EFFECT OF A STRUCTURED NEEDLESTICK INJURY PREVENTION PROGRAM ON SHARPS SAFETY COMPLIANCE AMONG HEALTHCARE WORKERS IN A TERTIARY CARE HOSPITAL, MULTAN

Abstract

Background:

Needlestick injuries (NSIs) remain a pervasive occupational hazard for healthcare workers (HCWs) in Pakistan, with underreporting and inconsistent compliance with sharps safety protocols contributing to a significant burden of bloodborne pathogen exposure. Local evidence from tertiary care settings in Multan indicates a high frequency of NSIs, with nurses and junior doctors being disproportionately affected and recapping needles identified as a leading cause. Despite this, structured, hospital-based prevention programs remain limited.

Objective:

 To evaluate the effect of a structured needlestick injury prevention program on sharps safety compliance, knowledge, and the incidence of self-reported NSIs among HCWs at a tertiary care hospital in Multan.

Methods:

A quasi-experimental pre-post intervention design was employed over six months (January–June 2025) at a tertiary care hospital in Multan. A total of 180 HCWs (nurses, doctors, and technicians) were selected through consecutive sampling. The intervention comprised a multifaceted bundle: (1) a didactic educational session on NSI risks and the "no-recapping" policy; (2) hands-on simulation training for safe sharps disposal; (3) distribution of safety-engineered devices in high-risk wards; and (4) implementation of a simplified, non-punitive reporting system. Sharps safety compliance was measured using a structured observational checklist (20 items) across four domains: hand hygiene, glove use, needle handling, and waste segregation. Knowledge and self-reported NSI incidence were assessed via a validated questionnaire at baseline and at three months post-intervention. Data were analyzed using SPSS v26; paired t-tests and McNemar's test were applied, with *p* < 0.05 considered significant.

Results:

Post-intervention, overall sharps safety compliance scores improved significantly from a baseline mean of 61.4% (SD 12.7) to 84.2% (SD 9.8) (*p* < 0.001). The most pronounced improvement was observed in the "needle handling" domain, where compliance with the no-recapping policy rose from 42.8% to 88.9% (*p* < 0.001). Knowledge scores regarding post-exposure prophylaxis and reporting pathways increased from a mean of 58.3% to 89.7% (*p* < 0.001). The self-reported incidence of NSIs in the preceding three months decreased from 22.2% at baseline to 8.3% at follow-up (*p* = 0.004). However, compliance with glove use during emergency procedures remained suboptimal (from 51.1% to 67.8%, *p* = 0.012), highlighting a persistent gap.

Conclusion:

A structured, multi-component prevention program was effective in improving sharps safety compliance and knowledge while reducing self-reported NSIs among HCWs in a resource-constrained tertiary care setting. The findings underscore the necessity of moving beyond passive education toward bundled interventions that include environmental modifications (safety devices) and systemic changes (reporting culture), as advocated in recent quality improvement literature (Vitus et al., 2026). Sustained compliance requires integration into institutional policy and continuous reinforcement.