Background: While staffing levels would seem obviously related to the frequency of needlestick injuries and related incidents in hospital nurses, there are essentially no data that show this. Furthermore, no studies have examined the relationship of hospital organizational factors to these events. Methods: We collected and analyzed data from two national surveys of nurses conducted in 1991 (~730 nurses from 40 units in 20 hospitals) and 1998 (~2500 nurses from 22 hospitals). Data collected daily in the first study provided prospective information about sharps injuries over a one-month period. In both studies, survey questions provided retrospective data regarding the previous month and year. Survey data with validated tools aggregated to the unit and hospital levels measured organizational characteristics. Various staffing measures were also examined. Using robust regression models, we estimated risks of injuries and near-misses for nurses from units and hospitals with differing staffing levels and organizational characteristics. Results: In the first data set, nurses from hospitals with low staffing levels and poor working climates had doubled rates of needlestick injuries and near-misses. Despite greater homogeneity across the hospitals surveyed and far lower incident rates, we documented similar but smaller associations in the second data set. Conclusions: Hospital nurses' exposures to bloodborne pathogens appear to be associated with organizational characteristics and staffing levels. While needlestick injury incidence can be reduced through staff education and the use of needleless systems, the potential impact of staffing levels and work environments must be considered by managers and policy-makers.
Learning Objectives: At the conclusion of this presentation, the learner will be able to: 1. Describe the organizational context of exposures to bloodborne pathogens in hospital nurses. 2. Identify specific staffing variables and workplace characteristics potentially associated with needlestick injuries and near-misses. 3. Discuss possible mechanisms to explain connections between staffing, work climate, and exposures to bloodborne pathogens as well as implications for practice and policy
Keywords: Occupational Safety, Health Care Restructuring
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
The 128th Annual Meeting of APHA