Needle stick injury in hospitals: a quantitative-qualitative study of experiences and attitudes of nursing personnel

Ubodni incident je svaka ozljeda nastala ubodom oštrog predmeta koja sama po sebi, ukoliko nije došlo do teže povrede, ne zahtjeva posebno zbrinjavanja, ali nažalost, može doći do prijenosa infekcije sa oštrog predmeta na osobu kojoj se ozljeda dogodila. Profesionalno su izloženi liječnici, medicinske sestre, spremačice te ostalo pomoćno osoblje koje dolazi u susret s medicinskim otpadom i kontaminiranim rubljem. Prilikom ubodnog incidenta može doći do prijenosa više od 20 različitih vrsta patogena koje se prenose krvlju od kojih su najopasniji virusni hepatitis B, virusni hepatitis C i virus humane imunodeficijencije. Najviše ubodnih incidenata se događa u tijeku rada sa pacijentom, nakon rada i prije odlaganja oštrih predmeta u za to predviđene spremnike. Procjenjuje se da se u Hrvatskoj ne prijavljuje oko 32 000 ubodnih incidenata godišnje. Ubodni incidenti najviše se ne prijavljuju zbog nepoznavanja procedure, kako i kome prijaviti. Prevencija se sastoji u samom smanjenju broja incidenata tehničkim mjerama, edukaciji medicinskih sestara, te dosljednom nošenju osobnih zaštitnih sredstava. U svrhu istraživanja stavova medicinskih sestara / tehničara u bolničkim uvjetima o ubodnom incidentu, konstruiran je polustrukturirani intervju. Naglasak je bio na iznošenje osobnih stavova, ali i iskazivanje stavova nakon što se ubodni incident dogodio. U istraživanju je sudjelovalo šesnaest medicinskih sestara / tehničara. Intervju se sastojao od tri skupine pitanja. Rezultati provedenog istraživanja ukazuju da između broja ubodnih incidenata i radnog staža na odjelu postoji statistički značajna povezanost, između broja ubodnih incidenata i dobi ispitanika postoji statistički značajna povezanost i između broja ubodnih incidenata i stručne spreme ispitanika (SSS, VŠS) ne postoji statistički značajna povezanost. Stavovi ispitanika temeljeni su pretežito na problemima s kojima se susreću prilikom ubodnog incidenta, ističu dobru upućenost na prijavljivanje ubodnog incidenta i poznavanje protokola prijave ozljede oštrim predmetom i izloženosti krvi te postekspozicijske profilakse. Kao najveći problem ispitanici ističu nedovoljnu edukaciju. Shodno tome je potrebno pokrenuti određene edukacije, predavanja ili dijeljenje letaka, koje bi uključile medicinske sestre / tehničare te na taj način pridonijeli stvaranju ukupno pozitivnog stava određenoj tematici i lakšem pristupu prevenciji.Sharp injuries are caused by the sting/cut of a sharp pointed object does not require special care or hospitalization unless there is a serious injury; unfortunately, there is always the risk of infection that can be transmitted from the aforementioned object to the injured person. Within their professions, doctors, nurses, cleaning and other support staff that are in contact with medical waste and contaminated laundry are more exposed to injuries. More than 20 different types of bloodborne pathogens can be transmitted during these types of incidents, the most dangerous of which are hepatitis B, hepatitis C and human immunodeficiency virus (HIV). A majority of stab wounds in medical professions occur during or after patient care and before placing sharp objects in provided containers. It is estimated that, in Croatia, approximately 32 000 needle stick injuries and incidents with sharps are not reported every year. They are mostly not reported due to the unfamiliarity with the procedure and reporting. Hence, prevention consists in reducing the number of incidents by technical measures, education of nurses, as well as consistent wearing of personal protective equipment. In order to investigate attitudes of nurses/technicians about sharp injuries in hospital conditions, a semi-structured interview was constructed. The emphasis was on expressing personal views, but in addition this research endeavour took into consideration expressed views after the incident occurred. Sixteen nurses/technicians participated in the study. The interview consisted of three groups of questions. The results indicate that there is a statistically significant correlation between the number of incidents and the length of service in the department as well as a statistically significant correlation between the number of sharp injuries and the age of the respondents. However, there was no statistical correlation between the number of sharp injuries and the education of the respondents (secondary school, university degree). Respondents’ attitudes were based mainly on the problems they encountered during the incident and emphasize good knowledge on reporting and awareness of the protocol for reporting sharp injuries and blood exposure, as well as post-exposure prophylaxis. The respondents pointed out insufficient and inadequate education as the biggest problem. In conclusion, it is necessary to initiate certain training programs, lectures or leaflet distribution which would involve nurses/technicians and thus contribute to the creation of an overall positive attitude to a particular topic and, in turn, easier access to its prevention