Profile of Splash, Sharp and Needle-Stick Injuries Among Healthcare Workers in a Tertiary Care Hospital in Southern India

Abstract

Background and objective Among biological hazards faced by healthcare workers, one of the most commonly reported is sharp-related injury. Needle-stick and sharp injuries transmit infectious diseases, especially blood-borne viruses. The conditions in which these exposures occur vary. Reporting of exposure and proper post-exposure prophylactic measures are important in controlling blood-borne infections in healthcare workers. Better analysis of such accidents is an important tool to reinforce exposure preventive measures. Hence, we conducted a study to describe the profile of splash, sharp and needle-stick injuries among healthcare workers in a tertiary care hospital. Methods A record-based cross-sectional study was done in a tertiary care hospital, in south Tamil Nadu. All healthcare workers who have reported needle stick, sharp, or splash injuries during the last five years in the hospital were included. Data was extracted from post-exposure reports maintained in the hospital. Results are expressed in mean, standard deviation and percentages. Results A total of 189 healthcare workers (HCWs) had reported instances of splash, sharp and needle stick injuries in the last five years. The most common exposure was needle prick (86.2%), followed by splash of fluids (7.4%). The majority of HCWs were from the nursing department (44.4%), and the most commonly reported place of exposure was the Emergency Department and Intensive Care Unit (ICU) (30.3%), followed by inpatient wards. The associated activity in the majority of the injuries/exposures was the transfer of sharps or cleaning surfaces (26.4%), followed by blood withdrawal (25.7%). After the exposure, 99.5% of HCWs washed the wound immediately. In a total of 135 exposures, the identity of the source, and thus, the serological status was known. Among these, hepatitis B was the most common (17.8%), followed by HIV (11.9%). All exposures related to unknown sources were considered positive exposure and were managed accordingly. Among the HCWs with possible seropositive exposure to hepatitis B, antibody titres were recorded and HBV Immunoglobulin (low titre), and vaccination were administered accordingly. Among the possible HIV exposures, 97.1% of HCWs initiated post-exposure prophylaxis (PEP). All probable hepatitis C exposures were given counseling and advised to follow up. No seroconversion at six months of follow-up has been recorded till now. Conclusion Healthcare workers are constantly at risk of exposure to splash, sharp and needle stick injuries, and although all categories of workers are at risk, nurses are at particularly high risk. A variety of activities can result in injury or a splash of fluids and so preventive activities, including health education, should be focused on all areas of healthcare and for all healthcare workers. More awareness is needed among healthcare workers regarding post-exposure prophylaxis.

Keywords: exposure; healthcare workers; hepatitis; hiv; needle stick injury.

Figure 1. Nature of the exposure

Figure 2. Distribution of healthcare workers who reported exposure according to their job description

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Figure 3. Healthcare workers with possible seropositive exposure to hepatitis B