Needlestick injuries among critical care nurses before and after adoption of universal precautions or body substance isolation.

A small, self-selected sample of Canadian acute-care hospitals participated in an analysis of their critical care nurses' needle disposal practices and needlestick injury experience before and after adopting new Universal Precautions or Body Substance Isolation infection control strategies. Covert observation of disposal practices, review of employee health injury reports and direct survey of the nurses indicated that employee health records documented fewer injured nurses during a thirty-day period (2.3% of 929 nurses in 33 hospitals) than was found by surveying nurses directly (3.5% of 312 nurses in 11 hospitals; only 36% of these injuries had been documented in employee health records). Injury rates in only one of eleven hospitals indicated appreciable needlestick risk reduction after adopting Universal Precautions or Body Substance Isolation, and an association between reduced needle recapping and reduced needlestick injury was not evident. Rates of injury found in this research remain commensurate with rates reported before the era of Universal Precautions and Body Substance Isolation. These findings suggest that new strategies have not had significant impact on healthcare workers' greatest source of exposure to bloodborne pathogens.