Preventing Sharp Injuries Among Nurses and Midwives in Sub-Saharan Africa

Friday, 3 August 2012: 10:15 AM

Barbara Smith, PhD, RN, FAAN
School of Nursing, University of Maryland, Baltimore, Baltimore, MD
Sue A. Blanshan, PhD
Academic Affairs10th Floor, Maryland Higher Education Commission, Baltimore, MD
Shijun Zhu, PhD
School of Nursing, University of Maryland Baltimore, Baltimore, MD
Margaret Maimbolwa, RN, PhD
Nursing, University of Zambia, Lusaka, Zambia

Learning Objective 1: Identify factors which increase the risk of exposure to blood borne pathogens via needlesticks in nurses and midwives in Sub-Saharan Africa.

Learning Objective 2: Discuss possible strategies to reduce needlesticks and other blood borne pathogen exposures in nurses and midwives in Sub-Saharan Africa.

Purpose: The purpose of this study was to examine the risks of sharps (needlestick) injuries among nurses and midwives providing care to patients in Sub-Saharan Africa. 

 Methods: An anonymous questionnaire was completed by 712 nurses from 11 different African countries who were attending the African Midwives Research Network meeting in Nairobi, Kenya and Dar Es Salaam Tanzania or other organized nursing meetings. Questions related to their knowledge of universal precautions, level of education, availability and use of protective apparel, sharps and splash injuries/exposures, work schedule, and needle use.  Generalized estimating equation models, accommodating the correlation within the residing country, were employed to examine the effects of work schedule and needle use on sharps injuries.

 Results: Results showed nurses who made home visits had higher odds of sharps injuries (adjusted OR [aOR] = 1.52, p = 0.043). Nurses engaged in direct care ≥ 50% of time (aOR = 2.31, p = 0.003 for 50-80%; aOR = 2.09, p = 0.006 for over 80%) or called in to work “off-hours” (aOR = 1.71, p = 0.008) were more likely to sustain an injury.  As could be expected, the number of times a nurse used a needle was associated with higher odds of injuries (aOR=1.61, P=0.015) as were starting IVs and recapping needles.    In addition, educational preparation and knowledge of Universal precautions will be discussed.

 Conclusion: Delivering care in patient’s home, more time spent in direct care, and increased needle use are risk factors for sharps injuries.  Interventions aimed at reducing the risk of injuries, improving procedures for working in the home, reducing the number of times the nurse must handle needles, and use of safety engineered needles may reduce blood borne pathogen (BBP) exposure in nurses and midwives practicing in Sub-Saharan Africa.