DEVICE-SPECIFIC SHARPS INJURY AND USAGE RATES - AN ANALYSIS BY HOSPITAL DEPARTMENT

Background: Whether universal precautions training has reduced percuta neous sharps injuries is questioned. Prevention programs directed to s pecific problem areas are required to further reduce injury. Our purpo se was to identify target areas. Methods: Device-specific sharps injur y rates per 100,000 devices purchased were determined by department at Yale New Haven Hospital (1993 to 1994). Usage per full-time equivalen t was calculated by department. Rates were modelled using Poisson regr ession. Results: Three epidemiologic patterns resulted: (1) injury rat es were independent of usage (butterfly needles); (2) injury rates var ied directly with usage (lancets); (3) injury rates varied inversely w ith usage (intravenous catheters, sutures, and scalpels). Device-speci fic usage and injury rates varied by department. Devices used little ( 9/full-time equivalent) but under difficult circumstances, such as int ravenous catheters in pediatric patients, were associated with high in jury rates (67.7/100,000). Devices, sometimes disassembled, such as bl ood collecting tubes, caused significantly more injury in departments where health care professionals work under time constraints, such as i n the emergency department and nursing. Unconventional use of devices (Luer-Lok syringes and scalpels) resulted in higher rates of injury (n ursing and laboratories). Building services appeared to be at risk for injury. Conclusions: With device-specific injury and usage rates by d epartment, injury prevention programs can now focus on specific device s and departments.