Audit of emergency department assessment and management of patients presenting with community-acquired needle stick injuries

2011 ◽  
Vol 35 (1) ◽  
pp. 57 ◽  
Author(s):  
Antonio Celenza ◽  
Lloyd J. D'Orsogna ◽  
Shervin H. Tosif ◽  
Samantha M. Bateman ◽  
Debra O'Brien ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Emergency Department ◽  
Hepatitis B ◽  
Emergency Departments ◽  
Hepatitis B Vaccination ◽  
Needle Stick Injury ◽  
Needle Stick ◽  
Post Exposure ◽  
Needle Stick Injuries

Objectives. To describe characteristics and management of people with community acquired needle stick injuries (CANSI) attending urban emergency departments; and suggest a guideline to improve assessment, management, and documentation. Methods. A retrospective analysis of cases with CANSI attending emergency departments in two tertiary hospitals between 2001 and 2005 using medical record review with follow up phone and written survey. Results. Thirty-nine cases met the criteria for CANSI. Persons younger than 30 years sustained 48.72% of all injuries. Source serology was available for only five cases (12.82%). Thirty-one of thirty-nine patients (79.49%) were classed as not immune to hepatitis B but only four of these (12.90%) received both hepatitis B vaccination and hepatitis B immunoglobulin. Six patients (15.38%) received HIV prophylaxis; of which two (33.33%) did not receive baseline HIV testing. Of ten patients referred to immunology clinic for follow up only two (20.00%) attended at 6 months. Conclusion. We have identified groups that are at high risk of CANSI, including young males, security workers and cleaners. In the majority of cases protection against hepatitis B was inadequately provided, and a substantial proportion had inadequate baseline assessment and documentation. A guideline is suggested that may be used to improve these deficits. What is known about this topic? Occupationally acquired needle stick injury guidelines are well established, but no guidelines currently exist for community acquired needle stick injuries (CANSI) which may require different risk stratification, assessment and management. Management of CANSI in Emergency Departments has not been well described. What does this paper add? An audit of Emergency Department management of community acquired needle stick injuries demonstrates deficits in risk assessment, documentation and use of post-exposure immunisation and prophylaxis. A guideline is suggested that may be used to improve these deficits. What are the implications for practitioners? Practitioners need to perform and document a risk assessment of the injury, perform baseline serology, and provide tetanus and hepatitis B immunisation. Use of HIV post-exposure prophylaxis is determined by local prevalence of disease, injury risk assessment, source serology if known, and time since injury.

scholarly journals Knowledge about blood-borne pathogens and the prevalence of needle stick injuries among medical students in Serbia

2017 ◽  
Vol 56 (3) ◽  
pp. 179-184 ◽  
Author(s):  
Vuk Marusic ◽  
Ljiljana Markovic-Denic ◽  
Olivera Djuric ◽  
Dragana Protic ◽  
Emilija Dubljanin-Raspopovic
Keyword(s):  
Medical Students ◽  
Hepatitis B ◽  
Disease Transmission ◽  
Cross Sectional Study ◽  
Hepatitis B Vaccination ◽  
Cross Sectional ◽  
Needle Stick ◽  
Sharp Object ◽  
Needle Stick Injuries ◽  
Needle Sticks

AbstractIntroductionMedical students are mainly exposed to needle stick and sharp object injuries in the course of their clinical activities during studying. They are at high risk due to their undeveloped skills, restricted clinical experience, lack of knowledge and risk perception. The objectives of this study were to determine the prevalence of needle stick injuries of the fourth and final year medical students, and to estimate their knowledge about blood-borne pathogens disease transmission and standard precautions.MethodsThis cross-sectional study was conducted at the Faculty of Medicine, in February 2014. The students were invited to self-administer a questionnaire of 26 closed questions prepared for this study.ResultsThe questionnaire was filled in and returned by 637 students. The prevalence of needle sticks and sharp object injuries was 29.5%. Needle stick injuries were the most common type of accidents, more frequent among the fourth compared to the sixth year students (p=0.002). The majority of accidents occurred in patient rooms (53%) and the emergency department (15%). 54% of participants reported an accident to the responsible person. Students without accidents had a significantly better perception of risk (3.79 vs. 3.35; p<0.05). Out of the total participating students, only 16.6% (106/637) received all three doses of Hepatitis B vaccination, while 16.2% were partially vaccinated.ConclusionsThere is a need for additional theoretical and practical education of our students on blood exposure via accidents, raising the awareness of the necessity of hepatitis B vaccination, and introducing the unique/comprehensive procedure for accident reporting for students and healthcare workers in the entire country.

scholarly journals Necessity of hepatitis B vaccination based on the current situation of needle stick injuries at our hospital

