In SafeHandS is the official

newsletter of the SafeHandS

network to promote health care
worker safety in the Asia Pacific.
It is compiled and distributed by
the Albion Street Centre.

SafeHandS is funded by AusAID.

Editorial panel:
Maggy Tomkins; Jeffrey
Sheather; Philip Melling;
Charmaine Turton

Compilation & Publication:
Maggy Tomkins; Gary Wright


Errata
The photograph accompanying
Dr Dimple Kasanas member
profile in the September 2009
issue of In SafeHands was
incorrect and not Dr Kasana. We
apologise for any embarrassment
or misunderstanding this may
have caused.
Newsletter of the SafeHandS network


..Information, support and practical solutions to promote health
care worker safety in the Asia Pacific

SEPTEMBER 2011
VOLUME 5, ISSUE 2
In SafeHandS
Disclaimer

Unless stated otherwise,
opinions expressed in this
newsletter are those of the
identified author and are not to
be regarded as the official
positions of SafeHandS, The
Albion Street Centre (ASC) or
AusAID. SafeHandS accepts
no responsibility for opinions or
information contained in this
newsletter. SafeHandS does
not receive any financial
support or contribution from
any commercial organisations
or agencies.
Inside this issue:
Editorial 2
Needlestick injuries among
studentsresources
3
Project report 7
Six years of the newsletter 10
Coming events 11
Teleclass update 13
Current resources 14
What is SafeHandS? 18
In the news 17
Contributions

We encourage members to contribute to
In SafeHandS by:

Participating in the Member Profile by
providing a brief profile about yourself
and a brief example about your
experience in improving health care
worker safety in your workplace
Providing information about recent
articles, resources or upcoming
events related to health care worker
safety
Submitting a question or concern or
comment you have about health care
worker safety

This issue focuses on:
Needlestick injuries among students

The next issue will be published in
December 2011

Deadline for contributions:
20 November 2011

Guidelines for contributors can be found
on the SafeHandS website

SafeHandS
The Albion Street Centre
150-154 Albion Street
Surry Hills NSW 2010
Australia
Email:safehands@sesiahs.health.nsw.gov.au
Tel: + 61-2 9332 9711
Fax: + 61-2 9380 6572
Web:
http://www.uow.edu.au/health/safehands/
index.html
Editorial: Despite advances in technology and the
reduction of injections, needlestick injuries still
occur, especially among students
Page 2 IN SAFEHANDS
Philip Melling is a
member of the
Editorial Panel for
IN SAFEHANDS
and is currently
working as an
Infection Control
Technical Advisor.

Philip recently
completed a nursing
refresher course in
Sydney, Australia, as
part of his
continuing
professional
education and to
update his clinical
nursing skills.
I recently completed a nursing
refresher course as part of my
continuing professional education
and to update my clinical nursing
skills. It was a very interesting
experience as I had not worked as a
clinical nurse in an acute care
hospital setting for almost 18 years. I
was eager to learn what had
changed and what improvements
had been achieved in the past two
decades.

At the end of the first day on the
wards the group of refresher
nurses, who had all been away from
the acute care clinical setting for
about the same length of time, all
looked at each other and
depressingly exclaimed nothings
changed! The much publicised 1:4
nurse-patient ratios were not in
evidence; 1:6 seemed to be the
norm. Doctors hand writing was still
appallingly bad and nurses still had
difficulty reading what doctors had
written in the notes. Some things
had even appeared to have got
worse. The amount of paperwork
nurses were expected to complete
each shift had, unbelievably,
increased substantially. The hospital
had also introduced taped
handovers which, to us old-timers,
appeared a turn for the worse as it
was frequently a challenge to just
hear what the speaker was saying
on the tape, let alone the inability to
ask the nurse questions about the
patients and their care.

I am happy, however, to report that
once we had completed a number of
shifts we discovered that there had
indeed been a number of initiatives
for the better and some of them
were in fact related to the safety of
health care workers.

The hospital now had a no lift policy
in place. No longer were nurses
expected to lift patients, not even up
the bed. Lifting aids, slide sheets,
sliding boards and tilting the high-
tech beds had removed lifting from
the nursing profession. No more
injured backs or a course in weight
lifting at the gym! Now all they need
to do is to get nurses to use the
lifting aids, as too many of the
permanent staff still resorted to the
quicker option of lifting the
patientswhen no one was looking
of course.

But for me, with my interest in health
care worker safety, needlestick
injuries and the prevention of blood-
borne virus transmission, by far the
most exciting initiatives were the
introduction of a needleless system
for IV administrations; the overall
reduction of injections administered;
and the almost total absence of
intramuscular injections. In fact we
were informed at the start of the
course that we would most probably
not have the opportunity to be
deemed competent in administering
intramuscular injections because so
few were now given in the hospital.
Amazingly, this turned out to be true.
Not one of the twelve refresher
nurses had the opportunity to give
an IMI during the 2-month course.
Two decades ago it would have
been the norm to administer several
IMIs on any given shift in an acute
care hospital. How times had
changed.

So, a needleless system for IV
administrations, an overall reduction
in the number of injections
administered and the almost total
elimination of IMIs should surely
mean a reduction in needlestick
injuries? Wrong. One of the nurses
on the course did in fact sustain a
needlestick injury, the result of an
overfilled sharps container resulting
in a jammed needle and syringe in
the containers mechanism that the
nurse was attempting to dislodge.
VOLUME 5, ISSUE 2
Page 3
The incident again highlights the vulnerability of
students and new staff to needlestick injuries and
other occupational exposures which is well
documented in the literature.

Studies have identified medical and nursing
students as vulnerable for blood and body fluid
exposures, especially needlestick injuries, due to
their limited clinical experience or a lack of
understanding of proper procures and correct
disposal. Improper recapping and inappropriate
disposal are common causes. Reporting on the
National Surveillance System for Hospital Health
Care Workers, Tan et Al (2001) observed that
38% of percutaneous injuries occurred during
use, 42% occurred after use of needles but
before disposal, and 20% occurred after disposal.

The needlestick injury prevalence rate among
nursing students seems to vary widely between
countries in published studies. For example,
Yassi and McGill (1991) found that 12% of their
students working in a large medical centre had a
needlestick injury. Among Chinese nursing
students, the needlestick injury rate was around
32% (Wang et al, 2003). Alternatively, Shiao et al
(2002) reported 61.9% of Taiwanese nursing
students sustained a needlestick injury, and Puro
et al (2001) calculated that 15% of all needlestick
injury exposures in 18 Italian hospitals were
incurred by nursing students.

