Prevalence of nonreporting behavior of sharps injuries in Taiwanese health care workers

Background: Health care workers (HCWs) were surveyed to identify factors associated with nonreporting behavior of sharps injuries (SIs) in Taiwan. Methods: We surveyed 10,469 full-time medical, nursing, technical, and supporting personnel employed at 16 randomly selected hospitals from 132 available accredited teaching hospitals in Taiwan. Information about the most recent injury and reporting behavior after an SI were collected from July 1996 to June 1997 by using a pretested structured questionnaire. Eleven categories, including an open-ended option, were provided for participants to explain their nonreporting behavior. Results: Questionnaires were completed by 82.6% (8645) of our sample, of whom 87.3% reported to have experienced a recent SI. A used item was the most commonly (P < .001) involved item in an SI, and SIs with a used item were significantly more likely (odds ratio 3.6; CI 95%, 3.03-4.26; P < .001) to be reported compared with an SI that involved unused items. A total of 81.8% of injuries were not reported, with job category significantly affecting reporting behavior (P < .001). Medical staff had the highest nonreporting rate (85.2%). Although attendees of a prevention program were statistically more likely (P < .001) to report an injury compared with nonattendees, the level of reporting in both groups was not encouraging (21.3% and 17.2%, respectively). All reasons given for nonreporting were disconcerting, but none more so than the use of subjective assessment of risk by 21.7% of HCWs who did not report their injuries. Other reasons for not reporting Sis included that the item was unused (34%) and that the HCW was too busy to report the SI (14.9%), unaware of reporting requirements (14.4%), or immune to hepatitis B virus (12.4%). Conclusions: With 82% of Sis in Taiwanese HCWs going unreported, the expected national incidence will be seriously underestimated and impact the appropriateness of prevention programs. The very low rate of reporting suggests that the current reporting system requires simplification. Because most injuries involved used items, the reporting systems also should include a more responsive management component. The results also suggest that the current prevention programs, currently provided by the general nursing department, require expert content knowledge in infection control if nonreporting and Sis are to be reduced.