The Epidemiology of Sharp Injuries in Healthcare Workers at a Trinidadian Community Hospital

Abstract

OBJECTIVE To describe the epidemiology of sharp injuries, in healthcare workers, at the Sangre Grande Hospital (SGH) in Trinidad. A secondary analysis of non-sharp injuries was also done. Sharp injuries predispose staff to blood borne infections and thus are occupational infection prevention and control matters. Sharp injuries were observed to be a problem at the SGH. This study served to gather data for informed decision making. METHODOLOGY A retrospective descriptive study was done by reviewing all IPC reporting forms from reported healthcare worker injuries at the Infection Prevention and Control (IPC) Department for the period 2007-2017. All persons recorded as having being injured by sharps and secondarily, non-sharp occupational exposures, at the IPC department were included. We looked at employee case management including testing for blood borne Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and C virus (HCV), management and treatment. Simple descriptive statistics were used to present the findings. RESULTS All 148 notes were reviewed after which entries having greater than 10 missing data points or fields were excluded from the study analysis, leaving 138 notes. Age ranges were between 20 – 62 years with the mean age of the affected population being 33 years. A total of 104 (75.4%) females were injured compared to 32 (23.2%) males. Persons injured were mainly from the wards (n=81, 58.5%): internal medicine (n=46, 33.3%) and general surgery (n=22, 15.9%). Accident & Emergency (A&E) accounted for 10.1% (n=14) of the cases. Registered nurses (n=37, 26.8%), physicians (n=22, 15.9%) and students (n=20, 14.5%) were the main categories of staff affected. The highest number of events occurred between 10:00-11:00 in the morning [am] (n=29, 20.6%). The majority of these incidents (n=123, 89.1%) were first reported to SGH A&E. Most injuries occurred while disposing of needles (n=17, 12.3%). It was noted that 73 (52.9%) of the documented cases occurred on fingers. HIV, HAV & HBV tests were done in 136 (98.6%) of the 138 staff members recorded. In 120 (87%) events the source patient was tested. A total of 114 (84.4%) persons had been vaccinated for HBV; 77 (58.8%) persons had post exposure prophylaxis (HIV) for one month. One (1.3%) person reported seroconversion after six months to positive HIV status. CONCLUSION Sharp injuries in employees were common in internal medicine and general surgery wards. These injuries were common in the late morning, on the fingers. Only one exposed employee seroconverted over the entire period.