Abstract
Amaç: Kesici-delici alet yaralanmaları, hemşirelik öğrencileri için önemli bir mesleki risk oluşturarak onları kan yoluyla bulaşan patojenlere maruz bırakmaktadır. Bu çalışmanın amacı, dördüncü sınıf hemşirelik öğrencilerinin klinik uygulamaları sırasında yaşadıkları kesici-delici alet yaralanmaları sıklığını, nedenlerini ve sonuçlarını araştırmaktır.
Materyal ve Metot: Bu prospektif ve tanımlayıcı çalışma, 2022-2023 akademik yılında Türkiye'deki bir üniversitede 190 dördüncü sınıf hemşirelik öğrencisi ile yürütülmüştür. Öğrenciler, her biri güz ya da bahar döneminde 14 haftalık bir klinik stajı tamamlayan iki gruba ayrılmıştır. Veriler yapılandırılmış bir vaka raporlama formu kullanılarak toplanmış ve tanımlayıcı istatistiklerle analiz edilmiştir.
Bulgular: Öğrencilerin %14,7’si kesici-delici alet yaralanmaları yaşamıştır. Yaralanmaya en sık neden olan işlemler subkutan enjeksiyonlar (%32,1) ve iğne kapatma işlemleri (%50,0) olmuştur. Yaralanmalar en fazla dâhiliye servislerinde (%39,3) görülmüş ve klinik uygulamanın 21–40. günleri arasında en yüksek seviyeye ulaşmıştır (%42,9). Başlıca nedenler dikkatsizlik (%64,3), yetersiz malzeme (%50,0) ve deneyimsizlik (%32,1) olarak belirlenmiştir. Yaralanmalara verilen duygusal tepkiler arasında kaygı (%64,3) ve korku (%50,0) öne çıkmıştır. Yaralanan tüm öğrencilere takip bakımı sağlanmış olup, HIV, HBV veya HCV serokonversiyonu gözlenmemiştir.
Sonuç: Bulgular, hemşirelik öğrencilerinde görülen kesici-delici alet yaralanmalarının büyük ölçüde deneyimsizlik, yetersiz ekipman ve güvensiz uygulamalarla ilişkili olduğunu göstermektedir. Simülasyon temelli eğitim yaralanma oranlarını azaltabilirken, klinik uygulama sırasında artan güven ve işlem hızının riski artırabileceği belirtilmiştir. Klinik uygulamalarda güvenliğe odaklanan müfredatların geliştirilmesi, sıkı gözetim sağlanması ve duygusal destek sunulması hem yaralanma oranlarını azaltmak hem de öğrencilerin klinik öğrenme deneyimlerini ve mesleki gelişimlerini iyileştirmek açısından temel stratejiler olarak önerilmektedir.
Keywords
Hemşirelik eğitimi hemşirelik öğrencileri iş yeri güvenliği kesici-delici alet yaralanmaları mesleki maruziyet
References
- Health and Safety Executive (HSE). Sharps injuries. 2025. https://www.hse.gov.uk/healthservices/needlesticks/. Accessed January 11, 2025.
- World Health Organization (WHO). Sharps injuries: Assessing the burden of disease from sharps injuries to health-care workers at national and local levels. 2005. https://www.who.int/publications/i/item/sharps-injuries-assessing-the-burden-of-disease-from-sharps-injuries-to-health-care-workers-at-national-and-local-levels. Accessed April 5, 2025.
- Benner P, Sutphen M, Leonard V, Day L. Educating Nurses: A Call For Radical Transformation. 15th ed. San Francisco, CA: John Wiley & Sons; 2009.
- Benner P. From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Commemorative ed. London: Prentice-Hall International; 2001.
