Prevalence And Risk Factors Of Sharp Injuries Among Anesthesia Residents In Southwest China

Objective:This study was conducted to investigate the incidence and risk factors of sharp injuries(SIs)among anesthesia residents in southwestern China and the psychological condition with SIs.And the systematic review was emplemented to analyze the effect of education and training on reducing the incidence of SIs among health care workers(HCWs).Part I:A cross-sectional survey of prevalence and risk factors of sharp injuries among anesthesia residents in Southwestern ChinaObjective:A cross-sectional survey was conducted to investigate the incidence and risk factors of sharp injuries(SIs)among anesthesia residents in southwestern China and the psychological condition with SIs.Methods:The literature related to the occurrence of SIs among HCWs were searched comprehensively.An anonymous semi-structured questionnaire was presented for anesthesia residents.Chi square test was used to analyze the risk factors of SIs.Logistic regression analysis was used to analyze the relationship between anxiety and single factors such as age,working years and the experience of SIs respectively.P<0.05 was considered statistically significant for a difference.Results:We recruited a total of 397 participants from 5 hospitals.The incidence of SIs was 70.5%among the respondents.The risk factors of SIs include young age,recapping needles,lack of safety injection devices and safety training program(X~2=74.244、44.216、76.591、11.073、6.692,P<0.01).72.5%(203/280)of the residents did not report to the relevant departments of the hospital after injury.The main reasons for non-reporting are negative blood test results from the source patient(63.5%,129/203)and injury caused by clean needles(60.6%,123/203).198 residents felt anxious,and SI was the risk factor(OR 39.99,95%CI 15.387-103.954,P<0.05).Conclusion:These results showed a high prevalence of SIs among anesthesia residents.Effective measures like providing safety engineered injection devices,modification of working schedule,developing educational program are essential for the prevention of SIs.Part II:The effect of education and training on the prevention of sharps injuries,a systematic review and meta-analysisObjective:The systematic review was emplemented to analyze the effect of education and training on reducing the incidence of SIs among health care workers(HCWs).Method:Literatures related to preventive education of SIspublished before July 2021 were searched using Pubmed,Cochrane Library,Embase,Web of science,CNKI,VIP,CBM and Wanfang Database.Two researchers were responsible for the screening according to the established inclusion and exclusion criteria.And the Cochrane systematic quality assessment tool was used to evaluate the risk of bias in the included studies.Two researchers independently extracted data,and Revman 5.4 software was recruited for meta-analysis.Results:A total of 19 literatures were included in the systematic review.Significant difference of the incidence of SIs between two groups was observed using meta-analysis with 12 clinical control trials(CCTs,RR1.97,95%CI 1.22-3.20,P<0.05).Meta-analysis results of 7 controlled before-and-afer studies trials(CBAs)showed that education and training could significantly reduce the incidence of SIs among medical personnel(RR 2.51,95%CI 1.65-3.84,P<0.05).Five studies compared glove-wearing rate between two groups(RR 0.59,95%CI 0.26-1.35,P>0.05).There were four studies illustrating the rate of handling needles correctly(RR 1.12,95%CI 0.68-1.85,P>0.05).Five literatures were included to compare the the correct utilization rate of sharp instrument box(RR 0.75,95%CI 0.60-0.95,P<0.05).Four studies described the changes of relevant knowledge between the two groups,and the difference showed statistical significance(RR 0.71,95%CI 0.58-0.86,P<0.05).Four studies evaluated the rate of correct handling after SIs(RR 0.48,95%CI0.32-0.73,P<0.05).Five studies described the reporting rate after injury(RR0.39,95%CI 0.11-1.36,P>0.05).Conclusion:Education and training on sharp injury prevention are conducive to reduce the incidence of SIs,enhance protective behaviors,and improve the correct handling rate and reporting rate after injury.However,there are many limitations in this study,more high-quality research is still needed to evaluate its effectiveness in the future.