KNOWLEDGE, ATTITUDE

AND PRACTICE OF SHARP

INJURIES AMONG NURSES
AT KNH OPERATING
THEATRES
By

Background
The operating room environment is
unique because of the carefully
orchestrated team approach to
surgical care.
Surgeons, nurses and operating room
technicians work very closely
together handling the same
instruments in a confined space.

Background
Needlestick and sharps injuries
represent a major occupational
hazard especially among this group.
Contaminated needlestick injuries
are very efficient at transmitting
blood borne pathogens between
patients and healthcare staff

Background.

Nurses are vulnerable to serious

infectious diseases such as human
Immunodeficiency virus (HIV),
hepatitis B virus and hepatitis C virus
following a needlestick injury

Background.
It is reported that 6-16% of these
injuries occur during hand to hand
passing of sharp instruments, suture
needles and other sharp devices.
A team approach to safety in the
operating room is critical if injury
rates are to be reduced.

Conceptual Framework

Conceptual Framework
The Neuman Systems Model served
as the theoretical framework for this
study.
This model identifies the client as a
central core surrounded by three
types of defense mechanisms:
flexible line of defense (FLD), normal
line of defense (NLD), and lines of
resistance (LOR).

Conceptual Framework
The Neuman Systems Model also
focuses on interventions, including
primary, secondary, and tertiary.
Primary prevention prevents
encounters with stressors.
Secondary prevention involves
screening for stressor penetration,
while tertiary prevention is centered
on reconstitution of the FLD and
NLD.

Conceptual Framework
Primary prevention includes engineered
safety devices, no recapping of
needles, and educational programming.
Secondary interventions for the nurse
include continuing assessment of
incidence of needlestick injuries.

Conceptual Framework
An example of tertiary intervention
would be post-exposure prophylaxis
following a needlestick injury.

Study Objectives
Determine the Socio - economic and
demographic characteristics of nurses
working at KNH main theatres.
Assess the Knowledge, attitude and
practices of disposing needles/sharps in
KNH main theatres
Determine the frequency of needlestick
injuries among nurses working at KNH
operating theatres.
Determine the relationship between sociodemographic and frequency of sharp injury

METHODOLOLOGY
A descriptive cross-sectional study
design was used by means of self
administered questionnaire from 75
randomly sampled nurses.
Data was entered and analyzed using
statistical package for social science
(SPSS) Version 13.0.

Results
75 nurses were recruited from whom
75 completed questionnaires were
obtained (Overall response rate
100%)
The respondents were mostly female
nurses (58.8%) . Males were 41.2%.

Results

Results
Slightly above two third of the
respondents (88.2%) had a working
experience of 1 year and above in
operating room.
Those with experience of less than 1
year accounted for 11.8% .

Results
Highest
percentage
of nurses
had worked
in the
operating
theatre for
period
above 1
year

Results
85.3% of nurses reported no
needlestick/sharp injuries events.
However 14.7% reported at least 1-2
pricks in the past 1 year.

Results

There was a significant association

between an incident of sharp or
needlestick injury and knowledge on
safety precaution guidelines
(P > 0.001)
Nurses who had adequate
knowledge, good attitude and right
practice had minimal or no
needlestick injury

Universal Precaution

Percent (%)

100

95.8%

80
60%

60
40%

40
20
0

4.2%
No
Yes
Ever had needlestick
Knowledge on Universal P.

No Knowledge on universal P.

Diseases Transmitted by
Sharps
Incidences of sharps or needlestick
injuries was significantly associated
with adequate knowledge on diseases
transmitted by this sharps ((P=
0.002)

Diseases Transmitted by Sharps

Wearing of Gloves
Wearing gloves when disposing needles or
sharps was significantly associated with a
case of Sharp or needlestick injury (P=
0.004) O.R 3.2(95% C.I 1.8-5.5)
Nurses who wear gloves always when
disposing sharps had minimal or no sharp
injury

Wearing of Gloves

Recapping of needles
A case of sharp or needlestick injury
was significantly associated with
recapping needles (P= 0.034).
Nurses who did not practice needle
recapping got minimal or no
sharp/needlestick injury

Percent(%)of N. recapping

Recapping of needles
100.0

93.1%

80.0

60.0%

60.0

40.0
20.0
0.0

40.0%
6.9%
Yes

No

Should needles be recapped

Never had Needlestick
Ever had Needlestick

Discussion
85.3% of nurses reported no
experiencing NSI/Sharp injury in the
past 12 months which compares well
with similar studies done in
Turkey(78%) and Uganda(87%)

Discussion
Although majority of the nurses
reported no incidences of NSI, a
sizeable proportion (14.7 %) got the
NSI or still went unreported.
The non-reporting of NSI event is a
contentious issue within nursing
profession and appears to be
widespread .

Discussion
For example, in the USA , it has been
shown that NSI are more common
than institutional figures suggested
and do not occur at random.

Recommendations
There is need for continuous refresher
course especially on safety precautions
when handling sharps/needles
Since it was a small project , there is
also a need for further research on
NSI to ratify the findings

References
Shah S.M. A., Barbara S., David B, Michael F.,
John K,(2003) Safety & Health
Assessment &
Research for Prevention,
(SHARP) Retrieved on 5/10/2008 from
http://www.lni.wa.gov/Safety/Research/files
/NeedleStick.pdf
Smith. D., Choe. M, Jeong. J., Jeon. Y, Chae. M
& An. G. (2006) Epidemiology of Needlestick
and Sharps Injuries among Professional Korean
Nurses. Journal of Professional
Nursing,Volume 22,Issue 6,Pages 359 - 366

References

Smith. D. R., & Leggat. P. A (2004)

Needlestick and Sharps Injuries among
nursing Students: Journal of advanced
Nursing. Vol 51. Issue 5. pp 449-455.
Nsubuga F. M. & Jaakkola M, S., (2005)
Needlestick injuries among nurses in subSaharan Africa. Journal of Tropical
medicine and International health Volume
10 Number 8 page 773-781