Australian medical and dental students may
suffer higher needlestick injury rates than their
nursing counterparts with de Vries and Cossart
(1994) documenting the prevalence at 22% and
72% respectively. Other studies of medical
students around the world also seem to support
this. Needlestick injuries among medical students
has been reported internationally at the following
rates: 24% in France (Rosenthal et al, 1999), 30-
33% in the United States of America (Shen et al,
1999, Patterson et al, 2003), 12-33% in England
(Waterman et al, 1994) and 35% in Singapore
(Chia et al, 1993). Of the nursing students who
sustained needlestick injuries in the Australian
investigation by Smith and Leggart (2005), 18.8%
had had multiple needlestick injuries, numbering
between 2 and 5.

Needlestick and sharps injuries are the most
efficient method of transmitting blood-borne
pathogens between patients and healthcare
workers. Students are known to be a high risk
subgroup for these incidents due to their limited
clinical experience. Therefore the following
points need to be addressed:
Students should receive adequate
education and training on the safe use,
handling and disposal of sharps.

Students should be made aware of the
risks involved with occupational exposures
and needlestick injuries.

Students should be closely monitored and
supervised when performing procedures.

Safety devices and the safest equipment
available should be used at all times, and
the students be familiar with the equipment
and safety devices.

Students should be well versed in the first
aid procedures following an occupational
exposure.

Students should be aware of the reporting
mechanisms in the institutions where they
are studying and practising if they sustain
an occupational exposure.

Students should understand the importance
of reporting all incidents, no matter how
minor.

All exposures should be seen as a priority,
and risk assessments and reporting
mechanisms should be streamlined and
made as simple as possible.

Students should be encouraged to report all
exposures and should be well supported by
the healthcare facility and academic
institution.

References
Yassi A & McGill M (1991) Determinants of blood and body fluid
exposure in a large teaching hospital: hazards of the intermittent
intravenous procedure, American Journal of Infection Control, 19,
129-135.

Wang HH et al (2003) A training programme for prevention of
occupational exposure to bloodborne pathogens: impact on
knowledge, behavior and incidence of needlestick injuries among
student nurses in Changsha, Peoples Republic of China, Journal of
Advanced Nursing, 41, 187-194.

Shiao JSC et al (2002) Student nurses at high risk for needlestick
injuries, Annals of Epidemiology, 12, 197-201.

Puro V et al (2201) Risk of exposure to bloodborne infection for
Italian healthcare workers, by job category and work area, Infection
Control and Hospital Epidemiology, 22, 206-210.

de Vries B & Cossart YE (1994) Needlestick injury in medical
students, Medical Journal of Australia, 160, 398-400.
Page 4
IN SAFEHANDS
Title Needlestick / sharps injuries among
vocational school nursing students in
southern Taiwan

Author Ya-Hui Yang et al

Date 2004

Source American Journal of Infection Control, 32: 431
-5

Background: Although most needlestick/sharps
injuries research focuses on health care workers,
students in hospital internships are also at risk.
Investigations that examined needlestick/sharps
injuries in student populations generally studied
medical rather than nursing students. In 1999,
approximately 17,000 nursing graduates were
exposed to the hazard of needlestick/sharps injuries.
We examined the frequency and mechanism of
needlestick/sharps injuries among vocational nursing
students in southern Taiwen.
Methods: Between July and December of 1999, within
1 week after the nursing students completed their
internship training one of the researchers, who was a
teacher in this vocational school, asked them to fill out
questionnaires.
Results: Five hundred and twenty-seven of 550
(92.6%) questionnaires were considered valid. Two
hundred and sixty-four of 527 (50.1%) responders
sustained one or more needlestick/sharps injuries.
Ninety-six of 527 (18.2%) responders suffered
contaminated needlestick/sharps injuries. The average
number of needlestick/sharps injuries per student was
8.0 times/year (4.9 times/student/year for needlestick
injuries and 3.1 times/student/year for sharps injuries.
Needlestick/sharps injury rates for nursing students in
10-week and 4-week internships were significantly
different ( P = .039): 53.3% versus 34.7% respectively.
The needlestick/sharps injuries frequencies were
influenced by length of internship: 7.3 times/student/
year in 10-week internship and 11.7 times/student/
year in 4-week internship. Logistic regression analysis
indicated that length of internship rotation was
statistically significant with respect to contaminated
needlestick/sharps injuries (OR = 1.682; 95% CI:
1.005-2.81; P = .048).
Conclusions: The needlestick/sharps injuries
frequencies of nursing students were higher than
those for health care workers. We found that
frequency of needlestick/sharps injuries for vocational
school nursing students is above average. Whether
the young age of these nursing students put them at
greater risk for needlestick/sharps injuries warrants
further inquiry.




Title Needlestick and sharps injuries among
nursing students

Author DR Smith & PA Leggart

Date 2005

Source Journal of Advanced Nursing, 51(5), 449-455

Aims: This paper reports the first investigation of the
prevalence and nature of needlestick injuries among
Australian nursing students.
Background: Needlestick and sharps injuries are the
most efficient method of transmitting blood-borne
pathogens between patients and healthcare staff.
Although nurses are known to be a high-risk subgroup
for these events, nursing students may be at even
greater risk due to their limited clinical experience.
Despite this fact, the epidemiology of needlestick and
sharps injuries among nursing students has not been
clearly elucidated in Australia.
Methods: A questionnaire-based methodology
adapted from other international investigations was
conducted among nursing students. We recruited a
complete cross-section of students from a large
university nursing school in North Queensland,
Australia, in March 2004, and analysed needlestick
and sharps events as a percentage of all students and
also as a proportion of all cases. Risk factors were
evaluated using logistic regression.
Results: From a group of 319 students, 274
successfully completed questionnaires were obtained
(overall response rate 85.9%). A total of 38 students
(13.9%) reported a needlestick or sharps injury during
the previous 12 months. By causative item, 6.2% of
students had been injured by a normal hollow-bore
syringe needle, 3.6% by a glass item and 3.3% by an
insulin syringe needle. Regarding prior usage, 81.6%
of all injuring items were unused, 15.8% had been
used on a patient and the status of 2.6% was
unknown. Most needlestick injuries occurred either in
the nursing laboratory (45%) or the teaching hospital
(37%). Recapping the needle cap was the most
common causative event (28% of all cases). A total of
39.5% of needlestick injuries were not reported. The
main reason for non-reporting was that the item was
unused (42%). Logistic regression analysis revealed
that students in the third year were 14.8 times more
likely to have experienced a needlestick injury than
their counterparts in other years (odds ratio 14.8, 95%
confidence interval 5.2-50.3, p < 0.01). These injury
rates were higher among Australian nursing students
than in other international studies.
Conclusions: Although hepatitis B vaccination
coverage among the students was excellent, it is
important that the principles of infection control training
and reporting of all needlestick and sharps injuries
continue to be emphasized throughout undergraduate
nursing education.
Needlestick Injuries Among StudentsResources
VOLUME 5, ISSUE 2 Page 5





Recently got email access?
Changed your email address?

