Needlestick and other percutaneous sharps injuries among nurses and midwives across 26 hospitals in Sierra Leone: a cross-sectional study of burden, reporting, and associated workplace factors
Year: 2026
Type: article
Study design: Observational Study
Abstract: Needlestick and other percutaneous sharps injuries expose nurses and midwives to bloodborne pathogens. Evidence across Sierra Leonean hospitals remains limited. We assessed injury burden, post-exposure response, and associated workplace factors. We conducted a hospital-based cross-sectional survey of nurses and midwives in 26 purposively selected hospitals from 3 to 28 November 2025. Participants self-reported needlestick and other percutaneous sharps injuries and workplace exposures. We estimated major prevalence intervals with a 20,000-replicate hospital-cluster bootstrap and fitted modified Poisson models with finite-sample-corrected hospital-cluster covariance and t-based inference using 25 cluster degrees of freedom. We calculated model-standardized prevalence differences to express absolute associations. Of 1,194 eligible participants, 1,091 completed the survey (91.4%). Past-year injury was reported by 400 participants (36.7%, hospital-cluster bootstrap 95% confidence interval [CI] 34.2%–39.2%), and lifetime injury by 632 (57.9%, 95% CI 55.3%–60.7%). Among 400 injured participants, 202 reported the injury within 24 h (50.5%) and 232 received post-exposure prophylaxis (PEP) assessment (58.0%). Among 192 participants for whom HIV PEP was indicated, 109 (56.8%) initiated PEP. Among the 109 initiators, 84 (77.1%) started within 24 h, 73 (67.0%) completed the 28-day course, and 68 (62.4%) had documented follow-up. Injury prevalence was higher with recapping (adjusted prevalence ratio [aPR] 1.85, 95% CI 1.57–2.18), self-reported high patient load (aPR 1.33, 95% CI 1.10–1.61), and no recent sharps or infection prevention training (aPR 1.28, 95% CI 1.10–1.48). Prevalence was also higher with no sharps container within arm’s reach (aPR 1.23, 95% CI 1.06–1.41), at least five recent night shifts (aPR 1.21, 95% CI 1.03–1.42), and emergency, surgical, or theater work. Recapping showed an adjusted prevalence difference of 24.4% points (95% CI 17.9–30.9). Routine unavailability of safety-engineered devices showed no clear association (aPR 1.06, 95% CI 0.90–1.24). Self-reported needlestick and other percutaneous sharps injuries were common among nurses and midwives in participating hospitals. Reporting and follow-up were incomplete. The findings support accessible sharps disposal, no-recapping systems, reporting pathways that staff know how to use, hepatitis B vaccination, and 24-hour exposure care. Safety-engineered devices warrant costed prospective evaluation before wider adoption. The cross-sectional, non-probability design limits causal and national inference. Not applicable.
Source: BMC Nursing
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,090
OpenAlex ID: W7204723921