Exploring Needlestick & Sharp Injuries Amongst

The College of the Bahamas Student Nurses:

Grosvenor Close Campus

By:
Narissa Adderley, Brittany Bartlet, Kuanda Collie,
Estherlee Newbold-Thompson & Katrina Rolle

Of 35 million percutaneous exposure worldwide the World Health Organization (WHO)

estimated that 3 million are exposures to blood-borne pathogens ( as cited in Petrucci, Alvaro,
Cicolini, Cerone & Lancia, 2009).
WHO estimated that exposures will result in approximately 2 million hepatitis B virus
(HBV), 0.9 million hepatitis C virus (HCV) and 170,000 human immunodeficiency virus
(HIV) infections in healthcare workers (as cited in Petrucci et al., 2009).
The WHO estimated that 90% of these infections will occur in developing countries (as cited
in Petrucci et al., 2009)
Incidence rate of NSIs and sharp injuries in nursing students internationally ranges from 9.4%
to 61.9% in Asia, US, Canada, Australia and European countries of which non-reported
injuries ranged from 39.5% to 96.24% (Hambridge, 2011).
Based on international investigations 10.29% of nursing students experienced at least one
accidental exposure to blood or infected biological material during practical training; and the
hollow-borne needle was the device most commonly involved (Petrucci et al., 2009).
45% of the accidental exposures occurred when the student worked independently on a
medical or surgical ward (Petrucci et al., 2009).

Incidence rate and context of NSIs and sharps injury among

the Grosvenor Close student nurse populous is unknown.
Nursing students are exposed to the risks of contracting more
than 20 blood-borne pathogens that can be contracted
following a needlestick or sharps injury (as cited in
Hambridge, 2011).
There still exist a paucity of accurate data relating to the
numbers of NSIs and sharps injury in the student nurse
population due to non-reporting.
Student nurses are thought to be at high risk of NSIs and
sharps injuries due to poor technique, inexperience and poor
use of universal precautions (Ofili & Sogbesan, 2009).

To determine the incidence of needlesticks and sharp

injuries.
to describe the factors that contributed to the injury.
to examine what predictors influence the reporting
and non-reporting between the first-year through
fourth year student nurses at the College of the
Bahamas Grosvenor Close campus.

 Haddon

Matrix Model (1970):

The model is used to identify risks related to an injury.

It will allow for a better understanding of the nature of the NSIs and
Sharp injuries and aids in the development an approach from an
occupational and a nursing education perspective to identify targets
for prevention, mitigation, and intervention.
The model is based on the epidemiologic model (host, agent, and
environment) and levels of prevention (pre-injury, injury and post
injury) to help researchers think about injuries in their pre-event,
event, and post-event phases.
Applying Haddon's matrix to needlestick injuries suggests factors
that may contribute to injury occurrence and post-event efforts that
might be made to prevent these injuries from occurring in the future.

Host (Student)
Pre-Injury Phase

Injury Phase

Agent (Device of Injury)

Environment (Physical)

Surroundings awareness,

Clinical supervision, type of device,

Clinical Area exposure control plan

Knowledge of prevention and use of

Use of sharps with retractable, safety

Implementation of surveillance and

safety device, level of training, use

features (needles, lancets,); sharps

prevention of sharps injuries

of safe work practice

disposal containers

protective equipment quality,

Type of device used

Positioning and condition of sharps

container., Supervision, Area
occurred

Post-Injury

Exposure control plans and

reporting of exposures, tests
and post-exposures
prophylaxis offered, time
consumed.

Encourage Safety Measures

Presence of reporting center; use of

reporting center, evaluation,
treatment, and followup; and the
availability of post exposure
prophylaxis

Haddon Matrix Model

Used to provide the framework to identify
risks related to an injury; and recognizes that
different factors operate in each phase of the
model and that any possible intervention (s)
should take these factors into consideration.

Author

Study Design

Outcome Variable

Small, Pretorius, Walters and Ackerman,

(2011)

Quantitative Descriptive

Incidence rate and context of occurrence

Mitra, Mallik, Das, and Roy (2010)

Cross Sectional Descriptive

Perception and practice

Smith & Leggat, 2005

Questionnaire Based

Prevalence and nature

Askarian, Malekmaken, Memish,

Assadian, 2012

Cross Sectional

Frequency and practices

Unver, Tastan, and Coskun (2012)

Cross-Sectional Descriptive

Frequency and causes

Foster, Lee, McGraw and Frankson

(2010)

Cross-Sectional Descriptive

Incidence Rate

Irmak and Baybuga (2011)

Descriptive Cross-sectional

Prevalence and Factors

Kumakech , Achora Berggren and

Bajunirwe (2011)

Descriptive Cross-sectional

To assess frequency of occupational

exposure to HIV, circumstances,
predisposing factors, high-risk groups,
reporting and post exposure PEP

Talas (2009)

Descriptive and retrospective

Frequency, activities and devices

Hulme (2009),

Anonymous Questionnaire

Incidence Rate

Review Board Approval

Recruitment
Access to Participants
Cover letter
Voluntary participation
Anonymity
Small token of appreciation

Methods & Sample

Design

Quantitative cross-sectional correlational

Sample Size

One hundred and fifty (150) participants recommended

Setting

College of the Bahamas Grosvenor Close Campus

Instrumentation:

Researchers Self-Developed Questionnaire

Adapted from 3 international studies.

Containing 30 open and closed ended questions.

Inclusive criteria

Nursing students, 18 years and older, in their 1st to 4th

year, attending the Grosvenor Close Campus, presently
enrolled or have completed clinical practice in a PHA or
DPA institution.
o Able to speak, read and write English.

Exclusion criteria

Non-nursing students and nursing students, under 18

years of age, not in their 1st through 4th year, not
attending the Grosvenor Close Campus, presently not
enrolled or have not completed clinical practice in a PHA
or DPA institution.
o Unable to speak, read and write English.

Research Questions:

1.
What is the incidence of needlesticks and sharps injuries among COB student nurses?

2.
What are the factors that contribute to needlesticks and sharps injuries among COB student nurses?

3.
What is the percentage of reported needlesticks and sharps injuries among COB student nurses?

4.
What is the percentage of non-reported needlestick and sharps injuries among COB student nurses?

5.
What is the influence of select demographic on needlestick and sharp injuries in COB student
nurses?
Research Hypotheses:

H1. COB student nurses in the fourth and third years will have a higher incidence NSIs and sharps
injuries than student nurses in first and second years.
H2. The disposable needle (hypodermic) needle will be highest contributing factor to needlesticks
and sharps injuries in COB student nurses.
H3.There will be a low percentage of needlestick and sharps injuries amongst COB student nurses.
H4. There will be a high percentage of non-reported needlestick and sharps injuries amongst COB
student nurses.
H5. There will be strong positive correlation between the academic class of student nurses and the
incidence of needlestick and sharps injuries.

Implications of the Study:

Nursing Education
New strategies such as -use of simulation laboratory for practical nursing training.
Education programs directed towards student nurses to increase their awareness and encourage
reporting.

Nursing Practice
A separate surveillance unit for nursing students that follows up injured student nurses as a part of a
local research or ongoing audit.

Future Research
Measurement of the impact of the new strategy on the reduction of NSIs and sharps injury.
The experiences of nurses injured through NSIs could be explored to enhance support.
Factors associated with NSIs and sharps injuries and reasons for non-reporting can be explored more
Study Limitations:

Generalizability is limited: Only conducted in one nursing school

Data based on self reports: there may be reluctance to report injuries
Sample Size
Willingness to participate
Student nurses present at time of survey

Thank you