Effectiveness of measures to prevent needlestick injuries among ...

4 Intervention program evaluation
Corlett et al. evaluated a “no touch” technique for abdominal wall closure following
laparotomy [91]. Surgeons were randomly assigned to use the traditional technique
with manual wound closure during suturing, or to use a “no touch” technique in which
the wound edges are held by toothed forceps. The investigators assessed the number
of glove perforations occurring during closure. They found no significant differences in
perforations occurring during surgery but prior to wound closure (9/50 “hands in”,
12/50 “no touch”; p = 0.62), and reported a significant protective effect of the
“no touch” technique during wound closure (16/50 “hands in”, 3/50 “no touch”;
p = 0.0017). Although this intervention used a strong design to evaluate the new sur-
gical technique, there was no indication that the surgeons had any experience with the
“no touch” method prior to randomization, and there was no discussion of compliance
included in the paper.
In another pre-post intervention comparison, Linnemann et al. reported no effect of
universal precautions training on the rate of NSI [92]. Results of this evaluation were
likely to have been biased towards the null due to implementation of two additional
other safety interventions in the two-years preceding the universal precautions training.
A previously described ecological study by D’Arco et al. investigated a multidiscipli-
nary approach to needlestick prevention [43]. From 1987 to 1988, three concurrent
needlestick prevention protocols were implemented. These included installation of rigid
disposal containers, staff training regarding HIV and AIDS risks, and training regard-
ing the importance of reporting NSI. A 12 % increase in NSI reports was observed
from 1987 to 1988, suggesting success in motivating staff to report NSI.
Edmond et al. reported no effect of an education intervention program paired with
installation of bedside needle disposal units (described above) [73]. The details and
goals of the educational program were not discussed in the paper. The outcome of
interest was frequency of recapped needles with counts obtained through direct obser-
vation of nurses at work.
Training components were included in the programs described by Dale et al. and
Gartner, but were not separately evaluated for efficacy in reducing NSI [42; 48; 93].
Report „Needlestick injuries“ 55