• 대한간호
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• 제34권2호
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• pp.45-57
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• 1995

A study .to identify an occupational hazards for hospital working health care providers from needle stick injury as an occupational hazards of health care providers in hospital and prevention A survey of 2430 health professionals (2184 nurses, 182 doctors, and 64 Lab technicians) was conducted to describe and provide information about 1) the experience of needle stick. 2) the number of needle stick, 3) the treatment after needle stick. 3) the situation of needle stick, 4) the report of needle stick, 5) the cause of needle stick, 6) the discard method of used needles, and 7) how to worry about getting infection disease after needle stick. Data were collected using questionnarires constructed by the authors and tested by a pilot study. Results of the study showed that 96.7% of the sample had an experience of needle stick (96.8% of the nurses, 96.7% of the doctors, and 92.2% of Lab technicians). Seventy seven percent of the sample experienced less than 10 needle sticks, 19% of the sample experienced 11 to 20 needle sticks, and the rest of the sample experienced more than 20 needle sticks. The situations where needle sticks occurred include intrvenous injection (36.5%), intramuscular injection (21.6%), blood withdraw (17.8%), and preparation(11.8%). The study showed that needle sticks (67.5%) usually occurred after client treatment. Health professionals used recapping method (55%) after they used needles. Needle sticks were predominantly caused by the carelessness of health professionals (61%), After needle sticks, 88.2% of the sample subjects treated needle sticks using disinfection technique by themselves. Most of health professionals (92.6%) did not report the accident. and 95.6% of them did not receive any test or further treatment. After needle sticks, 87.8% of nurses, 83.6% of doctors, and 96.6% of lab technicians worried about hepatitis infection. 'Health professionals also worried about AIDS infection, tetanus, venereal infection, and skin injury. These findings suggest that health professionals are at high-risk of needle stick and fail to report needle stick accidents. They should pay more attention to needle stick in order to avoid unwanted infection.

• 한국간호교육학회지
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• 제21권2호
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• pp.168-181
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• 2015

Purpose: This study was conducted to determine the factors affecting the prevention of needle stick injury. Methods: Data collection was conducted during the period July 15-31, 2013 by a self-administered questionnaire involving 220 nurses working in 7 hospitals. The data was analyzed by SPSS v18 and AMOS v18. Results: Actions by nurses to prevent needle stick injury were directly and indirectly influenced by perceived benefits, attitude toward the behavior, perceived behavioral control, and intention underlying the behavior. Specially, perceived behavioral control is verified to have not only direct influence but also indirect influence on the performance of preventive action through the intention underlying the behavior. Also, perceived benefits indirectly influence the intention toward the behavior and performance of preventive action through attitude toward the behavior and perceived behavioral control. The predictor variables in this model are 52% explicable in terms of intention of prevention action against needle stick injury, and 66% explicable in terms of performance of preventive action. Conclusion: To ensure high performance of preventive action against needle stick injury, constructing not only the solution that inspires the intention toward behavior but also a system that can positively solve and improve obstructive factors in behavioral performance is of primary importance.

• Journal of Preventive Medicine and Public Health
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• 제27권3호
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• pp.403-409
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• 1994

A questionnaire survey wds conducted to assess the experience of the needle stick injury in 144 seniors of a medical school during the previous 10 months. One hundred and five of them (73%) had responded. About sixty-nine percent (72 cases) of the respondents had suffered at least one u and there had been 129 injuries in total. Seventy-eight (56.6%) of the injuries took place at the time of the venipuncture. The emergency and operating room incurred 76.7% and 23.3% of the injury, respectively. Injuries with bleeding account for 50.4%. None of the respondents was systematically educated about the prevention of injury. This survey shows that the needle-stick Injury is a great risk for the medical students' health, and that educational effort for its prevention is warranted.