If you received this newsletter in the post, it means you have not supplied
your email address or that the one you supplied is no longer working.
Please help to keep our postage costs down by letting us know if you get
access to email or if your address changes.
Email access means your copy of the newsletter is available the day it is
published. The print (mailed) version of the newsletter will also be smaller
than the email version. More importantly, you can join in email discussions
with other members and receive up to date information by email.
Just email us at: safehands@sesiahs.health.nsw.gov.au
Title Needlestick injuries during medical
training

Author S Deisenhammer, K Radon, D Nowak, J
Reichert

Date 2006

Source The Journal of Hospital Infection, 63, 263-267

Summary: Medical students are at risk of acquiring
infections caused by needlestick injuries, although it is
unknown when needlestick injuries are most likely to
occur during medical training. The aim of this study
was to define high-risk periods over the course of
medical training. A cross-sectional study was
conducted among medical students in the first, third,
fourth and fifth years of training at two medical schools
in Munich. Overall, 1317 (85%) students returned a
questionnaire on demographic data, vaccination status
against hepatitis B, lifetime prevalence of needlestick
injuries, level of knowledge about measures after such
accidents and transmission risks. Lifetime prevalence
of needlestick injuries was 23%, ranging from 12% in
first year students to 41% in fourth year students.
These accidents happened most commonly during
medical internships, especially during blood-taking
practices; an activity that usually starts during the third
year of training. The frequency of respondents not
vaccinated against hepatitis B also varied between
first (21%) and fourth (6.6%) year students.
Needlestick injuries occur frequently and early on in
medical training. In order to decrease the risk of
preventable infections, complete coverage of
vaccination against hepatitis B should be achieved
early in medical training.

Title Needlestick injuries among medical
students

Author JMM Patterson, CB Novak, SE Mackinnon,
RA Ellis

Date 2003

Source American Journal of Infection Control, 31:226-
230

Background: Concern about occupational exposure
to bloodborne pathogens exists, and medical students,
who lack experience in patient care and surgical
technique, may be at an increased exposure risk.
Methods: This prospective cohort study evaluated
needlestick injuries and practices regarding the use of
protective strategies against blood borne pathogens in
medical students. A questionnaire was developed and
sent to 224 medical students.
Results: Of 224 students, 146 students (64%)
returned questionnaires. Forty-three students (30%)
reported needlestick injuries that most commonly
occurred in the operating room; 86% of students
reported always using double gloves in the operating
room; 90% reported always wearing eye protection,
and all but one student had been vaccinated against
hepatitis B. A concern about contracting a bloodborne
pathogen through work was noted in 125 students,
although they usually reported that this concern only
slightly influenced their decision regarding a career
subspecialty.
Conclusion: Medical students have a high risk for
needlestick injuries, and attention should be directed
to protection strategies against bloodborne pathogens.
Page 6 IN SAFEHANDS
Title Needlesticks and other occupational
exposures to body fluids amongst
employees and medical students of a
German university: incidence and follow-
up

Author K Schmid, C Schwager, H Drexler

Date 2007

Source Journal of Hospital Infection, 65, 124-130

Summary: The aim of this study was to obtain data
concerning the incidence, reporting and follow-up of
occupational exposure to blood or other body fluids
(OEB). A questionnaire was distributed to employees
and medical students (N=787) and official reports of
OEB during the year 2003 (N=203) and their
consequent follow-up (N=100) were evaluated. The
percentages of needlestick injuries were 29.5% for
students and 22.5% for employees. Incidence rates
per 1000 employee days were 0.61 for needlestick
injuries or sharp object injuries and 0.27 for
mucocutaneous exposure to body fluids. The mean
rate of underreporting was approximately 45%.
Contrary to expectations, only 4.3% of nurses and
3.9% of doctors officially reported an OEB in 2003.
The number of persons who did not attend for a
serological test increased during the follow-up period.
Considering all documented test results, 35 out of 100
affected persons were lost to follow-up due to default
of appearance. As a consequence, the employer
should provide safety devices and enforce didactical
interventions with practical training and incident
reporting. Periodical occupational health medicals,
including serological testing, should be mandatory for
all employees, including medical students and student
nurses. To increase compliance after OEB, a short
follow-up period using improved laboratory tests
requires further discussion.



Title Medical students knowledge of sharps
injuries

Author SKF Elliott, A Keeton, A Holt

Date 2005

Source Journal of Hospital Infection, 60, 374-377

Summary: Healthcare workers including medical
students are at risk of occupational exposure to blood-
borne viruses following incidents including needlestick
injuries. The recent Department of Health guidelines
recommend that all healthcare workers entering a
career involving exposure-prone procedures should be
tested for hepatitis C, making preventative strategies
even more relevant. A survey of current medical
students knowledge regarding prevention of sharps
injuries in Birmingham, UK, was carried out to
determine their awareness of these risks and to
compare the findings with an earlier cohort of
students. Two hundred and fifty-six medical students
were enrolled into the study. Their knowledge of
needlestick injury, prevention and management had
significantly improved compared with the previous
study. This demonstrates that intensive teaching and
self-learning programmes can improve the knowledge
of healthcare workers and reduce the number of
needlestick injuries.



Title Needlestick and other potential blood and
body fluid exposures among health care
workers in British Columbia, Canada

Author H Alamgir et al

Date 2008

Source American Journal of Infection Control, 36:12-
21

Background: Health care workers have high risk of
exposure to human blood and body fluids (BBF) from
patients in acute care and residents in nursing homes
or personal homes.
Methods: This analysis examined the epidemiology
for BBF exposure across health care settings (acute
care, nursing homes, and community care). Detailed
analysis of BBF exposure among the health care
workforce in 3 British Columbian health regions was
conducted by Poisson regression modeling, with
generalized estimating equations to determine the
relative risk associated with various occupations.
Results: Acute care had the majority of needlesticks,
sharps and splash events with the BBF exposure rate
in acute care 2 to 3 times higher compared with
nursing home and community care settings.
Registered nurses had the highest frequency of
needlestick, sharps and splash events. Laboratory
assistants had the highest exposure rates from
needlestick injuries and splashes, whereas licensed
practical nurses had the highest exposure rate from
sharps. Most needlestick injuries (51.3%) occurred at
the patients bedside. Sharps incidents occurred
primarily in operating rooms (26.9%) and at the
patients bedside (20.9%). Splashes occurred most
frequently at the patients bedside (46.1%) and
predominantly affected the eyes or face/mouth. The
majority of needlestick/sharps injuries occurred during
use for registered nurses, during disposal for licensed
practical nurses, and after disposal for care aides.
Conclusion: The high risk of BBF exposure for some
occupations indicates there is room for improvement
to reduce BBF exposure by targeting high-risk groups
for prevention strategies.
Page 7 IN SAFEHANDS
SafeHandS small grants project report
The Safe @ Work Program:
Safe Handling and Disposal of Needles and Sharps
Background
Davao Regional Hospital, Tagum
City, Philippines, formulated policies
on handling and safe disposal of
needles and sharps in 2003 which
were revised in 2008 to include the
reporting and treatment of
needlestick injuries. There were
identified violations to policies such
as not observing procedures in
proper handling of syringes and
needles when administering
parenteral injection and not reporting
such incidents for fear of sanctions.
In 2009, only three cases of
needlestick injuries were reported.
Since 2003, there have been two
cases of Hepatitis B infection of
healthcare staff probably due to
needlesticks involving Hepatitis B
infected patients, suggesting the
serious nature of underreporting and
the need for improved safe handling
of syringes and needles.

