To investigate the incidence and risk factors of needle stick injury(NSI) and the association between NSI and hepatitis B infection in hospital personnel, a prospective cohort study was conducted at a university hospital in Pusan city from April 1, 1994 to September 30, 1994.
Of five hundred and thirty hospital personnel, 38.7 percent reported one NSI or more. The annual person incidence rate of NSI was 81.3 per 100 persons and annual spell incidence rate was 144.3 per 100 persons.. The annual incidence rate in registered nurses (192.8 cases per 100) was the highest, followed by physicians (115.4 cases per 100), nurse aids (75.5 cases per 100) and laboratory technicians (51.8 cases per 100) (p<0.05).
Risk factors significantly associated with needle stick injuries were being interns higher than residents (p<0.05) for physicians, the incidence rate decreased as length of employment increased (p<0.05) for registered nurses and working in operating room and central supply room higher than working in surgical department (p<0.05) for nurse aids.
The most common device related to needle stick injuries was disposable needles (49.7%) , the most frequent activity related to needle stick injuries was recapping needle (35.7%) , and most of the needle stick injuries occurred in nurse station (40.9%) and patient room (34.1%).
The vaccination rate for hepatitis B virus was 40.2 percent. Of the non-vaccinees, 4.5 percent were positive for hepatitis B surface antigen and 69.2 percent were serologically positive for hepatitis B viral markers at the beginning of this study. Of 80 negative personnel for all hepatitis B viral markers, 27 persons experienced needle stick injuries during study period. Three out of 27 persons were positive for hepatitis B markers at the end of follow-up. However, all of 53 personswho had no experience of needle stick injuries were negative. Therefore, NSI was significantly associated with HBV infection and the annual incidence for hepatitis B virus infection was as 8.0 per 100 in hospital personnel.
These findings suggest that hospital personnels are at a high risk group for needle stick injuries. Particularly interns, novice registered nurses (length of employment less than 1 year), and nurse aids who are working at operating room and central supply room are the highest risk group. It is recommended that NSI prevention program for hospital personnel should be developed to minimize the risk of needle stick injuries in the hospital.
|