Evaluation of a Safety Resheathable Winged Steel Needle for Prevention of Percutaneous Injuries Associated With Intravascular-Access Procedures Among Healthcare Workers

2003 ◽  
Vol 24 (2) ◽  
pp. 105-112 ◽  
Author(s):  
Meryl H. Mendelson ◽  
Bao Ying Lin-Chen ◽  
Robin Solomon ◽  
Eileen Bailey ◽  
Gene Kogan ◽  
...  
Keyword(s):  
New York ◽  
Healthcare Workers ◽  
Injury Rate ◽  
Outpatient Services ◽  
Safety Feature ◽  
Safety Mechanism ◽  
Risk Of Injury ◽  
Butterfly Needle ◽  
Study Intervention ◽  
Intravascular Access

AbstractObjective:To compare the percutaneous injury rate associated with a standard versus a safety resheathable winged steel (butterfly) needle.Design:Before-after trial of winged steel needle injuries during a 33-month period (19-month baseline, 3-month training, and 11-month study intervention), followed by a 31-month poststudy period.Setting:A 1,190-bed acute care referral hospital with inpatient and outpatient services in New York City.Participants:All healthcare workers performing intravascular-access procedures with winged steel needles.Intervention:Safety resheathable winged steel needle.Results:The injury rate associated with winged steel needles declined from 13.41 to 6.41 per 100,000 (relative risk [RR], 0.48; 95% confidence interval [CI95], 0.31 to 0.73) following implementation of the safety device. Injuries occurring during or after disposal were reduced most substantially (RR 0.15; CI95, 0.06 to 0.43 Safety winged steel needle injuries occurred most often before activation of the safety mechanism was appropriate (39%); 32% were due to the user choosing not to activate the device, 21% occurred during activation, and 4% were due to improper activation. Preference for the safety winged steel needle over the standard device was 63%. The safety feature was activated in 83% of the samples examined during audits of disposal containers. Following completion of the study, the safety winged steel needle injury rate (7.29 per 100,000) did not differ significantly from the winged steel needle injury rate during the study period.Conclusion:Implementation of a safety resheathable winged steel needle substantially reduced injuries among healthcare workers performing vascular-access procedures. The residual risk of injury associated with this device can be reduced further with increased compliance with proper activation procedures.

Preschool Behavior Problems and Subsequent Risk of Injury

PEDIATRICS ◽  
1988 ◽  
Vol 82 (4) ◽  
pp. 644-651
Author(s):  
L. L. Davidson ◽  
S. J. Hughes ◽  
P. A. O'Connor
Keyword(s):  
Behavior Problems ◽  
Injury Rate ◽  
Background Information ◽  
Discipline Problems ◽  
Specific Behavior ◽  
Maternal Characteristics ◽  
Risk Of Injury ◽  
Increased Risk ◽  
Widespread Belief ◽  
Preschool Behavior Problems

The hospital records of 951 children from a previously established birth cohort for which behavioral and extensive background information was available were checked for 3 years following the fifth birthday of the youngest child. The aim was to determine whether children with certain specific behavior disorders had a higher rate of injury than those without. Although the predicted relationships between overactive behavior, decreased concentration, and injury rate were not found, the hypothesis of an increased risk of injury for boys and for children with discipline problems was confirmed. Also, the association between male sex and injury remained after controlling for the behavior variables related to injury. In general, some support was found for the suggestion of increased risk of injury among children who have specific behavior problems, although, contrary to widespread belief, this relationship accounts for only a small percentage of the injuries found in the cohort. Moreover, the relationship is modified by maternal characteristics and by the sex of the child. Unexpectedly, encopresis and marked fears were found to be risk factors for injury, although these effects were relatively small.

