Effectiveness of measures to prevent needlestick injuries among ...

4 Intervention program evaluation
(Bioplexus, Inc.), and Venipuncture Needle Pro resheathable vacuum tube blood-
collection needles (Protex Inc.) for phlebotomy [37; 38]. The ten participating hospitals
did not use standardized reporting methods: some relied on institutional injury sur-
veillance policies and data collection, while others surveyed their employees specifi-
cally for this evaluation. In spite of documented differences in data collection methods
and associated differences in likelihood of completeness, and therefore, potential for
bias, the authors combined data from all ten hospitals for their efficacy analysis.
Completeness of reporting, assessed by comparing interview (recall) results for a
sample of participants with the number of phlebotomy-related NSI reported at the
institution level, was about 90 %. Although the authors concluded that the three
selected replacement devices reduced NSI rates when compared with conventional
devices, they were not able to verify that conventional equipment had, in fact, been
replaced.
Trape-Cardoso et al. [39] used passive surveillance data available from the NaSH
system for an ecological evaluation of the effectiveness of multiple interventions intro-
duced between 1997 and 2002. In addition to safety piggyback (interlink) systems,
safety butterfly needles, retractable lancets, and, eventually, replacements for all
needles attached to syringes, administrative and educational interventions were
also implemented. Specific product names or manufacturers were not specified.
From unadjusted analyses, the authors concluded that NSI to medical and dental
students and nursing staff declined over a five-year period. Reported incidence rates
decreased from 7.9 % in 2000 to 2001 to 2.6 % in 2001 to 2002 for students, and
from 9.2 % in 1997 to 1998 to 2.7 % in 2001 to 2002 for nursing staff. There was
also a small decrease in NSI among residents, but the effect was temporary. The
reversal of the trend in NSI among residents argues against a causal effect of the
interventions, and suggests the possibility of differential completeness of reporting by
HCW category. If the devices were effective at reducing NSI, the effect should have
been seen among all potential users and should not have been transient.
Younger et al. [40] evaluated the Monoject Safety Syringe (Sherwood Medical), a
shielded 3 cc safety syringe. Three participating medical centers reported the number
of NSI among staff relative to the number of inventory units ordered per year. Younger
Report „Needlestick injuries“ 37