Follow-up study for the analysis of needlestick injuries (NSI) among students of human medicine in consideration of the regulations of the TRBA 250

Status:

completed 03/2012

Aims:

The study aimed at surveying and analysing the prevailing risks for medical students due to needlestick injuries (NSI), i.e. injuries of the skin by handling sharp objects by which blood of patients can be transmitted to the health professional.

Activities/Methods:

After introducing preventive measures in a typical German university hospital, a total of 1,903 students of human medicine in their clinical period from 2009 to 2012 (from a total of 2,024 subjects – a rate of 94.0%) were questioned in detail about potential needlestick or other injuries related to their work.

Results:

The results show that such injuries happen particularly during the clinical period of the medical studies: While only 20.6% of the students indicated a needlestick injury at the beginning of this period, half of the students (50.9%) had experienced at least one injury at the end of the clinical period. The activities mentioned most frequently were taking of blood samples and injections.

Needlestick injuries happened most frequently in chirurgical units, in internal medicine and in gynaecology. Accidents happened mostly during secondary employment, medical traineeship, or in the context of practical nursing. If one compares the international literature, whose investigations reflect the condition before the introduction of safe instruments, needlestick injury is most frequently encountered by sewing students (32%), followed by blood sampling (25%) and assisting activities (21%). This is followed by injections (intravenous, intramuscular or subcutaneous) at 5% and arterial blood withdrawal at 4%. The so-called "recapping" is only in 13% of cases the cause of a needlestick injury and thus much less common than with doctors and nurses. Due to the high level of participation, the study has a high degree of representativeness for a typical German university hospital after the introduction of reliable instruments. Nor have any studies been conducted on needlestick injury among students of human medicine after the legal obligation to introduce safe instruments has come into force. The trend towards more education at the bedside and the deliberately greater involvement in the clinical routine entail a higher risk potential than at the time of previous examinations. It became clear that with the introduction of the stab-proof instruments in the presented study the problem of the risk of needlestick injury for students has not yet been solved. In particular, the students' "risky secondary jobs" have a decisive influence on the frequency of needlestick injuries. In consequence, measures for improvement of the primary prevention should start with training on the one hand: Only briefing seems to be insufficient – intensive exercises in using stick-proof instruments seems to be more promising. On the other hand, the comprehensive introduction of stick-proof instruments has to be supported.

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