SARS-CoV-2 Seroprevalence Among Healthcare Workers by Job Function and Work Location in a New York Inner-City Hospital

2021 ◽  
Vol 16 (5) ◽  
Author(s):  
Murli U Purswani ◽  
Jessica Bucciarelli ◽  
Jose Tiburcio ◽  
Shamuel M Yagudayev ◽  
Georgia H Connell ◽  
...  
Keyword(s):  
Emergency Department ◽  
New York ◽  
Inner City ◽  
Healthcare Workers ◽  
Administrative Staff ◽  
City Hospital ◽  
Antibody Testing ◽  
Pharmacy Staff ◽  
Work Location ◽  
Job Function

OBJECTIVE: To describe the seroprevalence and risk for SARS-CoV-2 among healthcare workers (HCWs) by job function and work location following the pandemic’s first wave in New York City (NYC). METHODS: A cross-sectional study conducted between May 18 and June 26, 2020, during which HCWs at a large inner-city teaching hospital in NYC received voluntary antibody testing. The main outcome was presence of SARS-CoV-2 antibodies indicating previous infection. Seroprevalence and adjusted odds ratios (aORs) for seropositivity by type and location of work were calculated using logistic regression analyses. RESULTS: Of 2,749 HCWs tested, 831 tested positive, yielding a crude seroprevalence of 30.2% (95% CI, 29%-32%). Seroprevalence ranged from 11.1% for pharmacy staff to 44.0% for nonclinical HCWs comprised of patient transporters and housekeeping and security staff, with 37.5% for nurses and 20.9% for administrative staff. Compared to administrative staff, aORs (95% CIs) for seropositivity were 2.54 (1.64-3.94) for nurses; 2.51 (1.42-4.43) for nonclinical HCWs; between 1.70 and 1.83 for allied HCWs such as patient care technicians, social workers, registration clerks and therapists; and 0.80 (0.50-1.29) for physicians. Compared to office locations, aORs for the emergency department and inpatient units were 2.27 (1.53-3.37) and 1.48 (1.14-1.92), respectively. CONCLUSION: One-third of hospital-based HCWs were seropositive for SARS-CoV-2 by the end of the first wave in NYC. Seroprevalence differed by job function and work location, with the highest estimated risk for nurses and the emergency department, respectively. These findings support current nationwide policy prioritizing HCWs for receipt of newly authorized COVID-19 vaccines.

Proposed Antiretroviral Therapy Guidelines for Prophylaxis of Occupationally Related HIV Seroconversion A Practical Approach

1996 ◽  
Vol 17 (10) ◽  
pp. 672-674
Author(s):  
Aaron E. Glatt
Keyword(s):  
New York ◽  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Healthcare Workers ◽  
Medical Center ◽  
Therapy Guidelines ◽  
Antiretroviral Prophylaxis ◽  
New Information ◽  
Immunodeficiency Virus ◽  
Hiv Seroconversion

AbstractRecent research indicates that antiretroviral prophylaxis significantly reduces occupationally related human immunodeficiency virus (HIV) seroconversion. This article outlines principles on which guidelines were based for treating aggressively those healthcare workers (HCWs) exposed to HIV occupationally at the Catholic Medical Center in Jamaica, New York. These recommendations attempt to provide HCWs with the best possible available antiretroviral therapy to treat occupational HIV seroconversion. New options must continue to be explored as new information becomes available.

scholarly journals Partnering with African American Churches to Create a Community Coalition for Mental Health

2018 ◽  
Vol 28 (Supp) ◽  
pp. 467-474 ◽  
Author(s):  
Sidney H. Hankerson ◽  
Kenneth Wells ◽  
Martha Adams Sullivan ◽  
Joyce Johnson ◽  
Laura Smith ◽  
...  
Keyword(s):  
Mental Health ◽  
New York ◽  
African American ◽  
Lessons Learned ◽  
Community Coalition ◽  
Evidence Based Practices ◽  
African American Churches ◽  
Study Intervention ◽  
American Churches ◽  
Academic Interests

Community partnered participatory research (CPPR) emphasizes community engagement, respect, and empowerment as guiding principles to promote mental health equity. This article describes the “Vision” stage of a CPPR-informed model to implement evidence-based practices for de­pression in two African American churches in Harlem, New York. Essential parts of the Vision include engagement of stakeholders and collaborative planning. The engage­ment process increased awareness about the project via a community-focused mental health symposium. The collaborative plan­ning stage resulted in creating a multi-dis­ciplinary Community Coalition for Mental Health, establishing the Coalition’s values, agreeing to change the initial chosen study intervention from Interpersonal Counseling to Mental Health First Aid, and developing a website to disseminate the group’s work. Key lessons learned from our partnered process are: 1) support from the lead pas­tor is crucial; 2) balancing community and academic interests can be challenging; 3) icebreaker activities foster relationships and reinforce CPPR principles; 4) multiple com­munication channels can enhance commu­nity participation; and, 5) should organize data in ways that make them easier to interpret.Ethn Dis. 2018;28(Suppl 2):467- 474; doi:10.18865/ed.28.S2.467

