To the Editor:
Several studies have indicated a reduction in percutaneous exposure after the introduction of safety-engineered devices (SEDs).
1
, 2
, 3
, 4
Even though Brazilian laws mandate the use of SEDs in health services, there are still barriers to its adherence, such as high costs and lack of knowledge of health workers.3
This shift toward the implementation of new technology was the main motivation behind this study. Its aim was to assess the annual rates of injuries involving peripheral venous catheters, with or without SEDs, between 2009 and 2014 in a Brazilian public hospital specialized in infectious diseases, in accordance with a formula proposed by other studies.
5
, 6
The results showed 117 (100%) exposure events, mainly among women (n = 91; 77.8%) and the nursing team (n = 85; 72.6%). Of the total number of events, 70 (n = 117; 59.8%) injuries were percutaneous, and 6 involved peripheral catheters. Table 1 presents the rate of percutaneous injury from peripheral catheters according to the number of devices purchased.
Table 1Percutaneous injury rate from peripheral catheters according to the number of devices purchased between January 2009 and December 2014 at a Brazilian public hospital, Belo Horizonte, Minas Gerais, 2015
| Year | No. of devices purchased per year | Accidents per year | Injury rate | 95% confidence interval |
|---|---|---|---|---|
| 2009 | 17,492 | 1 | 5.72 | 0.10-31.91 |
| 2010 | 17,151 | 0 | — | — |
| 2011 | 14,896 | 1 | 6.71 | 0.21-37.42 |
| 2012 | 16,127 | 0 | — | — |
| 2013 | 22,175 | 2 | 9.02 | 1.11-32.64 |
| 2014 | 22,576 | 2 | 8.86 | 1.10-32.03 |
* Number of injuries per year/total devices purchased in the same period ×100,000.
Between 2013 and 2014, the records show 4 catheter injuries with SEDs, showing the importance of ongoing education in the use of these devices.
The device-specific needlestick injury rates increased over the last 2 years, when no safety devices were used. Limitations, such as the lack of data on notification forms about ongoing training of health workers in the use of these devices and details about how the device was handled, hindered an accurate explanation for such an increase. Similar findings were presented by other studies
3
, 5
, 6
and may be related to workers being more sensitized to notify their exposure injuries because of the implementation of the safety device program.7
Despite these limitations, our research can be considered a starting point for other studies in the hospital and in other services that comprise the Brazilian public hospital system and that have adopted SEDs. It also contributed to identifying points for improvement in the care protocol for workers exposed to biologic material and the training of workers for the use of new technologies.
Acknowledgments
We thank all participants for their contribution to this study; the occupational health department; and the inventory supply workers for their contribution to data collection.
References
- Devices for preventing percutaneous exposure injuries caused by needles in healthcare personnel.Cochrane Database Syst Rev. 2014; (CD009740)
- Using an intravenous catheter system to prevent needlestick injury.Nurs Stand. 2010; 24: 42-46
- Impact of a single safety-engineered device on the occurrence of percutaneous injuries in a general hospital in Brazil.Am J Infect Control. 2014; 42: 174-177
- Reduction of needlestick injuries in healthcare personnel at a university hospital using safety devices.J Occup Med Toxicol. 2013; 8: 1-5
- Using denominators to calculate percutaneous injury rates: articles by center personnel in advances in exposure prevention, 1994-2005.International Healthcare Worker Safety Center, University of Virginia, Charlottesville (VA)2002: 8-9
- Device-specific rates of needlestick injury at a large military teaching hospital.Am J Infect Control. 2008; 36: 750-752
- Effectiveness of safety-engineered devices in reducing sharp object injuries.Occup Med. 2015; 65: 39-44
Article info
Publication history
Published online: March 01, 2016
Footnotes
P.C.F.C and S.E.M.T. contributed equally to this study.
Conflicts of interest: None to report.
Author contributions: Study design: S.E.M.T. and P.C.F.C. Data collection and analysis: F.M.V.P., P.C.F.C., and S.E.M.T. Manuscript preparation: F.M.V.P., R.K.R., P.C.F.C., and S.E.M.T.
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Copyright
© 2016 Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.
