Lucille Christensen Woolston and Dr. Renea L. Beckstrand, College of Nursing
My research questions regarded needlestick and sharp instrument injuries, how many were reported, and what behavior changes have been made following the injury. I approached nurse managers at Utah Valley Regional Medical Center and gave surveys to nurses in staff meetings. I received results that I expected. I found most injuries that are not reported are clean injuries and so the staff feels the injuries are not worth reporting.
Needlestick Injuries
Of the 35 subjects who responded to the survey, 34.3% had one needlestick injury, 28.6% had 3 needlestick injuries, 11.4% had 2 needlestick injuries, 11.4% had no needlestick injuries, 8.6% (n=3) had 5 or more needlestick injuries, and 5.7% had 4 needlestick injuries. The number of needlestick injuries reported was 111. Of the nurses that reported the year of their needlestick injury, 18.0% occurred <2 years ago, 23.4% occurred 3-5 years ago, 29.7% occurred 6-10 years ago, and 17.1% occurred >10 years ago. Nurses reported 11.7% needlestick injuries that occurred in unknown years.
Of the 35 subjects who responded to the survey, 34.3% reported 100% of their needlestick injuries. The next most frequent was 22.9% who reported 0% of their needlestick injuries. Next, 14.3% reported 75% of their needlestick injuries, 11.4 % reported 50% of their needlestick injuries and 11.4% reported only 25% of their needlestick injuries. 5.7% did not report needlestick injuries.
The survey listed possible reasons for not reporting a needlestick injury. 21 nurses selected the option, “I was stuck with a ‘clean,’ not-contaminated needle.” 9 nurses selected the option, “I washed the puncture site immediately.” 5 nurses selected, “I was too busy caring for patients to leave the unit.” 5 nurses selected, “I was not concerned about the health status of the patient.” 4 nurses selected, “It takes too much time to report the injury.” 4 nurses selected, “It requires too much paperwork to report the injury.” 4 nurses selected, “There was no nurse available to replace me on my unit.”
The survey also included a space for nurses to comment on why they did not report a needlestick injury. The comments revealed the following themes: the nurse reported the injury based on whether the needle was clean or dirty, the nurse had problems with Employee Health and believed reporting was detrimental to themselves or of no use, and they did not report years ago because there were not the same concerns about bloodborne pathogens that there are now.
The survey listed possible behavior changes. 15 nurses selected, “I now employ the safety guards that come with the needle.” 14 nurses selected, “I now immediately dispose of contaminated needles.” 11 nurses selected, “I no longer recap a contaminated needle.” 10 nurses selected, “I now recap a contaminated needle by “scooping” it up with one hand. The survey also included a space for nurses to comment on what behavior changes they made following a needlestick injury. The following themes were identified: nurses are more careful or they made procedural changes. The survey included a space for nurses to comment on why they did not report behavior changes following a needlestick injury. The following themes were identified: nurses felt no change was needed because the injury was a true accident, they tried to change but have been unable to, or they felt no changes were necessary because they were stuck with a clean needle.
Sharp Instrument Injuries
Of the 35 subjects who responded to the survey, 34.3% had no sharp instrument injuries, 25.7% had one sharp instrument injury, 11.4% had 2 sharp instrument injuries, 11.4% had 3 sharp instrument injuries, 8.6% had 4 sharp instrument injuries, and 8.6 % had 5 or more sharp instrument injuries.
The number of sharp instrument injuries reported was n=199. Of those 199 reported injuries, 16.8% occurred <2 years ago, 17.6% occurred 3-5 years ago, 25.6% occurred 6-10 years ago, and 35.2% occurred >10 years ago. Nurses reported 5.5% sharp instrument injuries that occurred during unknown years.
Most frequently, 34.3% reported 0% of their injuries. The next most frequent was 11.4% reported 100% of their injuries. 5.7% reported 75% of their injuries, 5.7% reported 50% of their injuries, and only 2.9% reported only 25% of their injuries. 40% had no sharp instrument injury. The survey listed possible reasons for not reporting their sharp instrument injuries. 12 nurses selected the option, “I was stuck with a ‘clean,’ not-contaminated sharp.” 8 nurses selected the option, “I washed the puncture site immediately.” 5 nurses selected, “It takes too much time to report the injury.” 5 nurses selected, “It requires too much paperwork to report the injury.” The survey also included a space for nurses to comment on why they did not report a sharp instrument injury. The comments revealed the following themes: the nurse reported the injury based on whether the sharp was clean or dirty. Most of the injuries were from glass ampules, which are not contaminated. The second theme was the nurse had problems with Employee Health and believed reporting was detrimental to them or of no use.
The survey listed possible behavior changes. 10 nurses selected, “I now open ampules using hospital-designated procedures. 6 nurses selected, “I now employ the safety guards that come with the needle.” 4 nurses selected, “I now immediately dispose of contaminated needles.” 4 nurses selected, “I now recap a contaminated needle by “scooping” it up with one hand.”2 nurses selected, “I no longer recap a contaminated needle.” The survey also included a space for nurses to comment on what behavior changes they made following a needlestick injury. The following themes were identified: nurses are more careful or they made procedural changes such as not being rushed and using assistive tools. The survey included a space for nurses to comment on why they did not report behavior changes following a needlestick injury. The following themes were identified: nurses felt no change was needed, they have problems with Employee Health, or they felt no changes were necessary because they were stuck with a clean sharp.
I learned invaluable information from this research to help Employee Health improve their injury reporting process. More research could be done by specifying which departments make which behavior changes and how long a nurse has worked.