Needlestick Injury in Hospital Personnel: A Multicenter Survey From Central Italy

1992 ◽  
Vol 13 (9) ◽  
pp. 540-544 ◽  
Author(s):  
Francesco Albertoni ◽  
Giuseppe Ippolito ◽  
Nicola Petrosillo ◽  
Lorenzo Sommella ◽  
Vincenzo Di Nardo ◽  
...  
Keyword(s):  
Intensive Care ◽  
Hepatitis B ◽  
Healthcare Workers ◽  
Student Nurses ◽  
Injury Rate ◽  
Needlestick Injury ◽  
Public Hospitals ◽  
Hospital Personnel ◽  
Hospital Workers ◽  
Multicenter Survey

AbstractObjectives:To assess the rate of needlestick injury in hospital personnel in an Italian region. To identify risk factors potentially amenable to correction.Design:Hospital workers undergoing hepatitis B prevaccination testing in 1985 through 1986 were interviewed regarding needlestick injury in the previous year, job category, area of work, years of employment, and other pertinent information.Setting:Of the 98 public hospitals of the Latium region, 68 participated in the survey: 32 of 55 with less than 200 beds, 20 of 25 with 200 to 300 beds, 11 of 13 with 400 to 900 beds, and all of the 5 with more than 1,000 beds.Participants:All healthcare workers providing direct patient care or environmental services as well as student nurses were invited by the hospital directors to undergo hepatitis B prevaccination testing and vaccination, if eligible.Results:Of 30,226 hospital workers of the 68 participating hospitals, 20,055 were interviewed (66.3%): 47.7% of the 7,172 doctors, 71% of the 14,157 nurses, 55.9% of the 2,513 technicians, and 71.9% of the 6,384 ancillary workers. Needlestick injury was recalled by 29.3%; the rates were 54.9%, 35.3%, 33.8%, 26.5%, 18.7%, and 14.7% in surgeons, registered and unskilled nurses, physicians, ancillary workers, and technicians, respectively. The recalled injury rate was 39.7% and 34.0% in surgical and intensive care areas; in infectious diseases, it was 16.7%. Bates were lower in hospitals with 200 to 300 beds (25.6%). The needlestick injury rate declined from 32% in those with less than 5 years of employment to 28% in those with more than 20 years (p<.01). Prevalence of HBV infection was higher in student nurses and young workers recalling a needlestick exposure (14.3% and 15.8%, respectively), versus 10.1% and 12.8% in those not exposed (p<.01 and <.05, respectively).Conclusions:Parenteral exposure to bloodborne infectious agents is a relevant risk among healthcare workers in our region, particularly in defined job categories and hospital areas (surgeons, nurses, surgical, and intensive care areas). Immunization and educational efforts should be made along with better designs of devices to reduce the risk of infection.

Prevention of Axillary Nerve Injury in Anterior Shoulder Reconstructions

2002 ◽  
Vol 30 (4) ◽  
pp. 601-606 ◽  
Author(s):  
Edward G. McFarland ◽  
Juan Carlos Caicedo ◽  
Tae Kyun Kim ◽  
Prachan Banchasuek
Keyword(s):  
Nerve Injury ◽  
Muscle Function ◽  
Significant Risk ◽  
Injury Rate ◽  
Axillary Nerve ◽  
Motor Dysfunction ◽  
Sensory Loss ◽  
Shoulder Stabilization ◽  
Subscapularis Muscle ◽  
Risk Of Injury

Background Previous authors have suggested that the axillary nerve should be explored or palpated during all anterior shoulder stabilization procedures. Objective The goal of this study was to document the axillary nerve injury rate in a cohort of patients who had undergone anterior shoulder stabilization without axillary nerve dissection. Hypothesis Use of a subscapularis muscle-splitting approach by using a retractor along the scapular neck does not result in significant risk of injury to the axillary nerve, and exploration of the axillary nerve is not necessary using this approach. Study Design Prospective cohort study. Methods One hundred and twenty-eight anterior stabilizations were performed with a subscapularis muscle-splitting approach that has been previously described. In all cases a retractor was placed along the inferior scapular neck to protect the axillary nerve. The axillary nerve was not exposed or palpated in any case. All patients were evaluated on the 1st postoperative day and again within 10 days for symptoms of axillary nerve palsy, including sensory loss and return of muscle function. One patient (0.8%) had paresthesia in an axillary nerve distribution; recovery occurred without the need for electromyography or other interventions. There were no clinically detected cases of axillary nerve motor dysfunction. Conclusions Routine exposure of the axillary nerve is not necessary during anterior stabilization procedures using a subscapularis muscle-splitting approach if proper precautions are taken to protect the nerve. Other techniques of anterior stabilization may require exposure of the axillary nerve.

