Inoculation injuries in hospitals in Trinidad and Tobago

This paper reviews the frequency of inoculation injuries, which occurred in hospitals in Trinidad and Tobago from 1991 to 1997 inclusive. A total of 3 97 cases of inoculation injuries were detected. Significantly more of these injuries occurred during diagnostic or therapeutic procedures (231, or 58. 2%; G=41.2, df9, p<0.001) than during disposal of needles and other sharps (136 or 34.3%), certain situations remote from patient care (21, or 5.2%), and 'rogue incidents' related to unsafe disposal with later injury to janit ors or others (9, or 2.3%). No statistically significant monthly or seasona l variations occurred in the incidence of reported inoculation injuries. Th e two institutions that saw the largest number of patients, the Port-of-Spa in General and San Fernando General Hospitals, accounted for the largest nu mber of cases of inoculation injury, with 139 (35.0%) and 135 (34.0%), resp ectively. Interestingly enough, there were 42 reported inoculation incident s at the St. Ann's Hospital for the Mentally Impaired and 23 (52.5%) of the se were bites, most of them occurring during attempted procedures. Nurses w ere the main recipients of inoculation injuries (287 cases, or > 72%), foll owed by doctors (9.3%), and ward maids (6.2%). The main modes of inoculatio n were needle sticks (305, or 76.8%). Bites (34, 8.6%), injuries with sharp s other than needles (29 or 7.3%), and splashes (29 or 7.3%) were the other types seen. One recipient was found to be infected with HIV following acci dental inoculation. The infection control methodologies used in hospitals i n Trinidad and Tobago are reviewed and recommendations for preventing injur ies are outlined.