Nearly a third of exposures to NSI occurred while using hollow needles in delivering care to patients (31%). Conversely, most of affected staff were nurses (43%). Syringe needles are the devices most used in administering care to patients. Similarly, nurses are the professional group that is most involve in delivering care [6,14,15]. Surgical procedures are the leading causes of occupational injuries [15,16]
Some 11.4% of Healthcare workers had experienced accidental exposure to blood during needle recapping. Recapping of needles, including bimanual, has been reported as the main circumstance of percutaneous exposure to blood [17,18]. Needlestick injuries are exacerbated by the excessive use of injections, pre-empted switch to second-line injectable treatments among healthcare workers. The use of syringes containing a sharps injury protection device (SIP device), has been recommended [20].
Reasons explaining percutaneous injuries were fatigue related to long working hours, work related stress, lack of PPE, ... There is an urgent need for decision-makers at the institutional and policy levels to set up a monitoring and early response system to prevent healthcare related infections, targeting improved working conditions and better healthcare environment. The present findings corroborate observations in other low-income settings of Ethiopia and Laos [21,22]. The shortage of PPE inclusive of gloves, mask, goggles, … and workload were associated with medical errors, exposure to blood and body fluids [23–25].
Percutaneous injuries were associated with professional status and medical staff were disproportionally affected. Medical staff are at the forefront during both minor and major surgeries in both Low and Middle-Income Countries [14,17].
Staff involved in blood collection procedures, laboratory and nursing activities frequently take blood samples in their daily activities [17,26]. Where these tasks are performed by interns as is the case in China, such groups are the most exposed [14].
Hygiene workers got their percutaneous exposure mainly while cleaning work surfaces. Needles left on the floor or in garbage cans were often involved in these accidental stings. This observation corroborates findings in both Low and High-Income Countries (eg China) [14,17]. The horizontal variation in percutaneous exposures among health facilities of the same hierarchical level indicates that structural and intrinsic characteristics of each hospital, the management style of decision-makers should be considered in implementing remedial options. The mastery of these health hazards is necessary to improve the safety and quality of healthcare for HCW, patients and visitors.
The reported recycling of scalpel blades for reuse is a risk taking activity, that reveals the poor adherence to standard precautions which prescribe their disposal in safety boxes [27,28]. The fact that the surgical department was the most affected is in line with the invasive procedures performed therein [21,29]. This finding corroborates observations in Kenya, Iran and China [21,30,31].
Staff less than 30 years old were less likely to undergo percutaneous exposure than their older counterparts. Older workers may develop routine, observe standard precautions less, loose awareness, particularly the systematic wearing of PPE [32].
Staff with less than 12 years of academic training had a lower risk of needlestick and sharp injury than their higher level counterparts, corroborating observations in Cameroon, Iran and Kenya [21,25,33]. Less educated HCW are less implicated in technical intervention, assigned to the monitoring of patients, cleaning activities, that expose to lower risk of exposure to needlestick and sharp injuries.
Interest in the control and prevention of infection in healthcare facilities was revamp with the unset of SARS-Cov 2 pandemic. There was enforcement in the supply of protective medical devices, PPE such as face masks and goggles/visors [4]. With the withdrawal of COVID-19 as a medical emergencies, such recommendation has relaxing in the observance of standard and additional precautions among HCW [4,34,35].
HCW from the surgical and obstetric wards were more likely to be exposed to splashes than workers from other departments. Splashes being associated with the amniotic fluids in the delivery rooms [35–38].