Kanzo ◽  
2020 ◽  
Vol 61 (4) ◽  
pp. 184-190
Author(s):  
Satoru Sekoguchi ◽  
Hitomi Hirose ◽  
Kanami Ikeda ◽  
Satoki Yamane ◽  
Seiko Hamada ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Current Situation ◽  
Hepatitis B Vaccination ◽  
Needle Stick ◽  
Needle Stick Injuries

scholarly journals NEEDLE STICK INJURIES AMONG DENTAL STUDENTS IN ISHIK UNIVERSITY FACULTY OF DENTISTRY AND HAWLER MEDICAL COLLEGE

2019 ◽  
Vol 7 (4) ◽  
pp. 1-13
Author(s):  
Salim Younus Mohamed ◽  
Balen Omer ◽  
Aveen Abdulrahman
Keyword(s):  
Hepatitis B ◽  
Dental Students ◽  
Dental Student ◽  
Needle Stick Injury ◽  
Cross Sectional ◽  
Needle Stick ◽  
Medical College ◽  
Needle Stick Injuries ◽  
Data Collections ◽  
Needle Sticks

Background and objectives: Needle stick injuries pose a high risk to health care workers including dental students. They represent a major risk factor for transmitting blood borne pathogens including hepatitis B virus, hepatitis C virus and human immunodeficiency virus. Needles of syringes are the most commonly identified sharp object causing the injuries. Therefore, this study conducted to determine the prevalence of needle stick injuries among dental students in Ishik university facualty of dentistry and Hawler medical college. Aim and objectives of the study: The study aimed were to: 1. Find out the prevalence of NSI among dental student in Erbil city-Iraq. 2. The percentage of dental students that had taken Hep B vaccine. 3. Study the knowledge of dental students regarding NSI.Subjects and method: The study was a cross sectional in nature, 114 students from Ishik University and Hawler Medical University Collage of Dentistry and data collections were done from the 1st of Dec till 2 of Feb 2018. Later on, data analysis and writing the thesis completed in May up to June, 2018. A questionnaire was completed through direct interview of the study students to measure their knowledge and practice about needle sticks injuries. All the obtained information including prevalence of needle sticks injuries, within previous 12 months, time of injury, and training on needle stick injury, knowledge, practice and attitude about needle sticks was then analyzed using statistical package for the social science software version 21.Results: The mean age of the participants was 22. The results of the study demonstrated that the prevalence of needle stick injury during past 12 months among dental students was 47,4%. Needle stick injury happened after using the needle in 35.2%, while in re-capping the needle occur in 27,8% and around 41.2% of the samples have precautions regarding NSI.Conclusion: The dental student had taken hepatitis B vaccine in a high percentage, while the prevalence of NSI was high and male showed higher prevalence than female. Training course regarding the precaution and management of NSI may need to be added to the curriculum of dental students.

scholarly journals Frequency of Needle Stick Injury among Dental Students and Dentists of Karachi

2015 ◽  
Vol 6 (4) ◽  
pp. 213-216 ◽  
Author(s):  
Kashif Ikram ◽  
Humayun Kaleem Siddiqui ◽  
Sana Maqbool ◽  
Maham Altaf ◽  
Sania Khan
Keyword(s):  
Hepatitis B ◽  
English Language ◽  
Cross Sectional Study ◽  
Dental Students ◽  
Hepatitis B Vaccination ◽  
Needle Stick Injury ◽  
Cross Sectional ◽  
Needle Stick ◽  
Health Related ◽  
History Of

ABSTRACT Objective To determine the frequency of needle stick injury in dental practice and to evaluate the level of knowledge, attitude and practices of the dental students and dentists regarding needle stick injuries prevention. Materials and methods This descriptive cross-sectional study was undertaken at eight different institutes of Karachi from July 2014 to March 2015. Data were collected in 800-sample questionnaire forms that comprised of ten questions in English language. Questionnaire was designed to obtain information regarding frequency, awareness and prevention of needle stick injury. Data were entered and analyzed in Statistical Package for the Social Sciences (SPSS) Version 20. Result A total of 800 samples were returned with a 100% response rate. About 73% participants gave a history of needle stick injury during practice. Of these 42% were the house officers. It was reported that knowledge regarding vaccination against hepatitis B was prevalent among participants. Most of the participants agreed that they have received guidelines regarding prevention and protection from needle stick injury. Conclusion It was concluded from this study that hepatitis B vaccination is necessary to prevent needle stick injury and proper instruments/guidelines should be given to all health related professionals in order to minimize the risk of bloodborne infections through needle stick injury. How to cite this article Ikram K, Siddiqui HK, Maqbool S, Altaf M, Khan S. Frequency of Needle Stick Injury among Dental Students and Dentists of Karachi. World J Dent 2015;6(4): 213-216.

