genome amplification (SGA) approach we identified genes coding the viral envelope glycoprotein E1E2 which composed these quasispecies. The E1E2 sequences were then directly sequenced and subjected to a phylogenetic analysis. By cloning these full-length E1E2 sequences, we investigated the phenotypic properties of the envelope glycoproteins potentially involved in selective HCV transmission and early stage of infection, a period during which the virus might be most vulnerable to elimination by preventive vaccines or immunotherapies.