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Abstract：
Introduction Needlestick and sharp injuries (NSI) continue to pose a significant risk for healthcare workers (HCWs) at their workplace. The incidence rate of NSI in hospitals depends on multiple risk factors. This study aimed to analyze the epidemiological characteristics of NSI among HCWs and the risk factors influencing NSI rates and to provide further direction for NSI prevention in secondary care hospitals. Methods This study included all the NSI cases reported by HCWs in King Abdul Aziz Hospital, Makkah from 2005 to 2017. All the cases were recorded in the Exposure Prevention Information Network (EPINet™) database (International Healthcare Worker Safety Center, University of Virginia, Charlottesville, USA). The study was executed by using data loaded in the EPINet™ Program, the hospital electronic recording system Medica Plus, and analyzed by the Statistical Package for the Social Sciences program (SPSS Inc. Released 2007. SPSS for Windows, Version 15.0. Chicago, SPSS Inc.). Results During the period of study, 524 NSI cases were reported. The mean incidence rate per 100 occupied beds with 95% CI was 25.43 (22.05-28.81) and a statistically insignificant decline in NSI incidence rate was observed from 2005 to 2017. The maximal annual incidence rate (35.63 per 100 occupied beds) was registered in 2010 and the minimal value (14.84 per 100 occupied beds) in 2013. Injuries were mainly reported in patient rooms/wards (30.2%) and most frequently by nurses (56.1%). The mean of incident reporting within 24 hours was 74.0, 95% CI (67.19-80.73). This rate showed a statistically significant (p=0.01) increasing trend of 5.0% per annum. The mean of identified source patients - 83.5, 95% CI (79.13- 87.23) - possessed an annual 2.1% rise during 2005-2017 which was statistically insignificant (p=0.7). Cases occurred after the use/before disposal of items in 45.0% of cases and during the use of items in 44.7%. Hollow-bore needles caused injuries in 46.5% of incidents. Blood sample taking - 23.2% and IV or arterial line insertion/removal/manipulation (19.1%) - presented exposure-prone procedures posing the highest risk. Conclusions The results of this study revealed a high rate of NSI in the hospital. NSI rate in hospitals was impacted by a group of related risk factors, particularly, the location of risk (patient room/ward, intensive care unit (ICU), and emergency room (ER) depending on job intensity, the kind and frequency of exposure-prone procedures (blood sample taking, IV or arterial line insertion/removal/manipulation) and handling of hollow-bore and solid needle connected to the main healthcare professional group at risk (nurses). Future direction in NSI prevention requires a complex approach of continuous staff education along with the usage of devices with safety features.
摘要：
介绍针头和锐器伤（NSI）继续对工作场所的医护人员（HCW）构成重大风险。医院NSI的发生率取决于多种危险因素。本研究旨在分析HCWs中NSI的流行病学特征以及影响NSI发生率的危险因素，为二级保健医院NSI的预防提供进一步的指导。方法本研究纳入了阿卜杜勒阿齐兹国王医院HCW报告的所有NSI病例，麦加从2005年到2017年。所有病例均记录在暴露预防信息网络（EPINet™）数据库中（国际医疗工作者安全中心，弗吉尼亚大学,夏洛茨维尔,美国）。该研究是通过使用EPINet™程序中加载的数据执行的，医院电子记录系统MedicaPlus,并由社会科学计划统计软件包（SPSSInc.2007年发布。SPSSforWindows,版本15.0。芝加哥,SPSSInc.)。结果在研究期间,报告了524例NSI病例。在95%CI的情况下，每100张床位的平均发病率为25.43（22.05-28.81），从2005年到2017年观察到NSI发病率在统计学上无统计学意义的下降。2010年登记的年发病率最高(每100张床位35.63张)，2013年登记的年发病率最低(每100张床位14.84张)。受伤报告主要在病房/病房（30.2％），护士最常见（56.1％）。24小时内事件报告的平均值为74.0,95%CI(67.19-80.73)。该比率显示出统计学上显著(p=0.01)的每年5.0%的增加趋势。确定的来源患者的平均值-83.5，95％CI（79.13-87.23）-在2005-2017年期间每年增长2.1％，在统计学上无统计学意义（p=0.7）。病例发生在使用后/处置前的物品占45.0%，使用期间的物品占44.7%。在46.5％的事件中，空心针头造成了伤害。血液样本采集-23.2％和IV或动脉管线插入/取出/操作（19.1％）-存在暴露倾向的程序，风险最高。结论本研究结果显示医院NSI发生率较高。医院的NSI率受到一组相关风险因素的影响，特别是,风险的位置(病房/病房，重症监护病房(ICU),和急诊室（ER）取决于工作强度，易暴露程序的种类和频率(血液样本采集，IV或动脉管线插入/移除/操作）并处理连接到处于危险中的主要医疗保健专业人员组（护士）的空心孔和实心针。NSI预防的未来方向需要一种复杂的持续员工教育方法，以及使用具有安全功能的设备。
