Effect of implementing safety-engineered devices on percutaneous injury epidemiology

Infect Control Hosp Epidemiol. 2004 Jul;25(7):536-42. doi: 10.1086/502436.


Objective: To assess the effect of implementing safety-engineered devices on percutaneous injury epidemiology, specifically on percutaneous injuries associated with a higher risk of blood-borne pathogen exposure.

Design: Before-and-after intervention trial comparing 3-year preintervention (1998--2000) and 1-year postintervention (2001--2002) periods. Percutaneous injury data have been entered prospectively into CDC NaSH software since 1998.

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

Participants: All employees who reported percutaneous injuries during the study period.

Intervention: A "safer-needle system," composed of a variety of safety-engineered devices to allow for needle-safe IV delivery, blood collection, IV insertion, and intramuscular and subcutaneous injection, was implemented in February 2001.

Results: The mean annual incidence of percutaneous injuries decreased from 34.08 per 1,000 full-time-equivalent employees preintervention to 14.25 postintervention (P < .001). Reductions in the average monthly number of percutaneous injuries resulting from both low-risk (P < .01) and high-risk (P was not significant) activities were observed. Nurses experienced the greatest decrease (74.5%, P < .001), followed by ancillary staff (61.5%, P = .03). Significant rate reductions were observed for the following activities: manipulating patients or sharps (83.5%, P < .001), collisions or contact with sharps (73.0%, P = .01), disposal-related injuries (21.41%, P = .001), and catheter insertions (88.2%, P < .001). Injury rates involving hollow-bore needles also decreased (70.6%, P < .001).

Conclusions: The implementation of safety-engineered devices reduced percutaneous injury rates across occupations, activities, times of injury, and devices. Moreover, intervention impact was observed when stratified by risk for blood-borne pathogen transmission.

Publication types

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

MeSH terms

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