The Safe @ Work Program will be
implemented hospital wide under the
direction of the Hospital Infection
Control Committee. The program
aims to improve the protection of
healthcare workers from needlestick
injuries by strengthening compliance
in safe handling and disposal of
needles and sharps through an
education campaign; review and
update of hospital policies and
procedures; surveillance and
institutionalization of the concept of
staff safety; and implementation of a
Safe @ Work No Blame reporting
strategy in order to encourage
reporting and development of best
practice.

Description of project
The project includes audits on
procedures and practices in handling
and disposing needles and sharps;
training of physicians, nurses,
medical technologists, nursing aides,
utility workers, and other healthcare
workers in contact with needles and
sharps; updating policies and
procedures; the production of
educational materials to promote
safety in handling and disposing
needles and sharps; and training of
hospital staff directly handling
needles and sharps. In implementing
such activities, staff capability for
supervision and implementation will
be strengthened. All these outputs
will provide the essential elements in
enhancing a Staff Safety Program for
the hospital.

Project objective
To ensure safety of all healthcare
workers at Davao Regional Hospital
from risks in handling and disposing
needles and sharps.

Executive summary
With the fear of bloodborne disease
acquisition among healthcare
workers while handling sharps, the
opportunity with SafeHandS
awakened the very silent doctrine of
safety at work in Davao Regional
Hospital.

A team of two physicians and three
nurses formulated the project with
the hospital managements approval.
As granted by SafeHandS on July
16, 2010, the team started off with a
lot of meetings and conferences until
a baseline audit was conducted in
October 2010. The initial team of five
was extended to ten adding five
senior nurses as auditors. The
baseline audit was conducted by
allowing staff to assess their own
devices (self audit) and paired with
audits of the team members/auditors
through spot checks in clinical and/or
work areas.

As expected, with the absence of
safety devices, staff were not
performing recommended
procedures using safety devices.
Project Objective:
To ensure safety of
all healthcare
workers at Davao
Regional Hospital in
the Philippines from
risks in handling
and disposing
needles and sharps
VOLUME 5, ISSUE 2 Page 8
Unfortunately, it had been quantified that even
with the presence of some devices, such as the
use of puncture resistant sharp containers, some
staff still missed the opportunity to perform this
indicator correctly. The majority were observed
recapping needles and syringes using both hands
and were not able to attend any training related to
universal precautions.

After the baseline audit, the team then launched
an information and educational campaign within
the hospital. A series of orientation sessions on
universal precautions, with emphasis on handling
and disposal of sharps, was conducted hospital
wide. Posters were placed in conspicuous sites of
the hospital and flyers were given to all heath
care workers handling sharps. Presentation and
evaluation of safety devices were facilitated too.

On the second and third audits, there was an
apparent improvement. Better practices were
noted, except those that required safety devices
as supplies of safety devices were still not
provided within the hospital. Safety devices were
requested by unit/section heads and procurement
of such devices is currently in progress.

Section/unit heads were informed of the audit
results through conferences. With the audit
results and team updates, the policies and
procedures on safe handling and disposal of
sharps were revised, approved and implemented.
A hospital manual on safe handling and disposal
of sharps is now in process bestowing this
special project and results.

The reporting of needlestick and sharp injuries
has increased. It is a significant change that the
project has caused. Although there could still be
injuries not reported, the figures of the reports for
the team were still astounding. Strengthening the
campaign for the reporting will still continue, until
all employees of the hospital acculturate the
imperative of sharp injury reporting.

The hospitals culture of safety is still a work in
progress. Both management and staff are now
starting to take their roles in the prevention of
sharp injury. The team in coordination with other
related committees can together make a
difference in time by making this project a
program of the hospital to be implemented
regularly. It may not be easy and fast, but change
is now felt and will continue until safety at work
becomes a way of life.

Implementation issues and challenges
The project was an added awareness of safety at
work ideations. Working in healthcare services is
a threat to safety of healthcare providers. But for
years Davao Regional Hospital has been existing
in a culture where staff do not mind so much of
their own safety while performing their duties.
Less than one percent (1%) of staff reported
sharp and other exposure injuries. With the
advent of the project, reporting of sharp injuries
and other blood borne exposure has increased.
The practices of staff on safe handling and
disposal of sharps have improved. Increasing
awareness of the risk involved made them
perform safe practices.

Although the project yielded positive outcome,
there were difficulties and issues identified both in
the performance of scheduled activities and
outcome of the project. One issue is human
resource in respect to time. The project team
together with the added auditors had a difficult
time conducting the audits. Each audit took a lot
longer than planned, especially in the area of the
Operating Room observing surgical procedures.
The project activities were added tasks to the
regular duties of the members and auditors.

Another difficulty in the conduct of audit is that
the rates vary from one auditor to another and
depend on the level of understanding of auditors.
This could have been prevented if the orientation
for auditors was very thorough and detailed. The
orientation was brief and auditors were believed
to have got the understanding with that short
orientation.

Another expected yet modifiable result is the low
compliance to procedures using devices with
safety features. As long as the required devices
are not available, compliance would never
improve. Fortunately, with the awareness of
hospital employees of the availability of such
devices in the market through the orientation that
the team had conducted, the unit heads are now
requesting for their procurement. As to this date,
there are two types of devices ready for
procurement and others are still in the process of
seeking approval from the hospital management.

In the conduct of orientation on safe handling and
disposal of sharps, the team has targeted the
100% attendance of physicians, nurses and
medical technologists to help in the acculturation
towards work safety. Unfortunately, according to
the recorded attendance we only had 66% of the
Page 9 IN SAFEHANDS
total target population. Thus, up to the writing of
this report the team is still going into units of the
hospital providing orientation to staff.

