Effectiveness of measures to prevent needlestick injuries among ...

4 Intervention program evaluation
Based on this initial screening, 161 articles were identified as containing potentially
useful descriptions of NSI prevention programs, and 117 articles were of uncertain
utility due to the lack of detail in their abstracts, titles and/or keywords. Thus, 278
unique papers were obtained for individual, preliminary review. Several additional ar-
ticles were added from the bibliographies of key review papers, and from the updated
PubMed search. After preliminary review using the criteria shown in Table 9 (see page
95), there were 98 articles retained for possible inclusion in the Quality Based Critical
Review (QBCR). These 98 studies were subjected to more detailed review to make a
final determination regarding inclusion in or exclusion from the QBCR. The distribution
of reasons for exclusion for the articles dropped from the QBCR based on the pre-
liminary review is shown in Table 10 (see page 96). Finally 61 papers were included in
the QBCR.
4.1.2 Detailed review
The final QBCR, comprising the remainder of this report, was organized according to
category of intervention (equipment, training in safety procedures, or both). Within
each of these categories, interventions were evaluated according to quality indicators
as summarized in Table 11 (see page 97). The quality indicators address such charac-
teristics as clarity of writing, degree of planning apparent in the development of the
intervention, intervention design characteristics (such as use of an appropriate compa-
rison group, random allocation to intervention vs. comparison group, likelihood of
bias resulting from data collection procedures), statistical rigor and reasonableness of
the authors’ interpretation of the results, including a critical consideration of alternative
explanations for the results. The form used to abstract data for the QBCR as well as
the instructions for the reviewers are provided in the Annex (see page 104).
4.1.3 Ranking
Within each category of intervention, papers were ranked according to their quality.
The most important characteristics considered were: clarity of study design and meth-
ods, study design and methods appropriately minimized bias and maximized informa-
tion, allowances were made for pre-testing and training on replacement equipment,
Report „Needlestick injuries“ 32