Effect of Implementing Safety-Engineered Devices on Percutaneous Injury Epidemiology

Abstract

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.