Recommendations
1. A manual on safe handling and disposal of
needles and sharps shall be formulated and
reproduced for distribution to all hospital
employees handling sharps.
2. Revision to the policies and procedures on
safe handling and disposal of needles and
sharps shall be recognized by staff for
practice.
3. Reporting of needlestick and sharp injuries
shall be intensified and monitored.
4. Through the project report to the hospital
administration, the team will request for
funds to be used for the program on an
annual basis.
5. Activities of the project shall be part of the
Infection Control program of the hospital
with the following schedule:
A. Annual orientation and reorientation on
safe handling and disposal of needles
and sharps.
B. Semi-annual audit of practices of staff in
handling and disposing sharps using the
tools.
C. Presentation of audit results to section or
unit heads through conferences.
6. The team shall recommend procurement of
safety devices through:
A. Facilitating evaluations of devices and
equipment that promote safety in
handling and disposing sharps.
B. Ensure requisition of section/unit heads
of safety devices/equipment.
C. Constant coordination with Procurement
Section of the hospital for the availability
of such devices or equipment.

Project Team:
Ivy Bersamen Ballesteros, RN
Hospital Infection Control Nurse

Rodel Migue Flores, MD, DPBS
Hospital Supervising Administrator, Diplomate
(General Surgery)

Bryan O. Dalid, MD, FPCS, FPSGS
Medical Training Officer, Fellow (General
Surgery)

Julmin Tan Tapsirul II, MD, DPPS
Chairman, Infection Control Committee,
Diplomate (Internal Medicine)

Jaybee Miranda Genobisa, RN
Coronary Care Unit, Head Nurse

Agnes Raceles Domingo, RN
Medicine Intensive Care Unit, Head Nurse

Research Consultants / Academics:
Nancy Brisa A. Fuentes, RN
Independent Consultant

Alan Barnard, RN
Senior Lecturer

Auditors:
Maritess M. Estrelloso, RN
Nenet C. Burigsay, RN
Jill G. Ganzales, RN
Charisse D. Booc, RN
Christine Lourdes L. Tan, RN


Davao Regional Hospital, Tagum City, Philippines
VOLUME 5, ISSUE 2 Page 10
In SafeHandS the newsletter of the SafeHandS project has now been published for six years.
Below is a list of the topics we have covered. Archives of the newsletter are available here:
http://www.uow.edu.au/health/safehands/newsletters/index.html




Year Month Volume Issue Topic
2005 Jun 1 1 Health care worker safety
Oct 2 Occupational exposures
Dec 3 Respiratory zoonoses
2006 Mar 4 HIV/AIDS
Jun 5 Pacific region
Oct 6 Indonesia
Dec 2 1 Surveillance
2007 Mar 2 Stigma and discrimination
Jun 3 Clinical practice improvement
Oct 4 Papua New Guinea
Dec 5 HIV and the workplace
2008 Mar 6 Health workers with infectious diseases
Jun 3 1 HIV post exposure prophylaxis
Oct 2 SafeHandS Phase II
Dec 3 E-learning
2009 Mar 4 Education and training
Jun 5 Pandemic influenza
Oct 6 Infection Control Congress
Dec 4 1 Professional organisations
2010 Mar 2 SafeHandS small grants
Jun 3 Care of the deceased
Oct 4 Safety for pregnant health workers
Dec 5 Biomedical waste and health worker safety
2011 Mar 6 Self-care for health workers
Jun 5 1 Six years of SafeHandS in review
Six years of In SafeHands the SafeHandS Newsletter
Contribute to the newsletter

We welcome member contributions to the newsletter.
We would love to receive:
ideas for future topics
photos
articles
case studies
teaching materials
policies or protocols
letters

To contribute, send an email to: safehands@sesiahs.health.nsw.gov.au
Page 11 IN SAFEHANDS
Coming Events
IN SAFEHANDS
provides information
about conferences
and events which may
be of interest to
readers.

For more detailed
information, please
contact the
organisations
directly.
Eleventh Congress of the International Federation of Infection Control
12-15 October, 2011, Venice, Italy
The International Federation of Infection Control (IFIC), a world-wide umbrella
organisation of Societies and individuals working in the field of infection
prevention and control, is - true to its goal of providing leadership in education
and networking - proud to be associated with the Societa Italiana
Multidisciplinare per la Prevenzione delle Infezione nelle Organizzazione
Sanitarie (SIMPIOS) in the organization of its 11th International Conference,
to be held in the beautiful city of Venice. The challenges of infection
prevention and control are the same worldwide, what varies are the resources
available to deal with them. This Conference will not only bring state of the
art, evidence based information to inform strategies, but also allow
opportunities to explore how to move forward when faced with low resource
settings as well as enable practitioners to network in a convivial, supporting
environment.
Keynote presentations from internationally renowned speakers will be
supplemented by workshops, debates on key issues, and industry symposia.
We strongly encourage the submission of free papers, and will support
delegates attendance through a number of scholarships.
Abstract submission deadline closed 15 May 2011
For more information visit the website: http://www.ific2011.com/

Third Infection Prevention and Control Africa Network (IPCAN)
Conference
31 October - 3 November, 2011, Namibia
The disease profiles in Africa differ from those of the well-resourced countries
and lean towards diseases of poverty as well as healthcare-associated
infections. The IPCAN conference will address the diversity of diseases and
will address aspects of infection prevention and control relevant to our
continent. Nevertheless infection preventionists speak a universal language.
The presence of international delegates will also offer a unique opportunity for
the sharing of experiences between infection control professionals from
different countries and backgrounds. We also hope it will initiate contacts
between delegates who are experienced in the subject and others who may
be just starting out.
Abstract submission deadline closed 25 July 2011
For more information visit the website: http://www.ipcan.co.za/conference-
2011

Asia Pacific Society of Infection Control, 5th International Congress
8-11 November, 2011, Melbourne, Australia
The International Congress of APSIC is held every two years and attendance
at the past few Congresses has increased substantially. It is being hosted by
the Victorian Infection Control Professionals Association. The Congress is
valued as an integral part of ongoing professional development and provides
a carefully assembled program including state of the art keynote
presentations, research papers, education presentations of scientific quality in
all areas of infection prevention and control. Infection Control is a rapidly
increasing area within the Health Care sector of the Asia Pacific Region.
Health Care professionals involved in this field will be well represented at the
Congress.
Abstract submission deadline closed 15 July 2011
For more information visit the website: http://www.apsic2011.com/

VOLUME 5, ISSUE 2 Page 12
Florence Nightingale Conference
Provisional Date: March, 2012
London, United Kingdom
Following the overwhelming positive response of the March 2011 Inaugural Conference, a provisional
date of March 2012 has been proposed for the 2nd Conference. Co-organised by the Florence
Nightingale Foundation, topics will include patient safety, education and research, commissioning and
quality innovation productivity and prevention.
For more information visit the website: http://www.glasgows.co.uk/florencenightingale/index.html

Australian Society for Infectious Diseases (ASID) Scientific Meeting
21-25 March, 2012
Fremantle, Western Australia
The meetings focus is to explore what the future holds for infectious diseases. Specific topics will
include origins and spread of new infectious diseases, how host factors may determine outcome from
infection, what tools we can use to predict, diagnose, manage and monitor infections, as well as a
range of other topics including malaria, travel-related infections, viral hepatitis, antimicrobial use and
abuse, current controversies in infectious diseases and the emergence and spread of multiresistant
organisms in the community.
Abstract submission deadline: 27 January, 2012
For further information visit the website: http://www.asid.net.au

