Insulin-Injection-related Needle-stick Injuries Among Clinical Nurses at a Tertiary-Care Hospital in China

Zhiqi Luo, Na Li, Jiewei Huang, Xueyan Liu, Peiru Zhou
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Abstract

Needle-stick injuries (NSIs) are the main type of occupational injury experienced by health-care workers worldwide. They are widely reported in the literatures, but there have been few studies of insulin-injection-related NSIs. This study aimed to determine the prevalence of and risk factors for insulin-injection-related NSIs among clinical nurses working at a Chinese tertiary-care hospital. Methods: We used a questionnaire to investigate the incidence of and risk factors for insulin injection-related NSIs in a tertiary-care hospital in Guangzhou, China. The study involved 576 nurses from various departments, including endocrinology, internal medicine other than endocrinology, surgery, and obstetrics and gynecology. Results: Approximately half (54%) of the participants reported having >5-years of experience in clinical nursing, and 66.3% reported that they had received training on injection safety at work. While 16.0% of the nurses had experienced an insulin-injection-related NSI before, 58.7% of them did not report it to the relevant hospital department. When NSIs occurred, 69.6% of nurses were not wearing gloves, and 75% of the needles had been contaminated by patients. The largest proportion (34.8%) of the NSIs occurred when the needle cap was being re-attached after an injection. Multivariate logistic analysis showed that participation in training (odds ratio [OR]=0.605) and being a diabetes specialist nurse (OR=1.814) were independent factors related to the incidence of insulin-injection-related NSI. Conclusion: Insulin-injection-related NSIs are common among clinical nurses. Hospital management departments need to improve their training of nurses in preventing and handling NSIs, provide appropriate safety equipment, and implement simpler procedures for reporting NSIs.
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中国某三级医院临床护士胰岛素注射相关针刺伤害调查
针刺伤是全世界卫生保健工作者所经历的主要职业伤害类型。它们在文献中被广泛报道,但对胰岛素注射相关的nsi的研究很少。本研究旨在了解中国某三级医院临床护士中胰岛素注射相关nsi的患病率及危险因素。方法:采用问卷调查法调查广州某三级医院胰岛素注射相关nsi的发生率及危险因素。该研究涉及来自不同科室的576名护士,包括内分泌科、内分泌科以外的内科、外科和妇产科。结果:大约一半(54%)的参与者报告有>5年的临床护理经验,66.3%的参与者报告他们在工作中接受过注射安全培训。16.0%的护士曾发生过与胰岛素注射相关的自伤,58.7%的护士未向相关医院部门报告。发生nsi时,69.6%的护士未戴手套,75%的针头已被患者污染。最大比例(34.8%)的nsi发生在注射后重新连接针帽时。多因素logistic分析显示,参加培训(比值比[OR]=0.605)和作为糖尿病专科护士(比值比[OR]= 1.814)是影响胰岛素注射相关性自伤发生率的独立因素。结论:胰岛素注射相关nsi在临床护士中较为常见。医院管理部门需要加强对护士在预防和处理nsi方面的培训,提供适当的安全设备,并实施更简单的nsi报告程序。
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