- Smith DR, Leggat PA. Needlestick and sharps injuries among nursing students. J Adv Nurs. 2005;51(5):449-455. doi:10.1111/j.1365-2648.2005.03526.x
- Bevan V, Blake P, Radwan RN, Azzopardi E. Sharps and needlestick injuries within the operating room: Risk prone procedures and prevalence meta-analysis. J Perioper Pract. 2023;33(7-8):200-210. doi:10.1177/17504589221103810
- Ghanei Gheshlagh R, Aslani M, Shabani F, Dalvand S, Parizad N. Prevalence of needlestick and sharps injuries in the healthcare workers of Iranian hospitals: An updated meta-analysis. Environ Health Prev Med. 2018;23(1):44. doi:10.1186/s12199-018-0734-z
- Zhang X, Gu Y, Cui M, Stallones L, Xiang H. Needlestick and sharps injuries among nurses at a teaching hospital in China. Workplace Health & Safety. 2015;63(5):219-225. doi:10.1177/2165079915580035
- Zhang X, Chen Y, Li Y, et al. Needlestick and sharps injuries among nursing students in Nanjing, China. Workplace Health & Safety. 2018;66(6):276-284. doi:10.1177/2165079917732799
- Irmak Z, Baybuga MS. Needlestick and sharps injuries among Turkish nursing students: A cross-sectional study. Int. J. Nurs. Pract. 2011;17(2):151-157. doi:10.1111/j.1440-172X.2011.01920.x
- Nguyen TTD, Hoang HTM, Luong DTH. Sharp injuries in clinical practice among nursing students of Da Nang University of Medical Technology and Pharmacy. Journal of Clinical Medicine. 2022;113:34. doi:10.38103/jcmhch.78.7
- Talas MS. Occupational exposure to blood and body fluids among Turkish nursing students during clinical practice training: Frequency of needlestick/sharp injuries and hepatitis B immunisation. J Clin Nurs. 2009;18(10):1394-1403. doi:10.1111/j.1365-2702.2008.02523.x
- Xu X, Yin Y, Wang H, Wang F. Prevalence of needle-stick injury among nursing students: A systematic review and meta-analysis. Frontiers in Public Health. 2022-August-15 2022;10. doi:10.3389/fpubh.2022.937887
- Yang YH, Wu MT, Ho CK, et al. Needlestick/sharps injuries among vocational school nursing students in southern Taiwan. Am J Infect Control. 2004;32(8):431-435. doi:10.1016/j.ajic.2004.02.007
- Palloş A, Demirca K, Özkan S. Evaluation of needlestick and sharp injuries, contributing factors, and preventive measures among nursing students. CURARE Journal of Nursing. 2024;(6):21-29. doi:10.26650/CURARE.2024.1570121
- Cheung K, Ching SSY, Chang KKP, Ho SC. Prevalence of and risk factors for needlestick and sharps injuries among nursing students in Hong Kong. Am J Infect Control. 2012;40(10):997-1001. doi:10.1016/j.ajic.2012.01.023
- Green B, Griffiths EC. Psychiatric consequences of needlestick injury. Occupational Medicine. 2013;63(3):183-188. doi:10.1093/occmed/kqt006
- Osborne, S. A point about sharps safety. ACORN: The Journal of Perioperative Nursing in Australia. 2014;27(1):8–9. doi:10.3316/informit.270895952757577
- Zhang MX, Yu Y. A study of the psychological impact of sharps injuries on health care workers in China. Am J Infect Control. 2013;41(2):186-187. doi:10.1016/j.ajic.2012.02.023
- Sohn JW, Kim BG, Kim SH, Han C. Mental health of healthcare workers who experience needlestick and sharps injuries. J Occup Health. 2006;48(6):474-479. doi:10.1539/joh.48.474
- Hambridge K, Endacott R, Nichols A. The experience and psychological impact of a sharps injury on a nursing student population in the UK. British Journal of Nursing. 2021;30(15):910-918. doi:10.12968/bjon.2021.30.15.910
- Çakar M, Yıldırım Şişman N, Oruç D. Health risks in nursing students' clinical applications. Journal of Nursing Effect. 2019;12(2):116-125.
- Al-Mugheed K, Farghaly SM, Baghdadi NA, Oweidat I, Alzoubi MM. Incidence, knowledge, attitude and practice toward needle stick injury among nursing students in Saudi Arabia. Frontiers in Public Health. 2023;11:1160680. doi:10.3389/fpubh.2023.1160680
- Al Qadire M, Ballad CAC, Al Omari O, Aldiabat KM, Shindi YA, Khalaf A. Prevalence, student nurses’ knowledge and practices of needle stick injuries during clinical training: a cross-sectional survey. BMC Nursing. 2021;20:187. doi:10.1186/s12912-021-00711-2
- Janjua SS, Hanan A, Sarwar H, Afzal M, Ali A. Awareness in nursing students regarding prevention of needle stick injuries: Prevention of needle stick injuries. Nursearcher (Journal of Nursing & Midwifery Sciences). 2022:20-24. doi:10.54393/nrs.v2i01.30
- Khan R, Pari B. Impact of needle stick injuries on student nurses at KTH Hospital, Peshawar, Pakistan. Quantum Journal of Social Sciences and Humanities. 2023;4(4):268-276. doi:10.55197/qjssh.v4i4.280
- Chen M, Zhang L. Prevalence of needlestick injuries among nursing interns: A systematic review and meta-analysis. Annals of Palliative Medicine. 2021;10(7):7525-7533. doi:10.21037/apm-21-703
- Doğru BV, Akyol A. Evaluation of needlestick and sharp instrument injuries in nursing students. Acibadem Univ Health Sci J. 2018;(1):59-66.