Association for Professionals in Infection Control and Epidemiology (APIC), 39th Annual
Educational Conference & International Meeting
Infection Prevention: Improving Outcomes, Saving Lives
4-6 June, 2012, San Antonio, Texas, USA
APIC Annual Educational Conference & International Meeting is the largest annual gathering of
infection preventionists in the world. It is considered the premier educational opportunity for healthcare
professionals in all settings who have responsibility for infection prevention programs. It is the meeting
place for infection preventionists of all levels of experience and those in related fields to expand their
knowledge bases, establish practical expertise in infection prevention and epidemiology, and network
with experts and peers.
The Call for Abstracts will open October 17, 2011, and will remain open through January 16, 2012.
For more information visit the website http://www.apic.org

International Society for Infectious Diseases, 15th International Congress on Infectious
Diseases
1316 June, 2012, Bangkok, Thailand
ISID exists to encourage collaboration between leaders as well as students to find new solutions to the
world's infectious diseases. ISID promotes this by bringing together clinicians, researchers,
microbiologists and epidemiologists of infectious diseases from all countries of the world to share their
commitment and expertise. The end result will be new partnerships, new preventive methods and new
therapeutics.
The 15th ICID will be a chance for ongoing collaborative efforts, as well as for individuals, to present
and share their experiences fighting infectious diseases. To commemorate the 30th year of our
Society we are keen to provide attendees in Bangkok with an outstanding scientific program that will
run the spectrum from cutting edge research with clinical implications, to state of the art practices in
infectious diseases by a truly international faculty composed of world leaders in their areas. ISID looks
forward to working together with our collaborator in Thailand, the Infectious Disease Association of
Thailand (IDAT), as well as other organizations to develop 15th ICID.
Abstract submission deadline is 12 February 2012
For more information visit the website: http://www.isid.org/icid/

Australian Infection Control Association (AICA) Conference
8-10 October, 2012, Sydney, Australia
Building, Believing, Balancing & Beyond...
Further information will be added as it becomes available in future issues of In SafeHandS.

VOLUME 5, ISSUE 2 Page 13
8 September Practical Aspects of Hospital Infection Control for Influenza
Speaker: Dr. Fidelma Fitzpatrick, HPSC and Beaumont Hospital, Ireland
27 September
Free
Voices of CHICAPart 2
Speaker: Community and Hospital Infection Control Association of Canada Board and Guests
29 September Nosocomial Transmission of Influenza and Healthcare Worker Vaccination
Speaker: Dr. Helena Maltezou, Helenic Center for Disease Control and Prevention, Greece
6 October Using Metals in Infection PreventionA Welcome Addition or a Retrograde Step?
Speaker: Dr. Carol Pellowe, Thames Valley University
13 October Infection Prevention and Control in Long Term Care Facilities
Speaker: Prof. Bjorg Marit Andersen, Oslo University, Norway
Teleclass sponsored by Diversey Inc (www.diversey.com)
26 October
South Pacific
Teleclass
Public Health Lessons Learnt from the Christchurch Earthquakes
Speaker: Dr. Ramon Pink, University of Otago, New Zealand
27 October

The Role Of Microbial Biofilms in Chronic Bacterial Infections
Speaker: Dr. William Costerton, Center for Genomic Sciences
3 November

How Should We Clean Our Hospitals
Speaker: Dr. Stephanie Dancer, NHS Lanarkshire, Scotland
Teleclass sponsored by Diversey Inc. (www.diversey.com)
10 November

Infection Prevention Challenges in Home Care: Preparing for Survey
Speaker: Dr. Mary McGoldrick, Home Health Systems Inc
17 November

An Overview of the HICPAC Norovirus Guideline
Speaker: Dr. Taranisia MacCannell, Centers for Disease Control
Teleclass sponsored by Virox Technologies Inc (www.vrox.com)
1 December

Strategies for Improving Hand Hygiene Compliance in the ICU
Speaker: Dr. Alexandre R. Marra, Hospital Israelita Albert Einstein, Brazil
Teleclass sponsored by Deb Ltd (www.debgroup.com)
7 December Best Practice for Cleaning, Disinfection and Sterilization in Healthcare
Speaker: Prof. William Rutala, University of North Carolina
Teleclass sponsored by the World Health Organization First Global Patient Safety Challenge:
Clean Care is Safer Care (www.who.int/gpsc/en)
15 December Surgical Implantables Being Reprocessed: Pandoras Surgery Box is Opened!
Speaker: Dr. Michelle Alfa, Diagnostic Services of Mantioba

More information about classes:
http://www.webbertraining.com/schedulep1.php

Recent additions to the free-access recordings library:
http://www.webbertraining.com/recordingslibraryc4.php

Professionally designed infection control posters (59) available for free download in web-resolution and
in print-resolution:
http://webbertraining.com/freeposterdownloadsc97.php
Webber training teleclass update
Page 14 IN SAFEHANDS
Current resources
In this section,
SafeHandS list
abstracts of recent
relevant articles and
any new resources
such as policies,
protocols and
training materials
about health care
worker safety.

SafeHandS may
include resources
from other regions if
they can inform
local practice.

SafeHandS can
provide most of the
articles on request.
Title Sharps injuries among employees of acute care hospitals in
Massachusetts, 20022007
Author Laramie AK et al
Source Infection Control and Hospital Epidemiology 2011 June;32(6):538-44
Country USA
Abstract

Objective: Sharps with engineered sharps injury protections (SESIPs) have
been found to reduce risk of sharps injuries (SIs). We examined trends in SI rates
among employees of acute care hospitals in Massachusetts, including the impact
of SESIPs on SI trends during 2002-2007.
Results: During 2002-2007, 16,158 SIs among employees of 76 acute care
hospitals were reported to the surveillance system. The annual SI rate decreased
by 22%, with an annual decline of 4.7% (P < .001). Rates declined significantly
among nurses (-7.2% per year; P < .001) but not among physicians (-0.9% per
year; P = .553). SI rates associated with winged steel needles and hypodermic
needles and syringes also declined significantly as the proportion of injuries
involving devices with sharps injury prevention features increased during the
same time period.
Conclusion: SI rates involving devices for which SESIPs are widely available
and appear to be increasingly used have declined. The continued use of devices
lacking SI protections for which SESIPs are available needs to be addressed. The
extent to which injuries involving SESIPs are due to flaws in design or lack of
experience and training must be examined.


