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HCW link needlesticks to excessive workloads, carelessness
Health care workers who sustained needlestick injuries while at work reported feeling anxious, angry and guilty after the incident and attributed their injuries to excessive workloads, according to recent findings.
“A [needlestick injury (NSI)] exposes health care workers to patient blood or body fluids and increases the risk of infection with bloodborne viral pathogens, such as hepatitis B, hepatitis C and HIV,” Jae Sim Jeong, RN, MPH, PhD, from the department of nursing at the University of Ulsan, South Korea, and colleagues wrote. “In addition to physical risk of NSI, employees who have experienced NSI show significantly higher levels of depression and anxiety than those who have not had an NSI.
“If such psychologic discomfort is not managed properly during the early stages, it can worsen or develop into a chronic condition, such as posttraumatic stress disorder.”
Jeong and colleagues surveyed 15 health care workers (HCW), including three doctors, eight nurses, two clinical pathologists, one sanitation worker and one medical engineer. All had reported an NSI within 6 months of the review. The participants were employed at one of 53 medical institutions participating in the national NSI surveillance system developed by the Korea Occupational Safety and Health Research Institute.
Interviews were conducted to glean general information about the NSI experience, and the researchers then posed more specific questions about the circumstances of the NSI. They recorded the participants’ thoughts and feelings afterward, severity of psychological discomfort, coping behaviors and insight on how future NSIs should be prevented.
NSIs frequently occurred in busy areas such as operating rooms, clinical pathology departments and hospital wards, according to the researchers. They found that the HCWs largely reported their NSI circumstances as being associated with their own carelessness and mistakes due to excessive workload.
Most participants reported having anxiety about disease onset, guilt and regret about their careless behavior, anger and resentment toward patients, and anger at the perceived unfairness of the NSI. Many of them evaluated medical charts to determine their risk for disease transmission.
Guideline-recommended active coping strategies frequently were used to manage the NSIs, such as reporting the incident to a monitoring system or seeking first aid. Some individuals, particularly trainees or less-experienced workers, said they coped passively and did not report the NSI incident for several reasons, including embarrassment or fear of reprimand, an ambiguous feeling that “everything would be fine,” time restraints due to excessive workload and beliefs that the NSI would not lead to negative consequences.
After the NSI, participants said they were more careful and acknowledged that attentiveness was the best way to prevent accidents. They recommended that a more complete employee education and greater recognition of NSI-prevention techniques would curtail future injuries.
“Although the participants had received education on NSI prevention from their hospitals, they were embarrassed that they did not perform proper preventive measures,” Jeong and colleagues wrote. “To prevent NSIs, medical institutions need to repeatedly provide education to employees so that they are familiar with guidelines for preventing NSIs and to increase their realization that these injuries can occur at any time, in any place, and to anyone.” – by Jen Byrne
Disclosure: The researchers report no relevant financial disclosures.