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The Fight to Prevent NSI is Still On

October 17, 2014

A recent study of sharps injuries in the US indicated that little has changed in terms of the number of incidents happening. The research, led by Mr Gimmond, fellow of the Australian Society for Microbiology, indicated that the problem may be down to education after safety devices, as well as increasing their adoption.

Blood exposure from percutaneous sharps injuries is a serious occupational risk for healthcare workers, and something that organisations and hospitals are proactively working to reduce. But data suggests that little progress has been made in a decade. 

Due to the lack of information on the subject, the Association of Occupational Health Professionals in Healthcare (AOHP) commissioned a new Exposure Study of Occupational Practice to determine a reliable and representative figure of blood exposure for the US.

As such, a nine-item electronic survey was developed and distributed to members of the AOHP to find out the underlying problem. The research asked for the total number of sharps injuries among healthcare workers in the organisation and the amount that had occurred during surgical procedures. 

Respondents were also asked for details about full-time equivalent (FTE) staff; average daily census, adjusted patient days (APD), teaching status, medical staff inclusion, and which state they were in.

The team then analysed the incidence rates per 100 FTE, per 100 occupied beds (OB), and per 1,000 APD, which were then compared to the national databases.  

During the research, best practices from the top ten lowest-exposure teaching and non-teaching hospitals were also collected. The survey results were then used to calculate a national estimate of blood exposure in hospital and non-hospital settings.

Some 125 hospitals across 29 states responded to the survey, making it the largest of its kind in the US. Overall sharps injury incidence rates were: 24.0/100 OB (17.8 in non-teaching and 27.4 in teaching hospitals); 1.89/100 FTE; and 0.53/1,000 APD. 

The report also highlighted some of the effective reduction strategies being used in low-incidence, “sharps aware” hospitals, such as regular competency education, monthly institutional emails, easy reporting process, involving management, immediate action on ‘trends’; and aims to reduce NSI to zero.

The survey indicates that across hospital and non-hospital settings in the US some 321,907 healthcare workers sustain sharps injuries, with 441,344 suffering blood exposure each year.


The study suggests that little progress has been made in the last decade, which is odd as Occupational Safety and Health Administration (OSHA) law dictates that each healthcare setting must implement safety engineered devices wherever commercially available and clinically feasible, as well as taking other measures to minimise the risk of sharps injuries.

Mr Gimmond, who is also director of the Grimmond and Associates Microbiology Consultancy, indicated that the issue could be down to incorrect disposing of needles and other medical sharps. He audited a sample of 18 sharps containers from five Florida healthcare facilities and found that more than half of the sharps were not safety devices.

However, of the safety devices more than a fifth (22 per cent) were not activated and therefore did not provide any protection.

This suggests that healthcare organisations need to do more to ensure that all healthcare workers are taking the appropriate precautions to minimise their risk of sharps injury. It is also the responsibility of the employer to have safety devices in place where possible to further safeguard employees.

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