Title An alternate approach to improving healthcare worker influenza
Author Esolen LM et al
Source Infection Control and Hospital Epidemiology 2011July;32(7):703-5
Country USA
Abstract

Optimizing employee influenza vaccination rates has become a
healthcare focus. We detail an approach involving a strong requirement
for unvaccinated workers to wear a face mask and a super convenient
vaccination process. Our major teaching hospital achieved 95%
compliance in 2009, and our health system reached 90% and 92%
compliance for 2 years.
Title
Bacterial contamination of hands and the environment in a microbiology laboratory
Author Ng LSY et al
Source Journal of Hospital Infection 2011 July;78(3):231-3
Country Singapore
Abstract

This study investigated both the impact of glove usage on bacterial hand contamination of laboratory
technicians and extent of environmental contamination of a microbiology laboratory with potential
bacterial pathogens. Two groups of laboratory technologists participated in the study - one group who
always used gloves when handling bacterial cultures and another group who did not.
Semiquantitative bacterial sampling from technicians' hands was performed before and after a
defined work period. Frequently touched areas of the laboratory were sampled over a four-week
period and selective or chromogenic media utilised for the identification of methicillin-resistant
Staphylococcus aureus (MRSA), Pseudomonas aeruginosa, Salmonella spp. and
Enterobacteriaceae. Laboratory technicians who did not use gloves were at significantly greater risk
of acquiring MRSA following their work periods but no protective effect was demonstrated for glove
usage against acquisition of Enterobacteriaceae.
VOLUME 5, ISSUE 2 Page 15
Hand washing was equally effective at removing acquired bacterial pathogens in both groups of
workers. Environmental sampling documented the presence of MRSA in one-fifth of sampled
sites, with the most frequent recovery from computer keyboards. Enterobacteriaceae and
P. aeruginosa were less commonly recovered from the environment. This study demonstrates
that glove usage is protective against the acquisition of MRSA and that MRSA is the most
frequently recovered bacterial pathogen from our microbiology laboratory environment.

Title World Health Organization-recommended hand-rub formulations do not meet European
efficacy requirements for surgical hand disinfection in five minutes
Author Kampf G & Ostermeyer C
Source Journal of Hospital Infection 2011 June;78(2):123-7
Country Germany
Abstract The World Health Organization (WHO) has recommended two hand-rub formulations for local
production based on 80% ethanol or 75% isopropanol (both v/v). We have looked at their
efficacy according to EN 12791. Twenty-six subjects treated their hands with the reference
procedure (n-propanol, 60%) for 3 min or with one of the two formulations for 1.5, 3 or 5 min
(Latin square design). Post-values (immediate effect) were taken from one hand, the other hand
was gloved for 3 h. After the glove had been taken off, the second post-value was taken (3 h
effect). The mean log(10) reduction of each hand rub at all three application times was
compared to Hodges and Lehmann's reference procedure for non-inferiority. In the first block the
reference procedure reduced bacterial load by 2.43 log(10) (immediate effect) and 2.22 log(10)
(3 h effect). The efficacy of the ethanol-based formulation (e.g. immediate efficacy of 1.41 log
(10) at 5 min) was inferior to the reference procedure at all application times [lower 95%
confidence interval (CI): less than -0.75]. In the second block the reference procedure reduced
bacterial load by 2.72 log(10) (immediate effect) and 2.26 log(10) (3 h effect). The efficacy of the
isopropanol-based formulation (e.g. immediate efficacy of 2.05 log(10) at 5 min) was also inferior
to the reference procedure at all application times (lower 95% CI: less than -0.75). Both WHO-
recommended hand-rub formulations failed to meet the EN 12791 efficacy requirements for
surgical hand disinfection within 5 min. A higher concentration of the active ingredients may
improve the efficacy.

Title Reporting of occupational exposures to sharp injuries among Jordanian healthcare
workers
Author Moayad WA et al
Source Healthcare Infection 2011 June 16(2) 71-77
Country Jordan
Abstract Objectives: (a) To determine the reporting rate of sharps injuries over the last 12 months; (b) to
examine the relationships between specific variables and reporting rate of sharps injuries; and
(c) to identify the reasons for failure to follow the guidelines for reporting of sharps injuries.
Method: A cross-sectional study of healthcare workers working in public and private hospitals
was undertaken using a survey that was developed by the Centers for Disease Control and
Prevention.
Results: Two thousand surveys were distributed to healthcare workers who were working in
private and public hospitals. One thousand and sixty-eight healthcare workers filled out the
surveys. The highest reporting rates were found among the following subgroups: female (34%);
years of experience less than 2 years (51%); dentists (57%); worked in laboratory (48%)
followed by operation room (36%); and worked between 7:00 a.m. and 3:00 p.m. (50%).
Respondents experiences with the health service post-exposure were the following: care was
not given in a timely manner; their questions and screenings were not answered; and place
where care was given was not good.
Conclusion: Reporting of occupational exposures to sharps injuries is a significant dilemma
facing Jordanian healthcare workers. Procedures for reporting sharps injuries must be available
and clear to all healthcare workers.
Page 16 IN SAFEHANDS
Title Occupational stress in the Australian nursing workforce: a comparison between
hospital-based nurses and nurses working in very remote communities
Author Opie, T, Lenthall S, Wakerman J, et al
Source Australian Journal of Advanced Nursing 2011 JuneAugust vol.28,no.4
Country Australia
Abstract Objective: To compare workplace conditions and levels of occupational stress in two
samples of Australian Nurses.
Design: The research adopted a cross=sectional design, using a structured questionnaire.
Setting: Health centres in very remote Australia and three major Australian Hospitals.
Subjects: 349 nurses working in very remote Australia and 277 nurses working in three
major hospitals in South Australia and the Northern Territory.
Main Outcome Measures: The main outcome measures were psychological distress
(assessed using the General Health Questionnaire-12), emotional exhaustion (assessed
using the Maslach Burnout Inventory), work engagement (assessed using the Utrecht Work
Engagement Scale-9) and job satisfaction (assessed using a single item measure based on
previous relevant research).
Results: Results revealed that nurses working in major Australian hospitals reported higher
levels of psychological distress and emotion exhaustion than nurses working very remotely.
However, both groups report relatively high levels of stress. Nurses working very remotely
demonstrated higher levels of work engagement and job satisfaction. There are common job
demands and resources associated with outcome measures for both nurses working very
remotely and nurses working in major hospitals.
Conclusion: This research has implications for workplace interventions and the retention of
staff in both hospitals and remote area health care facilities.