- Li M, Huo L, Du F, Li W, Zhang H, Shi B. Prevalence, emotional and follow-up burden of insulin injection-related needle-stick injuries among clinical nurses in Shaanxi Province, west of China: A cross-sectional study. Nursing Open. 2022;9(4):1984-1994. doi:10.1002/nop2.1200
- Büyük ET, Rızalar S, Yüksel P, Yüksel VT. Öğrencilerin delici kesici aletlerle yaralanma deneyimleri ve bu konuda uygulama alanında yapılan eğitimin bilgi düzeylerine etkisi. Samsun Sağlık Bilimleri Dergisi. 2016;1(1):167-178.
Abstract
Objective: Sharp instrument injuries constitute a significant occupational risk for nursing students, exposing them to blood-borne pathogens. This study aimed to investigate the prevalence, causes, and outcomes of sharp instrument injuries among fourth-year nursing students during their clinical training.
Materials and Methods: This prospective and descriptive study was conducted with 190 fourth-year nursing students at a university in Türkiye during the 2022–2023 academic year. Students were divided into two groups, each completing a 14-week clinical placement in either the fall or spring semester. Data were collected using a structured case reporting form and analyzed with descriptive statistics.
Results: Sharp instrument injuries occurred in 14.7% of students. The most frequent procedures leading to injury were subcutaneous injections (32.1%) and recapping needles (50.0%). Injuries were most common in internal medicine departments (39.3%) and peaked between days 21 and 40 of clinical practice (42.9%). Primary contributing factors included carelessness (64.3%), insufficient supplies (50.0%), and lack of experience (32.1%). Emotional responses to injury included anxiety (64.3%) and fear (50.0%). All affected students received follow-up care, with no seroconversion for HIV, HBV, or HCV reported.
Conclusions: Sharp instrument injuries pose a notable occupational risk for nursing students, primarily due to inexperience, inadequate equipment, and unsafe practices. While simulation training may lower injury rates, increased confidence and speed during clinical placements can heighten risk. Strengthening curricula on safe practices, ensuring supervision, and offering emotional support are key to reducing injuries and enhancing clinical learning.
References
- Health and Safety Executive (HSE). Sharps injuries. 2025. https://www.hse.gov.uk/healthservices/needlesticks/. Accessed January 11, 2025.
- World Health Organization (WHO). Sharps injuries: Assessing the burden of disease from sharps injuries to health-care workers at national and local levels. 2005. https://www.who.int/publications/i/item/sharps-injuries-assessing-the-burden-of-disease-from-sharps-injuries-to-health-care-workers-at-national-and-local-levels. Accessed April 5, 2025.
- Benner P, Sutphen M, Leonard V, Day L. Educating Nurses: A Call For Radical Transformation. 15th ed. San Francisco, CA: John Wiley & Sons; 2009.
- Benner P. From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Commemorative ed. London: Prentice-Hall International; 2001.
- Smith DR, Leggat PA. Needlestick and sharps injuries among nursing students. J Adv Nurs. 2005;51(5):449-455. doi:10.1111/j.1365-2648.2005.03526.x
- Bevan V, Blake P, Radwan RN, Azzopardi E. Sharps and needlestick injuries within the operating room: Risk prone procedures and prevalence meta-analysis. J Perioper Pract. 2023;33(7-8):200-210. doi:10.1177/17504589221103810
- Ghanei Gheshlagh R, Aslani M, Shabani F, Dalvand S, Parizad N. Prevalence of needlestick and sharps injuries in the healthcare workers of Iranian hospitals: An updated meta-analysis. Environ Health Prev Med. 2018;23(1):44. doi:10.1186/s12199-018-0734-z
- Zhang X, Gu Y, Cui M, Stallones L, Xiang H. Needlestick and sharps injuries among nurses at a teaching hospital in China. Workplace Health & Safety. 2015;63(5):219-225. doi:10.1177/2165079915580035
- Zhang X, Chen Y, Li Y, et al. Needlestick and sharps injuries among nursing students in Nanjing, China. Workplace Health & Safety. 2018;66(6):276-284. doi:10.1177/2165079917732799
- Irmak Z, Baybuga MS. Needlestick and sharps injuries among Turkish nursing students: A cross-sectional study. Int. J. Nurs. Pract. 2011;17(2):151-157. doi:10.1111/j.1440-172X.2011.01920.x
- Nguyen TTD, Hoang HTM, Luong DTH. Sharp injuries in clinical practice among nursing students of Da Nang University of Medical Technology and Pharmacy. Journal of Clinical Medicine. 2022;113:34. doi:10.38103/jcmhch.78.7