• 대한간호학회지
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• 제26권3호
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• pp.605-622
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• 1996

Needle stick injury, in which blood-borne pathogens including Human Immune-Deficiency virus and hepatitis B virus are transmitted, is one of the major occupational hazards that health professionals face everyday. In order to provide basic data for the development of educational programs for health professionals aimed at preventing and effectively managing needle stick injuries, a retrospective descriptive study was carried out .The subjects of the study were 630 health professionals, 499 nurses and 131 physicians, from two university hospitals in Seoul, Korea. Data on episodes of needle stick experiences over the past is months September 1994 through August 1995, were collected between September 1 and 7, 1995. A Questionaire developed by the researcher was used. The frequencies and the percentile score for episodes of needle stick injuries were calculated using the PC-SAS program. The differences and similarities in reference to the structure, career, and specialty variables were analysed by X$^2$-tests. Results are as follows : 1. Of the sample, 521(82.7%) reported a needle stick injury, 33.4% reported 3 or more episodes of needle stick injuries. 2. The needle stick injuries occured in the following processes : process of percutaneous venepuncture for intra-venous injection and infusion(55.3%), medical examination and treatment(48.9%), per-cutaneous venepuncture for blood sampling (46.3%) and intra-muscular injection(42.2%). 3. The study showed that needle stick injuries occured before(19%), during(25%), and after (56%) client treatment. The major causes of needle stick injuries were perceived to be hastiness(82.2%) and carelessness(48.3%). Of these injuries, 91.8% occured in emergency situations. 4. Follow of care for the injury consisted of : treating the injured site immediately using disinfectants(89.7%), reviewing the clinical records of the patient involved(84.2%), immunological investigation for the status of antibodies(11.1%) and self-medication of antibiotics (10.7%). Only 16.3% of the total episodes were founded to have been reported to the administrative unit. 5. The length of clinical experience of the nurses, clinical specialty and length of clinical experience in physicians were found to have influenced the episodes of needle stick injuries ; nurses with less than 1 year and with more than 6 years of clinical experiences had significantly lower levels (X$^2$=25.04, P=.00), surgeons had significantly higher levels (X$^2$=9.89, P=.02) compared to that of internists and interns, higher(X$^2$=4.54, P=.03)than residents.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1995년도 제47차 추계 학술대회 연제집
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• pp.137-138
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• 1995

• 기본간호학회지
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• 제12권3호
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• pp.337-346
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• 2005

Purpose: The purpose of this study was to investigate the levels in student nurse of knowledge, compliance and risk factor recognition for needlestick injuries. Method: Nine hundred and thirty eight(938) student nurse from 3 universities and 3 junior colleges participated in this study. Completed questionnaires were collected between October and November 2004. They were analyzed by using the descriptive statistics and $x^2$-test, t-test with the SAS program, Results: There were no significant differences in the general characteristics of participants between the two groups-Needlestick Injury(NSI) group and non-Needle stick Injury(non-NSI) group. The scores for knowledge levels of treatment after needle stick injuries and the risk factor recognition level were significantly higher in the NSI group. The scores for performance level as to handling and using needles after needlestick injuries were significantly higher in the non-NSI group. Conclusion: It is necessary to develop a preventive program to decrease the needlestick injury rate among student nurse.

• Safety and Health at Work
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• 제12권1호
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• pp.66-73
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• 2021

Background: The objective was to assess the knowledge level, attitude, and practice of health care workers towards standard precautions, and to identify the related factors. Furthermore, it was attempted to identify the proportion of having the experience of needle stick injuries (NSIs) and associated factors among participants. Methods: A cross-sectional study was conducted in a teaching hospital among 233 health workers using a self-administrated questionnaire. The questionnaire included eight knowledge items, seven practice items, and five attitude items. Based on the mean score of each category, responses were grouped into "satisfactory" and "unsatisfactory". Univariate, bivariate, and multivariable logistic regression analyses were done. Results: The mean age of the participants 32.95 (SD ± 9.70) and 62.2% of them were women. 57.5% of the staff had a satisfactory level of correct knowledge (>5 correct answers), 37.3% had a satisfactory positive attitude (>3 correct answers), and 30.9% had a satisfactory practice (>3 correct answers) towards standard precautions. The occupation was one of the predictors as doctors were less likely to have satisfactory knowledge and practice compared to nurses (OR = 0.269, 95% CI: 0.10-0.70 and OR = 0.248, 95% CI: 0.08-0.77, respectively). Out of 174 participants, 31.6% of them reported experiencing NSIs and support staff were 71% less likely to experience NSIs compared to nurses & paramedics. Conclusion: The findings revealed a substandard adherence of standard precautions among participants, which highlighted the necessity of the provision of a periodic, tailored training program based on the occupation and risk exposure.

