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Needlestick Injuries (needlestick + injury)
Selected AbstractsOccupational exposures occurring in students in a UK dental school,EUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 3 2002D. A. Stewardson Background:, Students whilst training may encounter a number of incidents where infection from patient body fluids may occur, especially as their manual skills are underdeveloped and their clinical experience is limited. Purpose of study:, (a) To assess the nature of the occupational exposures occurring to students in a UK dental school, (b) to assess the rate of reporting of incidents, and (c) to evaluate the association of various factors with these exposures. Students in the third, fourth and final years of the 5-year undergraduate dental course at the University of Birmingham were asked to complete a questionnaire that enquired into personal details, number and nature of incidents, their reporting and follow-up. A 100% response rate was achieved. Results:, Across the years, there was no significant correlation (p > 0.01) between sex, dominant hand, use of protective glasses or time of day. Slightly more exposures occurred in males, right-handed students, and in the afternoon. A significant decrease in exposures (p < 0.01) occurred within final year, and when an assistant was employed. Significantly more incidents occurred while a patient was being treated than during operational clean-up procedures. A substantial number of dental students had experienced one or more occupational exposures during training. Of these, percutaneous injuries predominated. Junior students appear to be more likely to experience exposures, and in these students, needlestick injuries are the most common source. Conclusions:, To reduce the incidence of these exposures, more instruction and training may be required in the earlier clinical years and more chairside assistance. Improvements are required in the monitoring of post-screening for seroconversion after HBV immunization, and in the reporting of test results in the event of an exposure incident. Under-reporting of incidents is common and ways to encourage and facilitate reporting should be sought. [source] ORIGINAL ARTICLE: A survey of the management of needlestick injuries from incapacitated patients in intensive care units,ANAESTHESIA, Issue 9 2010L. A. Burrows Summary The Human Tissue Act 2004 and Mental Capacity Act 2005 resulted in a change in the management of needlestick injuries sustained from incapacitated patients. It appears unlawful to test for blood-borne viruses without a patient's consent for the sole benefit of the healthcare worker. This survey of intensive care units within England, Wales and Northern Ireland investigated how needlestick injuries from incapacitated patients had been managed within the previous year. Of the 225 intensive care units surveyed, 99 (44%) responded. Sixty-two (62.6%) reported a needlestick injury to a healthcare worker from an incapacitated patient. Thirty-six (64.3%) patients were tested for blood-borne viruses without consent. Sixteen (25.8%) patients tested positive for blood-borne viruses. Only 19 (30.6%) healthcare workers took post-exposure prophylaxis following the injury. These results show that needlestick injuries from incapacitated patients are common and that the majority of patients were tested for blood-borne viruses without consent. [source] Integration of safety technologies into rheumatology and orthopedics practices: A randomized, controlled trial,ARTHRITIS & RHEUMATISM, Issue 7 2008Gautam R. Moorjani Objective To identify and integrate new safety technologies into outpatient musculoskeletal procedures and measure the effect on outcome, including pain. Methods Using national resources for patient safety and literature review, the following safety technologies were identified: a safety needle to reduce inadvertent needlesticks to heath care workers, and the reciprocating procedure device (RPD) to improve patient safety and reduce pain. Five hundred sixty-six musculoskeletal procedures involving syringes and needles were randomized to either an RPD group or a conventional syringe group, and pain, quality, safety, and physician acceptance were measured. Results During 566 procedures, no accidental needlesticks occurred with safety needles. Use of the RPD resulted in a 35.4% reduction (95% confidence interval [95% CI] 24,46%) in patient-assessed pain (mean ± SD scores on a visual analog pain scale [VAPS] 3.12 ± 2.23 for the RPD and 4.83 ± 3.22 for the conventional syringe; P < 0.001) and a 49.5% reduction (95% CI 34,64%) in patient-assessed significant pain (VAPS score ,5) (P < 0.001). Physician acceptance of the RPD combined with a safety needle was excellent. Conclusion As mandated by the Joint Commission and the Occupational Safety and Health Administration, safety technologies and the use of pain scales can be successfully integrated into rheumatologic and orthopedic procedures. The combination of a safety needle to reduce needlestick injuries to health care workers and the RPD to improve safety and outcome of patients is effective and well accepted by physicians. [source] Randomized controlled trial comparing the effectiveness and safety of intranasal and intramuscular naloxone for the treatment of suspected heroin overdoseADDICTION, Issue 12 2009Debra Kerr ABSTRACT Aims Traditionally, the opiate antagonist naloxone has been administered parenterally; however, intranasal (i.n.) administration has the potential to reduce the risk of needlestick injury. This is important when working with populations known to have a high prevalence of blood-borne viruses. Preliminary research suggests that i.n. administration might be effective, but suboptimal naloxone solutions were used. This study compared the effectiveness of concentrated (2 mg/ml) i.n. naloxone to intramuscular (i.m.) naloxone for suspected opiate overdose. Methods This randomized controlled trial included patients treated for suspected opiate overdose in the pre-hospital setting. Patients received 2 mg of either i.n. or i.m. naloxone. The primary outcome was the proportion of patients who responded within 10 minutes of naloxone treatment. Secondary outcomes included time to adequate response and requirement for supplementary naloxone. Data were analysed using multivariate statistical techniques. Results A total of 172 patients were enrolled into the study. Median age was 29 years and 74% were male. Rates of response within 10 minutes were similar: i.n. naloxone (60/83, 72.3%) compared with i.m. naloxone (69/89, 77.5%) [difference: ,5.2%, 95% confidence interval (CI) ,18.2 to 7.7]. No difference was observed in mean response time (i.n.: 8.0, i.m.: 7.9 minutes; difference 0.1, 95% CI ,1.3 to 1.5). Supplementary naloxone was administered to fewer patients who received i.m. naloxone (i.n.: 18.1%; i.m.: 4.5%) (difference: 13.6%, 95% CI 4.2,22.9). Conclusions Concentrated intranasal naloxone reversed heroin overdose successfully in 82% of patients. Time to adequate response was the same for both routes, suggesting that the i.n. route of administration is of similar effectiveness to the i.m. route as a first-line treatment for heroin overdose. [source] ORIGINAL ARTICLE: A survey of the management of needlestick injuries from incapacitated patients in intensive care units,ANAESTHESIA, Issue 9 2010L. A. Burrows Summary The Human Tissue Act 2004 and Mental Capacity Act 2005 resulted in a change in the management of needlestick injuries sustained from incapacitated patients. It appears unlawful to test for blood-borne viruses without a patient's consent for the sole benefit of the healthcare worker. This survey of intensive care units within England, Wales and Northern Ireland investigated how needlestick injuries from incapacitated patients had been managed within the previous year. Of the 225 intensive care units surveyed, 99 (44%) responded. Sixty-two (62.6%) reported a needlestick injury to a healthcare worker from an incapacitated patient. Thirty-six (64.3%) patients were tested for blood-borne viruses without consent. Sixteen (25.8%) patients tested positive for blood-borne viruses. Only 19 (30.6%) healthcare workers took post-exposure prophylaxis following the injury. These results show that needlestick injuries from incapacitated patients are common and that the majority of patients were tested for blood-borne viruses without consent. [source] |