Prevalence of Surgical Injuries, Commonest Causes of The Same and Uptake of Pep Amongst Health Workers at Jinja Regional Referral Hospital

ABSTRACT

BACKGROUND; A needle stick surgical injury is said to have occurred if a medical practitioner punctures the skin with a needle or sharp instrument that has been in contact with a patient’s blood. Splashing of blood or other body fluids to the conjunctiva is also included. OBJECTIVE; To determine the prevalence of surgical injuries, commonest causes attributed to the same and uptake of PEP amongst health workers at Jinja Regional Referral Hospital. METHODS; A descriptive cross sectional retrospective study was used with 168 documents reviewed. RESULTS; The study revealed a significant number of HCWs getting needle prick accidents and majority of these being nurses (35%) and interns (20%). 38% of accidents occur in the procedure rooms and 29% in the inpatient department wards and 20% of the injuries occurred in theatre. Majority, (48%) of the injuries occur during the night when HCWs are on night shift. Surgical needle manipulation 23%, disposal 17% and IV access 15% were the biggest culprit processes responsible for most injuries. Syringe needles were responsible for 36% of injuries followed by suture needles which were responsible for 26%, phlebotomy needles, 15%, IV cannula 12% and scalpel 11%. 68 HCWs were started on PEP after the NSI with 58 of them getting well and only 4 of them acquiring an infection. RECOMMENDATIONS; Refresher courses are required for HCWs who are less experienced. Safety guidelines need to be pinned in visually accessible sites in both procedure rooms and inpatient wards since most injuries occur there for easy reference in case need arises. Strict and proper schedule programming for staff and adequate breaks after long working hours to avoid fatigue. Closer monitoring and possible daily counseling of workers that have been initiated on PEP treatment. 

Contents 

DECLARATION.....................................................................2Error! Bookmark not defined.

CERTIFICATION ....................................................................Error! Bookmark not defined.

DEDICATION......................................................................................................................... 4

ACKNOWLEDGEMENT ............................................................................................................... 5

ABBREVIATIONS......................................................................................................................... 6

DEFINITION OF OPERATIONAL TERMS AND CONCEPTS............................................................ 7

TABLES AND FIGURES ................................................................................................................ 8

ABSTRACT ........................................................................................................................... 11

CHAPTER 1 .......................................................................................................................... 12

1.0 Introduction ..................................................................................................................... 12

1.1 Background...................................................................................................................... 12

1.2 Statement of the problem................................................................................................ 13

1.3 Aim of study..................................................................................................................... 14

1.4 Specific Objectives........................................................................................................... 14

1.5 Research Questions ......................................................................................................... 14

1.6 Justification of the study................................................................................................. 14

1.7 Scope of the study ............................................................................................................ 15

1.8 Conceptual framework...................................................................................................... 16

CHAPTER 2............................................................................................................................... 17

Literature review................................................................................................................... 17

2.1. Prevalence ....................................................................................................................... 17

2.2 Common Causes.............................................................................................................. 19

2.3 PEP Uptake ...................................................................................................................... 21

CHAPTER 3............................................................................................................................... 23

3.0 Methodology..................................................................................................................... 23

3.1 Study Design .................................................................................................................... 23

3.2 Study Area........................................................................................................................ 23

3.3 Study Population ............................................................................................................. 23

3.4 Sample size determination (Morgan’s table) ................................................................ 23

3.5 Inclusion and exclusion criteria ..................................................................................... 23

10

3.6 Definition of variables..................................................................................................... 23

3.8 Research Instruments ..................................................................................................... 24

3.9 Data collection method.................................................................................................... 24

3.10 Data processing and Analysis....................................................................................... 24

3.11 Data Presentation .......................................................................................................... 24

3.13 Ethical consideration..................................................................................................... 24

3.14 Study Limitations.......................................................................................................... 24

CHAPTER 4............................................................................................................................... 25

4.0 RESULTS ............................................................................................................................. 25

4.1 Incidence of NSIs............................................................................................................. 25

Occupational groups and injuries........................................................................................ 26

4.2 Common causes of NSIs.................................................................................................. 27

4.3 Uptake of PEP.................................................................................................................. 30

Table 3 .................................................................................................................................... 30

CHAPTER 5 .......................................................................................................................... 31

DISCUSSION......................................................................................................................... 31

5.2 Common causes of NSIs.................................................................................................. 32

5.3 Uptake of PEP.................................................................................................................. 33

CONCLUSION...................................................................................................................... 34

6.1 Prevalence of NSIs........................................................................................................... 34

6.2 Common causes of NSIs.................................................................................................. 34

6.3 Uptake of PEP.................................................................................................................. 34

RECOMMENDATIONS ...................................................................................................... 35

APPENDICES ....................................................................................................................... 36

REFERENCES ...................................................................................................................... 39