| Objective:To explore the feature and the characteristics of needle stick and sharps injuries(NSI) among nurses, to analyze the features and influencing factors for providing scientific evidence of taking corresponding occupational protection.Methods:A scene cross-sectional survey was made for the nurses from a tertiary hospital selected using the method of cluster sampling and the stratified-cluster sampling. Nurses were investigated by completing questionnaires, concluding self-designed NSI questionnaires, A type character scale, Maslach Burnout Inventory. To explore the personal information, bad operation behavior, A type character, Job burnout and NSI exposure contents such as NSI exposure levels, departments, exposure instrument, links, reporting situation, psychology and so on. We investigated 458 nurses of which 292 suffered from NSI and 166 patients without any injury were Non-NSI. All the data were analyzed with SPSS (version 13.0).Results:1. Retrospective survey results showed that of the 458 clinical nurses investigated during the past 1 year,292(63.76%)nurses had experienced at least one NSI in the previous year,166 nurses experienced multiple NSI accounting for 47.38%. Among 458 nurses, there had been a total of 1286 NSI events in the previous year, giving a crude incidence of approximately 4.40 NSI events/nurse/year.2. the most common causative devices were butterfly needles, which injured 31.66% of all nurses and accounted for 27.60% of all NSI events. Ampoules and hypodermic needles were the next most common causative devices, injured 27.07% and 19.43% of all nurses, accounting for 23.79% and 16.80% of all NSI events. Other causative devices were unspecified surgical tool, syringe needles, glass devices and else.3.44.48% (572) of all NSI events occurred in the preparing process,39.04% (502)of all NSI events occurred in the operating, instrument tiding up and refuse disposal were the next causative links, accounting 8.86%(114) and 1.63%(21) of all NSI events. There are also 77 cases NSI in other links. The most common operating link was opening an ampoule or vial, followed by removing the needle from the patient after transfusion/draw blood/injecting, take off the protective hat of the syringe needles.4. the most common injury site was hand, accounting for 94.8% of all NSI events. Fingers of both hands accounting for 89.43% of all NSI events, right index finger took the first high incidence among them, accounting for 37.48%, followed by the right middle finger and left index finger, accounting for 16.33% and 13.53%.5. The reason due to NSI were he did not care (47.82%), the operation was too hasty (17.65%), collisions with others (6.77%), patients do not fit (6.69%), quality problems caused by sharp injury (5.52%), Other causes of action (3.97%), damage caused by sharp inconvenient to use (3.81%), unskilled operation (3.19%), operating non-standard (2.95%), other (1.63%).6. Before the NSI occurred,159(54.5%) nurses indicated that their psychological normal,96(32.9%) nurses felt impatient or nervous and 37(12.7%) nurses reflected depressed or unhappy. Those who experienced NSI only 9.59% of them felt nothing, remaining 90.41% of the nurses showed varying degrees of anxiety and fear.7. Only 229 times (17.81%) NSI had been reported to related administration; 1057 times (82.19%) had not been reported. Main reason for not reporting followed "too busy", "do not know the reporting procedures", "that the report does not matter", "do not know who and what department to report". There are some nurses considered that the risk of injury leading to HBV, HCV and HIV infection is minorl.8. There are 166 nurses of the A type personality accounted for 36.24%; there are 32 nurses of the extreme character of the middle and 260 nurses of the B type character which accounted for 6.99% and 56.77%. Surgical department took a large number of the nurses with the A type personality. The job burnout survey result showed varying degree of burnout in all nurses. The burnout dimension scores lower than the normal level.9. By the chi-square test, we found the differences of NSI were especially notable among patients with different department, work experience, vision, job burnout, emotional exhaustion and depersonalization, but no statistical significance among patients with sex, marriage, forms of work, job title, and education. Defining the cases with NSI as 'injured group' and the cases without NSI as 'contrast group', we analyzed the relationship between NSI and job burnout, style-A by Case-control study. Single factor analysis showed the influencing factors included emotional exhaustion, depersonalization and style-A. The Spearman correlation analysis showed a significant positive correlation in them.10. we analyzed the data with non-conditional Logistic method.The analysis result showed that the independent risk factors of NSI were Work experience, job title, department, vision, style-A, Including surgery department, injection rooms/blood center, operating room, senior nurse,11-20-year working life of nurses.Conclusions:1. We should pay much more attention to NSI and take effective measures to reduce the morbidity of it because they are the high risk population. Most of the nurses have not do the right operation even they have been educated. So we should strengthen the supervision of NSI.2. The most common causative devices were butterfly needles and Ampoules; The most common operating link was opening an ampoule or vial, the next were Removing the needle from the patient after transfusion/draw blood/injecting; the most common injured site were fingers of both hands, right hand received much more injuries than left hand. Carelessness and the hasty operation is the main reason of sharp injuries, but also in part because patients do not fit, sharp quality and design is not well.3. There are significant differences between the number of NSI and different state of mind before NSI occurred. Nurses experienced NSI have widespread varying degrees of psychological problems such as fear, anxiety and other problems. Negative emotions after injury is also easily cause injury from happening again. For the injured nurses, especially the pollution of sharps injuries, we should pay attention to psychological counseling after the injury and other treatments.4. NSI reported condition isn't well, mainly because nurses were too busy to report, do not know reporting procedures, and other reasons that the report does not matter, and even there are some nurses reported but with no relevant post-treatment, so they give up it. Strengthen the supervision of nursing staff of sharp injuries, strictly supervise the implementation of reporting procedures after injury, and take active preventive measures for those injured nurse.5. That job titles, work experience, visual acuity, department, and job burnout related with the occurrence of NSI. Job burnout and style-A personality factors are the impact factors of NSI, but not independent risk factors. |
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