Costs and benefits of measures to prevent needlestick injuries in a university hospital

OBJECTIVE: To document the costs and the benefits (both in terms of costs a verted and of injuries averted) of education sessions and replacement of ph lebotomy devices to ensure that needle recapping did not take place. DESIGN: The percentage of recapped needles and the rate of needlestick inju ries were evaluated in 1990 and 1997, from a survey of transparent rigid co ntainers in the wards and at the bedside and from a prospective register of all injuries in the workplace. Costs were computed from the viewpoint of t he hospital. Positive costs were those of education and purchase of safer p hlebotomy devices; negative costs were the prophylactic treatments and foll ow-up averted by the reduction in injuries. SETTING: A 1,050-bed tertiary-care university hospital in the Paris region. RESULTS: Between the two periods, the proportion of needles seen in the con tainers that had been recapped was reduced from 10% to 2%. In 1990, 127 nee dlestick (12.7/100,000 needles) and 52 recapping injuries were reported ver sus 62 (6.4/100,000 needles) and 22 in 1996 and 1997. When the rates were r elated to the actual number of patients, the reduction was 76 injuries per year. The total cost of information and preventive measures was $325,927 pe r year. The cost-effectiveness was $4,000 per injury prevented. CONCLUSION: Although preventive measures taken to ensure reduction of needl estick injuries appear to have been effective (75% reduction in recapping a nd 50% reduction in injuries), the cost of the safety program was high (Inf ect Control Hosp Epidemiol 1999;20:614-617).