Needlestick and sharps injuries among nursing students


  • Derek R. Smith MHSc MPH PhD,

  • Peter A. Leggat MBBS MHSc MMedEd MPH MD PhD DrPH

Derek R. Smith,
Department of Hazard Assessment,
National Institute of Industrial Health,
6-21-1 Nagao,
Tama-ku, Kawasaki,


Aims.  This paper reports the first investigation of the prevalence and nature of needlestick injuries among Australian nursing students.

Background.  Needlestick and sharps injuries are the most efficient method of transmitting blood-borne pathogens between patients and healthcare staff. Although nurses are known to be a high-risk subgroup for these events, nursing students may be at even greater risk due to their limited clinical experience. Despite this fact, the epidemiology of needlestick and sharps injuries among nursing students has not been clearly elucidated in Australia.

Methods.  A questionnaire-based methodology adapted from other international investigations was conducted among nursing students. We recruited a complete cross-section of students from a large university nursing school in North Queensland, Australia, in March 2004, and analysed needlestick and sharps events as a percentage of all students and also as a proportion of all cases. Risk factors were evaluated using logistic regression.

Results.  From a group of 319 students, 274 successfully completed questionnaires were obtained (overall response rate 85·9%). A total of 38 students (13·9%) reported a needlestick or sharps injury during the previous 12 months. By causative item, 6·2% of students had been injured by a normal hollow-bore syringe needle, 3·6% by a glass item and 3·3% by an insulin syringe needle. Regarding prior usage, 81·6% of all injuring items were unused, 15·8% had been used on a patient and the status of 2·6% was unknown. Most needlestick injuries occurred either in the nursing laboratory (45%) or the teaching hospital (37%). Opening the needle cap was the most common causative event (28% of all cases). A total of 39·5% of needlestick injuries were not reported. The main reason for non-reporting was that the item was unused (42%). Logistic regression analysis revealed that students in the third year were 14·8 times more likely to have experienced a needlestick injury than their counterparts in other years (odds ratio 14·8, 95% confidence interval 5·2–50·3, P < 0·01). These injury rates were higher among Australian nursing students than in other international studies.

Conclusions.  Although hepatitis B vaccination coverage among the students was excellent, it is important that the principles of infection-control training and reporting of all needlestick and sharps continue to be emphasized throughout undergraduate nursing education.