Interventions to prevent needlestick injuries

Clinical bottom line

This systematic review of randomised studies showed that interventions like use of double gloves, safer needles, and other interventions were effective in reducing needlestick injuries in surgical settings.

Reference

B Rogers, L Goodno. Evaluations of interventions to prevent needlestick injuries in health care occupations. American Journal of Preventive Medicine 2000 18 (4S): 90-98.

Systematic review

A Cochrane search strategy was used looking at four electronic databases for randomised trials with the following inclusion criteria:

Intervention to reduce needlestick injuries was evaluated in a defined population.
Randomised study with appropriate comparison group.
Outcomes were objectively measured with interpretable data.

Results

Eleven studies were found. Four examined use of double gloves, three blunt suture needles, two evaluated safety devices, like needleless IV systems, and two surgical techniques.

Double gloves

Three studies had a significant reduction, but one had a nonsignificant increase in glove perforations, while reducing hand contamination for surgeons.

Blunt suture needles

Three studies with 1,054 individuals showed that blunt suture needles reduced needlesticks from an average of 18% to 6% (Figure 1), with a relative risk of 0.34 (0.23 to 0.49). The number needed to treat to prevent one needlestick with blunt rather than standard suture needles was 8 (6 to 12).

Figure 1: Needlesticks using blunt and standard suture needles

Other interventions

The use of needleless IV systems in two studies produced lower rates on needlestick injuries.

Comment

Randomised studies may well not be the only way to examine effect of safety devices or techniques on needlestick injuries. There are several reasons why this may be so, including the possible imposition of conditions that are not like normal, limiting applicability, and because the rates of needlestick are sufficiently low to warrant very large numbers. The studies in this review all chose high risk situations, and demonstrated that safety devices could reduce needlestick injuries.