• 한국직업건강간호학회지
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• 제7권2호
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• pp.143-154
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• 1998

The purpose of this research is to suggest basic materials for the practical infection precaution program to protect health care workers from hospital infection by grasping their compliance level of Universal Precautions and examining the factors affecting them. The number of the health care workers we studied were 486, including the doctors, the nurses, and the lab technicians who were working in a university hospital. The period of this research was from Aug. 18th, 1997 to Aug. 30th, 1997. The method of the study was to measure the compliance level of Universal Precautions with the item of "Universal Precautions" established by CDC in 1987, and examine the questionnaire of 52 questions dividing related factors into socio-populational, individual, socio-psychological and organizational management ones. The data was analyzed by t-test. ANOVA, and chi-square test. The results were as follows : 1. An the compliance level of Universal Precautions, hand washing had the highest score(85.4%), and doctors(18.9%), nurses(44.0%), and lab technicians(7.6%), had a low compliance level in the safe handling of an injection syringe, and item not to handle patients and their samples when the subject suffered from dermatitis or injury had the lowest score of 17.1%. 23.3% of them said that they wear protection gown, goggles and mask. 2. Female's Compliance level of Universal Precautions Was higher than male. 3. The health care workers who had high recognition on Universal Precautions got significantly higher compliance level of Universal Precautions than those have low recognition on Universal Precautions(P<0.001). 4. The health care workers experienced a needle stick injury had a significantly higher compliance level of Universal Precautions than those who had not(P<0.000). 5. The health care workers who had infection protection education got a significantly higher compliance level of Universal Precautions than those who didn't(P<0.000). 6. The health care workers who had a firm belief in the effect of Universal Precautions got a higher compliance level of Universal Precautions than those who didn't. 7. The health care workers who had less conflicts between treating patient arid protecting them-selves got a higher compliance level of Universal Precautions than others with many conflicts. 8. The health care workers who had a high score in organizational management factors got a significantly higher compliance level of Universal Precautions than those with a low score(P<0.000). 9. Only 16.9 percent of the all respondents(82 in number) answered that they knew well or a little about the Universal Precautions, which is very low rate of recognition. 10. The variables which affected the score in organizational management factors were age, sex, education period, work experience, the kind of work, recognition on Universal Precautions, the experience of needle stick injury, revealing dangerous circumstance related to infection, and training on precaution again infection. According to the result above, compliance level of Universal Precautions showed high correlation with sex, the recognition on Universal Precautions, the experience of needle stick injury, training on precaution against infection, the belief in the effect of Universal Precautions, the recognition degree of conflicts and organizatinal management factors. These results could be used as the basic materials for the developing infection protection programs. Also, There should have a systematic training course to elevate a effective compliance level of Universal Precautions as well as the manageeent of infection protection programs.

• 대한간호학회지
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• 제29권4호
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• pp.929-939
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• 1999

