Organizational Climate, Staffing, and Safety Equipment as Predictors of Needlestick Injuries and Near-Misses in Hospital Nurses

Since the first cases of HIV began surfacing over 20 years ago, the focus on the risks faced by health care workers from accidental needlestick injuries and exposure to blood-borne pathogens has increased. Today, the law requires that hospitals enact safety measures to guard against this risk and protect health care workers. Previous studies regarding the efficacy of various measures were limited and lacking in consistency. In the absence of clear empirical data, hospitals tend to make decisions about which safety measures to adopt based on product availability and cost, rather than on efficacy. Recognizing this problem, the authors of this article extend earlier work on needlestick risk factors and protective equipment. They surveyed over 2,200 nurses permanently assigned to medical-surgical units with direct patient care responsibilities in 22 deliberately selected hospitals across the United States. These data touched on a range of issues, such as compliance with precautions, nurse perceptions of risk, characteristics of the nursing workforce, the type of protective equipment available in a given hospital, organizational climate and past incidence of needlestick injuries or near misses. From their analysis, the authors found an association between staffing and organizational climate and needlestick injuries. Use of two types of protective equipment examined in this study, capless-valve secondary IV administration sets and protective devices for IV insertion, were associated with decreased incidence of needlestick injuries and near misses. Although these results must be interpreted with caution, they suggest the need for further study of the relationship between staffing and organizational climate with safety.