Post-Exposure Prophylaxis

2019 ◽  
Author(s):  
C. Y. William Tong
Keyword(s):  
Risk Assessment ◽  
Hepatitis B ◽  
Severity Of Illness ◽  
Unknown Origin ◽  
Needle Stick Injury ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Stray Dog ◽  
Mode Of Transmission ◽  
Exposure Prophylaxis

Post-exposure prophylaxis (PEP) is a treatment administered to an individual to prevent the development of infection or reduce the severity of illness after a potential or documented exposure to a microorganism. This may primarily be for the protection of the exposed individual concern, or in the case of a pregnant woman, for protecting the foetus in utero. PEP may also be useful in public health to reduce the risk of secondary spread of infection. A good history is required in order to make a proper assessment of the risk. The following questions should be asked: A. Which infection is suspected and is the source infectious? It is straight forward if the diagnosis of the source of exposure is already known, e.g. known HIV, established diagnosis of tuberculosis. However, in many cases, the diagnosis of the source may not be certain, e.g. needle stick injury involving a needle of unknown origin, bitten by a stray dog, exposed to a child with a non-specific rash. In such cases, a risk assessment is required to assess the likelihood that the source may be infectious. Knowledge of local epidemiology or recent outbreaks in a particular locality may help in such risk assessment. B. What is the nature of the exposure? Knowledge of the mode of transmission of a microorganism is important to establish if there is any risk of transmission through the exposure In the case of mother-to-child transmission, PEP to the neonate born to a mother with an infection is effective if the mode of transmission is predominately perinatal, e.g. hepatitis B. If the mode of transmission is transplacental, it is too late to administer PEP to the baby after delivery. Instead, the expected mother should be given prophylaxis during pregnancy to prevent infection, e.g. chicken pox, or given antivirals to reduce infectivity, e.g. maternal hepatitis B with a high viral load when transplacental infection may occur. In HIV, where transmission can occur both transplacentally and perinatally, antiretroviral therapy (ART) needs to be given during pregnancy and often during labour as well as to the baby after birth.

scholarly journals 986. Improvement in Administration of HIV Post-Exposure Prophylaxis in the Emergency Department Following Sexual Assault

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S521-S522
Author(s):  
Jennifer R Silva-Nash ◽  
Stacie Bordelon ◽  
Ryan K Dare ◽  
Sherrie Searcy
Keyword(s):  
Emergency Department ◽  
Sexual Assault ◽  
Hiv Transmission ◽  
Post Exposure Prophylaxis ◽  
Intervention Period ◽  
Post Intervention ◽  
Post Exposure ◽  
Assault Victims ◽  
Exposure Prophylaxis

Abstract Background Nonoccupational post exposure prophylaxis (nPEP) following sexual assault can prevent HIV transmission. A standardized Emergency Department (ED) protocol for evaluation, treatment, and follow up for post assault victims was implemented to improve compliance with CDC nPEP guidelines. Methods A single-center observational study of post sexual assault patients before/after implementation of an ED nPEP protocol was conducted by comparing the appropriateness of prescriptions, labs, and necessary follow up. A standardized order-set based on CDC nPEP guidelines, with involvement of an HIV pharmacist and ID clinic, was implemented during the 2018-2019 academic year. Clinical data from pre-intervention period (07/2016-06/2017) was compared to post-intervention period (07/2018-08/2019) following a 1-year washout period. Results During the study, 147 post-sexual assault patients (59 Pre, 88 Post) were included. One hundred thirty-three (90.4%) were female, 68 (46.6%) were African American and 133 (90.4%) were candidates for nPEP. Median time to presentation following assault was 12.6 hours. nPEP was offered to 40 (67.8%) and 84 (95.5%) patients (P&lt; 0.001) and ultimately prescribed to 29 (49.2%) and 71 (80.7%) patients (P&lt; 0.001) in pre and post periods respectively. Renal function (37.3% vs 88.6%; P&lt; 0.001), pregnancy (39.0% vs 79.6%; P&lt; 0.001), syphilis (3.4% vs 89.8%; P&lt; 0.001), hepatitis B (15.3% vs 95.5%; P&lt; 0.001) and hepatitis C (27.1% vs 94.3%) screening occurred more frequently during the post period. Labratory, nPEP Prescription and Follow up Details for Patients Prescribed nPEP Conclusion The standardization of an nPEP ED protocol for sexual assault victims resulted in increased nPEP administration, appropriateness of prescription, screening for other sexually transmitted infectious and scheduling follow up care. While guideline compliance dramatically improved, further interventions are likely warranted in this vulnerable population. Disclosures Ryan K. Dare, MD, MS, Accelerate Diagnostics, Inc (Research Grant or Support)

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