Effect of Implementing Safety-Engineered Devices on Percutaneous Injury Epidemiology

<jats:title>Abstract</jats:title><jats:sec id="S019594170007716X_abs1"><jats:title>Objective:</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec id="S019594170007716X_abs2"><jats:title>Design:</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec id="S019594170007716X_abs3"><jats:title>Setting:</jats:title><jats:p>A 427-bed, tertiary-care hospital in Manhattan.</jats:p></jats:sec><jats:sec id="S019594170007716X_abs4"><jats:title>Participants:</jats:title><jats:p>All employees who reported percutaneous injuries during the study period.</jats:p></jats:sec><jats:sec id="S019594170007716X_abs5"><jats:title>Intervention:</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec id="S019594170007716X_abs6"><jats:title>Results:</jats:title><jats:p>The mean annual incidence of percutaneous injuries decreased from 34.08 per 1,000 full-time–equivalent employees preintervention to 14.25 postintervention (<jats:italic>P</jats:italic> < .001). Reductions in the average monthly number of percutaneous injuries resulting from both low-risk (<jats:italic>P</jats:italic> < .01) and high-risk (<jats:italic>P</jats:italic> was not significant) activities were observed. Nurses experienced the greatest decrease (74.5%, <jats:italic>P</jats:italic> < .001), followed by ancillary staff (61.5%, <jats:italic>P</jats:italic> = .03). Significant rate reductions were observed for the following activities: manipulating patients or sharps (83.5%, <jats:italic>P</jats:italic> < .001), collisions or contact with sharps (73.0%, <jats:italic>P</jats:italic> = .01), disposal-related injuries (21.41%, <jats:italic>P</jats:italic> = .001), and catheter insertions (88.2%, <jats:italic>P</jats:italic> < .001). Injury rates involving hollow-bore needles also decreased (70.6%, <jats:italic>P</jats:italic> < .001).</jats:p></jats:sec><jats:sec id="S019594170007716X_abs7"><jats:title>Conclusions:</jats:title><jats:p>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.</jats:p></jats:sec>