- Talas MS. Occupational exposure to blood and body fluids among Turkish nursing students during clinical practice training: Frequency of needlestick/sharp injuries and hepatitis B immunisation. J Clin Nurs. 2009;18(10):1394-1403. doi:10.1111/j.1365-2702.2008.02523.x
- Xu X, Yin Y, Wang H, Wang F. Prevalence of needle-stick injury among nursing students: A systematic review and meta-analysis. Frontiers in Public Health. 2022-August-15 2022;10. doi:10.3389/fpubh.2022.937887
- Yang YH, Wu MT, Ho CK, et al. Needlestick/sharps injuries among vocational school nursing students in southern Taiwan. Am J Infect Control. 2004;32(8):431-435. doi:10.1016/j.ajic.2004.02.007
- Palloş A, Demirca K, Özkan S. Evaluation of needlestick and sharp injuries, contributing factors, and preventive measures among nursing students. CURARE Journal of Nursing. 2024;(6):21-29. doi:10.26650/CURARE.2024.1570121
- Cheung K, Ching SSY, Chang KKP, Ho SC. Prevalence of and risk factors for needlestick and sharps injuries among nursing students in Hong Kong. Am J Infect Control. 2012;40(10):997-1001. doi:10.1016/j.ajic.2012.01.023
- Green B, Griffiths EC. Psychiatric consequences of needlestick injury. Occupational Medicine. 2013;63(3):183-188. doi:10.1093/occmed/kqt006
- Osborne, S. A point about sharps safety. ACORN: The Journal of Perioperative Nursing in Australia. 2014;27(1):8–9. doi:10.3316/informit.270895952757577
- Zhang MX, Yu Y. A study of the psychological impact of sharps injuries on health care workers in China. Am J Infect Control. 2013;41(2):186-187. doi:10.1016/j.ajic.2012.02.023
- Sohn JW, Kim BG, Kim SH, Han C. Mental health of healthcare workers who experience needlestick and sharps injuries. J Occup Health. 2006;48(6):474-479. doi:10.1539/joh.48.474
- Hambridge K, Endacott R, Nichols A. The experience and psychological impact of a sharps injury on a nursing student population in the UK. British Journal of Nursing. 2021;30(15):910-918. doi:10.12968/bjon.2021.30.15.910
- Çakar M, Yıldırım Şişman N, Oruç D. Health risks in nursing students' clinical applications. Journal of Nursing Effect. 2019;12(2):116-125.
- Al-Mugheed K, Farghaly SM, Baghdadi NA, Oweidat I, Alzoubi MM. Incidence, knowledge, attitude and practice toward needle stick injury among nursing students in Saudi Arabia. Frontiers in Public Health. 2023;11:1160680. doi:10.3389/fpubh.2023.1160680
- Al Qadire M, Ballad CAC, Al Omari O, Aldiabat KM, Shindi YA, Khalaf A. Prevalence, student nurses’ knowledge and practices of needle stick injuries during clinical training: a cross-sectional survey. BMC Nursing. 2021;20:187. doi:10.1186/s12912-021-00711-2
- Janjua SS, Hanan A, Sarwar H, Afzal M, Ali A. Awareness in nursing students regarding prevention of needle stick injuries: Prevention of needle stick injuries. Nursearcher (Journal of Nursing & Midwifery Sciences). 2022:20-24. doi:10.54393/nrs.v2i01.30
- Khan R, Pari B. Impact of needle stick injuries on student nurses at KTH Hospital, Peshawar, Pakistan. Quantum Journal of Social Sciences and Humanities. 2023;4(4):268-276. doi:10.55197/qjssh.v4i4.280
- Chen M, Zhang L. Prevalence of needlestick injuries among nursing interns: A systematic review and meta-analysis. Annals of Palliative Medicine. 2021;10(7):7525-7533. doi:10.21037/apm-21-703
- Doğru BV, Akyol A. Evaluation of needlestick and sharp instrument injuries in nursing students. Acibadem Univ Health Sci J. 2018;(1):59-66.
- Li M, Huo L, Du F, Li W, Zhang H, Shi B. Prevalence, emotional and follow-up burden of insulin injection-related needle-stick injuries among clinical nurses in Shaanxi Province, west of China: A cross-sectional study. Nursing Open. 2022;9(4):1984-1994. doi:10.1002/nop2.1200
- Büyük ET, Rızalar S, Yüksel P, Yüksel VT. Öğrencilerin delici kesici aletlerle yaralanma deneyimleri ve bu konuda uygulama alanında yapılan eğitimin bilgi düzeylerine etkisi. Samsun Sağlık Bilimleri Dergisi. 2016;1(1):167-178.
Details
| Primary Language | English |
|---|---|
| Subjects | Nursing (Other) |
| Journal Section | Research article |
| Authors | |
| Early Pub Date | June 24, 2025 |
| Publication Date | June 30, 2025 |
| Submission Date | April 10, 2025 |
| Acceptance Date | June 18, 2025 |
| Published in Issue | Year 2025 Volume: 10 Issue: 2 |