The purpose of this study was to identify knowledge of universal precautions and its performance in practice. The research was conducted from November 2 to 30, 1998. A total 515 student nurses ; 249 from a baccalaureate nursing college and 266 from second and third year of a 3-year community nursing college were surveyed. The results are as following : 1. The average score for universal precautions knowledge was 270.41$\pm$19.43/300(range 150-300). The results showed that 99.2% of students avoid injury from used needles, 98.6% answered that they always wash their hands if they had contact with the patient's blood and they always dispose of used needles in special collectors (97.7%) for needles. But, 39.2% responsed that they dispose of used needles after recapping them. 2. The average score for universal precautions knowledge of the senior students in the 4-year college was the highest (277.65$\pm$13.99). 3. The average score for the performance of universal precautions knowledge was 53.18 $\pm$5.91(range 14-70). The items : ‘I cautiously avoid injury from the used needles’(4.92$\pm$0.33), ‘I always wash my hands if there has been contact with the patient's blood’(4.91$\pm$0.34), and ‘I always disposed of used needles in the appropriate collector’(4.89$\pm$0.42) showed the highest performance. However ‘I always dispose of used needles after recapping them’(2.19$\pm$1.39) and ‘I always use protection goggles when in danger of contamination’(2.19$\pm$1.20) showed low performance level. 4. The highest average score for universal precautions performance was shown among the second year students in 3-year nursing college (54.19$\pm$6.92) between the groups. It showed that the level of the universal precautions performance was higher for those who had education on university precautions prior to performance of the universal precautions than for those without any prior education. 5. The percentage of students who reported the experience of direct contact with patients' blood and/or body fluids was 42.30%. The experience of direct contact with blood and/or body fluids of the educational group was significantly higher than those were not educated. 6. The most frequent cause of the direct contact was ‘needle pricking and/or skin cut’(63.04%). The most frequent substance with which the students contact was ‘blood’(59.85%). The majority of the sample had answered that the mode of contamination was ‘unknown’(63.54%). The majority of the sample answered that strategies used after contamination included ‘washing with soap’(33.61%). Reviewing the chart of patients or asking other health professionals(28.85%). 7. The number of students who had the experience of a needle stick and/or skin cut was 145(28.16%). The clinical practice places where the incidents occurred were mainly in the internal medicine unit (45.07%) and the surgical unit (31.92%) followed by the intensive care unit and the emergency unit in order. The experience of a needle stick and/or skin cut happened during on intra-muscular injection 47.34% and intravenous injection 21.81%. The causes of the needle stick and/or skin cut were ‘putting the needle cap back on 77(35.81%)’. The number of students who took an appropriate post management blood test and/or vaccination was 27(18.62%). 8. The Pearson Correlation Coefficient between the knowledge of universal precautions and performance of universal precautions in practice showed a positive correlation.

• Archives of Plastic Surgery
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• 제33권1호
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• pp.120-123
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• 2006

Spontaneous extensor pollicis longus tendon rupture is commonly caused by attrition of the tendon from trauma or inflammatory processes. We experienced a patient with extensor pollicis longus tendon rupture after steroid injection, in which the rupture may have been caused by the effects of steroid itself as well as direct damage from the needle. A 51-year-old woman complained of inability to extend her right thumb at the first metacarpophalangal & interphalangeal joint level. The patient had a history of local steroid injection into the dorsal & radial side of wrist on two occations, and had no history of trauma or rheumatologic disease. After a physical examination of the patient, we decided to explore the wrist. The patient agreed with operation. Intraoperatively, an incision was made into the wrist and the proximal and distal ends of the ruptured extensor pollicis longus tendon were identified. The defect between the proximal and the distal end was measured to approach 8cm, and a palmaris longus tendon graft was performed. After three months of rehabilitation, the first metacarpophalangal & interphalangeal joint recovered the normal range of motion. Steroid injection has been widely used in various musculoskeletal disorders such as rheumatoid arthritis and osteoarthritis. However, inadvertent steroid injection into the extra or intra articular spaces may lead to tendon rupture. Steroids reduce tensile strength by decreasing tenocyte activity and collagen synthesis. Also, the physical effect of direct needle-stick injury into the mesotenon and blood vessels around the tendon may cause damage. In addition, hematoma and edema may increase pressure around the tendon and compromise blood supply, leading to tendon degeneration and subsequent rupture. When injecting steroid into an articular area, all physicians should have a complete understanding of the surrounding anatomy and always keep in mind the hazards of such procedures.