Title
World Health Organization-recommended hand-rub formulations do not meet
European efficacy requirements for surgical hand disinfection in five minutes
Author Kampf G, Ostermyer C
Source Journal of Hospital Infection 2011 vol. 7, issue 2: 123-127
Country Germany
Abstract The World Health Organization (WHO) has recommended two hand-rub formulations for
local production based on 80% ethanol or 75% isopropanol (both v/v). We have looked at
their efficacy according to EN 12791. Twenty-six subjects treated their hands with the
reference procedure (n-propanol, 60%) for 3 min or with one of the two formulations for 1.5,
3 or 5 min (Latin square design). Post-values (immediate effect) were taken from one hand,
the other hand was gloved for 3 h. After the glove had been taken off, the second post-value
was taken (3 h effect). The mean log
10
reduction of each hand rub at all three application
times was compared to Hodges and Lehmanns reference procedure for non-inferiority. In
the first block the reference procedure reduced bacterial load by 2.43 log
10
(immediate
effect) and 2.22 log
10
(3 h effect). The efficacy of the ethanol-based formulation (e.g.
immediate efficacy of 1.41 log
10
at 5 min) was inferior to the reference procedure at all
application times [lower 95% confidence interval (CI): less than 0.75]. In the second block
the reference procedure reduced bacterial load by 2.72 log
10
(immediate effect) and
2.26 log
10
(3 h effect). The efficacy of the isopropanol-based formulation (e.g. immediate
efficacy of 2.05 log
10
at 5 min) was also inferior to the reference procedure at all application
times (lower 95% CI: less than 0.75). Both WHO-recommended hand-rub formulations
failed to meet the EN 12791 efficacy requirements for surgical hand disinfection within
5 min. A higher concentration of the active ingredients may improve the efficacy.
VOLUME 5, ISSUE 2 Page 17
In the News

A study published by the Irish Nurses and Midwives Organisation (INMO) found that more than one third of nurses
in Ireland have experienced a needlestick injury and 70% of nurses know a colleague who suffered such an injury.
INMO director of professional development, Annette Kennedy, said nurses who experienced a needlestick injury
were afraid to go public because of the stigma. She was speaking at the INMO/European Biosafety Network
conference held to highlight the risk of sharps injuries among healthcare workers. Ms Kennedy said she had
approached four nurses to speak about their experiences but all declined.
We have to end this silent epidemic. It is one of the most serious and common injuries to affect all healthcare
workers, both in Europe and throughout the world.
She pointed out there were between 900 and 1,000 needlestick injuries every year across the Irish healthcare
sector and almost half were nurses.
Ms Kennedy said there had been no change in the average incidence of needlestick injuries over the past seven
yeas.If we had been doing something right, those figures should have gone down. The injuries were preventable
by providing effective training, safer working procedures and safely engineered medical devices that shield or
retract the needle after use, she said.
She pointed out that Connolly Hospital in Blanchardstown, Dublin, experienced a marked reduction in needlestick
injuries after it introduced safety cannulaes and training in 2003. Needlestick injuries at the hospital plummeted
from 129 between 2001 and 2003 to a single case, two-and-a-half years later.
INMO president Sheila Dickson called on Ireland and governments across Europe to implement the European
Union (EU) Sharps Directive, which sets up an integrated approach to assessing and preventing risks and to
training and informing health workers about these risks. Each EU state is required to bring in legislation to
implement the directive by May 11, 2013.
Source: The Irish Examiner, 2 June, 2011


A study of more than 1,300 doctors, nurses and midwives employed by the Waikato District Health Board (DHB)
in New Zealand found that 40% of those incidents were not documented according to DHB protocol.
Reasons for non-reporting included a lack of time, a lack of importance and awareness of the correct procedure to
follow. This was despite Waikato DHB having implemented a needlestick injury prevention programme that
included staff education of safe work practices.
Of the 123 people who revealed to researchers that they had been stuck by a needle over a 12-month period, 27
had had it happen two or three times and three had received five or six injuries.
In total, a third of needlesticks were not reported with 26 of 65 doctors not following protocol compared to 26 of 97
nurses affected.
Source: Sunday Star Times, 29 May, 2011


Nurses are amongst the most overworked, and arguably underpaid, of skilled professions in the United States of
America. They are also amongst the highest at risk of emotional stress or occupational harm.
According to one recent survey by the American Nurses Association, nearly two-thirds (64%) of US nurses say
needlestick injuries and blood borne infections remain major concerns, and 55% believe their workplace safety
climate negatively impacts their own personal safety. Estimates by the US Centers for Disease Control and
Prevention (CDC) put the number of sharps injuries in healthcare at well over half a million each year.
The costs associated with testing and treatment total around $2 billion annually, excluding the potential expenses
associated with actual infection of those healthcare workers who do contract hepatitis, HIV or other pathogens. As
a measure of likelihood of injury among hospital workers, it has been estimated that 28 sharps injuries occur
annually for every 100 occupied hospital beds.
Since 2002, the Massachusetts Department of Public Health has published annual reports on the number of
reported needlestick injuries occurring within their healthcare facilities. The report showed that the number of
needle and syringe accidents among hospital workers did not significantly change between 2002 and 2009. The
percentage of reported injuries caused by syringes with no safety features dropped from 60% to 30% during the 8
-year period, supporting the widespread transition to the use of safety products within US healthcare facilities.
However, this decline in reported injuries caused by standard syringes is largely off-set by those with safety
features. Since 2004, the majority of reported syringe-related injuries have been caused by safety products.
Between 2002 and 2009, the number of reported injuries has remained largely stable. The data indicates that
safety syringes have largely replaced standard syringes as the primary cause of harm.
Source: The Proactive Network, 10 May, 2011



What is SafeHandS?
SafeHandS is a virtual network designed to link and support health care
workers across the Asia-Pacific region who are caring for people with
HIV and other communicable diseases. We know that health care
workers are essential in responding to HIV and other communicable
diseases. Without health care workers, there is no health system. We
want this network to provide information, support and practical solutions
to help health care workers in resource limited settings to feel safe and
encouraged to provide optimal care.

SafeHandS is a forum where health care workers can share issues and
ideas. We can encourage and learn from each other to find practical
solutions to improve health care worker safety in resource limited
settings.

SafeHandS is being funded by the Australian Agency for International
Development (AusAID) and coordinated by the Albion Street Centre
(ASC). ASC is a public health care facility based in Australia for the
treatment, care and support of people living with or affected by HIV and
other communicable diseases.

We are pleased to report that at the end of February 2011, we had over
280 members of SafeHandS, working in 39 countries.
Become a member

Benefits of SafeHandS membership include:

Receiving a newsletter (In SafeHandS) every 3 months
Participating in a moderated group email discussion e-list for posting questions, comments
and issues
Access to a clearinghouse of new resources and publications produced by different
organisations about health care worker safety (links are posted on the website)
Access to resources developed by SafeHandS
Joining a database of expertise

Membership is free. To join, you can either:

Go to our website: http://www.uow.edu.au/health/safehands/index.html or

Send an email to: safehands@sesiahs.health.nsw.gov.au

You can elect to receive a hard copy of the newsletter by post. However, this will be a shorter
version than the electronic version. We encourage members to receive the newsletter by
email to reduce our postage costs.

Tell your colleagues!
Page 18 IN SAFEHANDS
Please pass
along this
information to
colleagues who
may be
interested in
health care
worker safety
issues