Safety-engineered device implementation: does it introduce bias in percutaneous injury reporting?

Infect Control Hosp Epidemiol. 2004 Jul;25(7):543-7. doi: 10.1086/502437.

Abstract

Objective: To examine whether implementation of safety-engineered devices in 2001 had an effect on rates of percutaneous injury (PI) reported by HCWs.

Design: Before-and-after intervention trial comparing 3-year preintervention (1998--2001) and 2-year postintervention (2001--2002) periods. PI data from anonymous, self-administered surveys were prospectively entered into CDC NaSH software.

Setting: A 427-bed, tertiary-care hospital in Manhattan.

Participants: HCWs who attended state-mandated training sessions and completed the survey (1,132 preintervention; 821 postintervention).

Intervention: Implementation of a "safer-needle system" composed of various safety-engineered devices for needle-safe IV delivery-insertion, blood collection, and intramuscular-subcutaneous injection.

Results: Preintervention, the overall annual rate of PIs self-reported on the survey was 36.5 per 100 respondents, compared with 13.9 per 100 respondents postintervention (P < .01). The annual rate of formally reported PIs decreased from 8.3 to 3.1 per 100 respondents (P < .01). Report rates varied by occupational group (P < or = .02). The overall rate did not change between study periods (22.7% to 22.3%), although reporting improved among nurses (23.6% to 44.4%, P = .03) and worsened among building services staff (90.5% to 50%, P = .03). HCWs with greater numbers of PIs self-reported on the survey were less likely to formally report injuries (P < .01). The two most common reasons for nonreport (ie, thought injury was low risk or believed patient was low risk for blood-borne disease) did not vary from preintervention to postintervention.

Conclusions: Safety-engineered device implementation decreased rates of PIs formally reported and self-reported on the survey. However, this intervention, with concomitant intensive education, had varying effects on reporting behavior by occupation and a minimal effect on overall reporting rates.

Publication types

  • Evaluation Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Bias
  • Equipment Design
  • Health Care Surveys
  • Humans
  • Infection Control / methods*
  • Infection Control / statistics & numerical data
  • Needlestick Injuries / epidemiology*
  • Needlestick Injuries / prevention & control
  • New York City
  • Occupational Diseases / epidemiology*
  • Occupational Diseases / prevention & control
  • Occupational Exposure / prevention & control
  • Occupational Exposure / statistics & numerical data*
  • Outcome and Process Assessment, Health Care
  • Risk Management / methods*