Effectiveness of measures to prevent needlestick injuries among employees in health professions (Report)

Abstract: The pathogens of greatest concern that may be transmitted by a needlestick injury (NSI) are hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). The objective of the study was to critically review and summarize the published literature on NSI, with the main focus on studies evaluating the effectiveness and cost aspects of the implementation of safer devices and other preventive measures in hospitals.

A comprehensive literature search on MEDLINE identified more than 2,300 publications. A multi-stage selection process was used to identify those studies appropriate for inclusion in the Quality Based Critical Review (QBCR), which finally included 61 publications on intervention studies. These studies were evaluated and rated according to quality indicators. Additionally, papers discussing the costs and benefits of the introduction of safer device have been analyzed.

Those with the most patient contact, nurses and physicians, were the most likely to report NSI, and NSI were most likely to occur in patient and operating rooms. However, underreporting presents a serious problem for the development of accurate risk estimates. The majority of the intervention programs, despite large differences in methodological quality, showed in general that engineering controls, especially the introduction of safety-designed devices, were effective in reducing the number of reported NSI. There are only few studies investigating the cost-effectiveness of this introduction and their results are suggesting that a complete substitution currently might not be cost neutral for a hospital. However, these studies showed little methodological consistency and therefore do not allow to draw firm conclusions. Societal as well as intangible costs and benefits should be considered in an overall assessment.