Shooting the Moon: Should states require the H1N1 vaccine for healthcare workers?

2009 ◽  
Vol 7 (6) ◽  
pp. 11
Author(s):  
Paris Nourmohammadi, JD ◽  
Brigid Ryan, JD
Keyword(s):  
New York ◽  
Healthcare Workers ◽  
New York State ◽  
Mitigation Strategies ◽  
World Health ◽  
Health Departments ◽  
State Health ◽  
H1n1 Vaccine ◽  
Policy Makers ◽  
York State

On June 11, 2009, the director of the World Health Organization (WHO) raised the phase of alert in the Global Influenza Plan from level five to level six. The cause for this was the H1N1 virus which had already affected several countries. A level five alert is declared when more than one country in a single WHO geographic region is affected by the same virus. A level six declaration means that community outbreaks are occurring in at least two WHO geographic regions. Once such a declaration is made, little time remains before mitigation efforts must be planned and communicated to the public. In the wake of the WHO declaration, policy makers are clamoring for adequate disease mitigation strategies. Some health departments intend to require employees to wear personal protective equipment while on the job. Other state health departments are encouraging employees to stay home sick if they think they might have the flu. The New York State Health Department has issued an order requiring all healthcare workers to be vaccinated for H1N1 or risk being terminated. This article will explore the New York State policy and make recommendations to policy makers about how to prevent the spread of H1N1.

scholarly journals Risk of Injury in Basketball, Football, and Soccer Players, Ages 15 Years and Older, 2003–2007

2011 ◽  
Vol 46 (5) ◽  
pp. 484-488 ◽  
Author(s):  
Elizabeth A. Carter ◽  
Beverly J. Westerman ◽  
Katherine L. Hunting
Keyword(s):  
United States ◽  
Emergency Department ◽  
Injury Rate ◽  
Sports Injury ◽  
The United States ◽  
Soccer Players ◽  
Injury Rates ◽  
Risk Of Injury ◽  
Males And Females ◽  
The U.S

Context: A major challenge in the field of sports injury epidemiology is identifying the appropriate denominators for injury rates. Objective: To characterize risk of injury from participation in basketball, football, and soccer in the United States, using hours of participation as the measure of exposure, and to compare these rates with those derived using population estimates in the denominator. Design: Descriptive epidemiology study. Setting: United States, 2003–2007. Participants: People ages 15 years and older who experienced an emergency department–treated injury while playing basketball, football, or soccer. Main Outcome Measure(s): Rates of emergency department–treated injuries resulting from participation in basketball, football, or soccer. Injury rates were calculated for people ages 15 and older for the years 2003–2007 using the U.S. population and hours of participation as the denominators. The risk of injury associated with each of these sports was compared for all participants and by sex. Results: From 2003 through 2007, annual injury rates per 1000 U.S. population were as follows: 1.49 (95% confidence interval [CI] = 1.30, 1.67) in basketball, 0.93 (95% CI = 0.82, 1.04) in football, and 0.43 (95% CI = 0.33, 0.53) in soccer. When the denominator was hours of participation, the injury rate in football (5.08 [95% CI = 4.46, 5.69]/10 000 hours) was almost twice as high as that for basketball (2.69 [95% CI = 2.35, 3.02]/10 000 hours) and soccer (2.69 [95% CI = 2.07, 3.30]/10 000 hours). Conclusions: Depending on the choice of denominator, interpretation of the risk of an emergency department–treated injury in basketball, football, or soccer varies greatly. Using the U.S. population as the denominator produced rates that were highest in basketball and lowest in soccer. However, using hours of participation as a more accurate measure of exposure demonstrated that football had a higher rate of injury than basketball or soccer for both males and females.

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