Effectiveness of measures to prevent needlestick injuries among ...

Table of contents
Preface ..........................................................................................................11
1 Introduction .......................................................................................13
1.1 Legal situation in Germany......................................................................14
1.2 Objectives and format of the report .........................................................16
2 Literature search: Methods and general results .................................19
3 Descriptive epidemiology of NSI........................................................21
3.1 Methods.................................................................................................21
3.1.1 Literature review .....................................................................................21
3.1.2 International NSI surveillance ..................................................................21
3.2 Results of literature review .......................................................................22
3.2.1 Risk of NSI..............................................................................................22
3.2.2 Modifiers of NSI risk................................................................................23
3.2.3 Underreporting.......................................................................................24
3.2.4 Infection risk by pathogen .......................................................................24
3.3 International NSI surveillance ..................................................................25
3.4 Summary................................................................................................27
4 Intervention program evaluation .......................................................31
4.1 Methods.................................................................................................31
4.1.1 Screening the literature ...........................................................................31
4.1.2 Detailed review.......................................................................................32
4.1.3 Ranking..................................................................................................32
4.2 Results....................................................................................................33
4.2.1 Replacement of hollow-bore needles for injection or blood drawing ..........33
4.2.2 Other sharps ..........................................................................................40
4.2.2.1 Needleless IV systems..............................................................................40
4.2.2.2 Blunt suture needles ................................................................................42
4.2.2.3 Safety-engineered IV systems (not needleless) ...........................................44
4.2.2.4 Retractable lancets..................................................................................45
4.2.3 Other safety equipment...........................................................................45
4.2.3.1 Assistive devices......................................................................................45
4.2.3.2 Disposal boxes .......................................................................................48
4.2.3.3 Double gloving.......................................................................................53
4.2.4 Training .................................................................................................54
4.3 Summary................................................................................................56