Predicting Factors Of Clinical Nurses’ Needlestick Injury Prevention Applying The IMB Model

Objective: This paper reports the prevalence and characteristics of clinicalnurses’ needlestick injuries (NSI)in the city of Suzhou, and describes the level ofknowledge, prevention motivation, self-efficacy, protection behavior; this study alsoexplores the influencing factors of NSI prevention and analyzes the relationships amongthem for providing scientific evidence of nursing administrators taking correspondingoccupational protection.Methods:1200nurses in8general hospitals and7community hospitals of Suzhouattended our investigation from May2012to November by stratified randomized clustersample method. The demographic questionnaire, a self-administered questionaire aboutNSI and information-motivation-behavior toward NSI prevention, and General Self-Effica-cy Scale were used in our investigation. The entire figure was input into computer andanalyzed by SPSS16.0statistic software.Results:1.1141valid questionnaires were returned.88.7%of nurses reported one ormore NSI since being a nurse,and36.6%nurses experienced more than10NSIs.64.4%ofnurses reported one or more NSI in the past year,while63.5%reported one or morecontaminated NSI.2. The most injuried part of the body was hand accounting for93.4%ofNSI,97.7%of the injuries were low or middle level which caused bleeding.40.2%of NSIoccurred by contaminated needles used on patients.72.2%of NSI occurred on day-shift.By location,43.7%of NSI occurred in the patient room. Before operation (21.9%),duringoperation (40.7%),after operation (31.7%)and disposal of medical wast (e3.8%)and otherswere the operation timing and injuries.22.2%of NSI occurred in the process of other afteruse-before disposal (in transit to trash, cleaning, sorting, etc).disposable syringe and winged steel needle (includes piggybacks&IV line connectors)were involved in themajority of NSI accounting for76.2%, followed by suture needle, vacuum tube bloodcollection holder/needle, catheter needle, etc.68.0%of nurses thought “non-SafetyDesign” needle or sharp medical device causing the injuries.3.The score of NSI relatedknowledge was from6to24,the affecting factors for nurses’ knowledge of NSI preventionwere section and needlestick experience;The score of prevention motivation was from30to100, the affecting factors for nurses’ NSI prevention motivation were needlestickexperience and knowledge level；The average score of self-efficacy was2.67±0.53，theaffecting factors for nurses’ self-efficacy was section, duties and needlestick experience.4.The total score of NSI protection behaviors was59.85±11.47. The Logistic regressionshows that age, section, NSI related knowledge, prevention motivation, self-efficacycontributed to protection behaviors, and explained31.5%of the variance.Through thePearson correlation and Kendall rank correlation test, NSI related knowledge, preventionmotivation and self-efficacy was positively correlated with protection behaviors. NSIrelated knowledge was the indirect factors of protection behaviors,prevention motivationand self-efficacy was the direct factors of protection behaviors.Self-efficacy mediated therelationship between NSI related knowledge, prevention motivation and protectionbehaviors.Conclusions:1. The rate and frequency of NSI among clinical nurses in hospitals ofSuzhou was still very high, and was much higher compared to other regions.2. The mostinjuried part of the body was hand and most injuries caused bleeding. Most NSI occurredby contaminated needles used on patients.NSI occurred mainly on day-shift and in thepatient room. NSI may occur in any process of the operation, many NSIs occurred in theprocess of other after use-before disposal. Disposable syringe and winged steel needlewere involved in the majority of NSI.3. Section and needlestick experience wereinfluencing factors of NSI related knowledge; needlestick experience and knowledge levelwere influencing factors of NSI prevention motivation; section, duties and needlestickexperience were influencing factors of self-efficacy.4. NSI protection behavior is affected by age, section, NSI related knowledge, prevention motivation, self-efficacy.5. There werepositively relationship among the influencing factors of protection behaviors.Self-efficacymediated the relationship between NSI related knowledge, prevention motivation andprotection behaviors.