Awareness and practice of injection safety among the staff nurses working in El-Beyda Medical Center
Abstract
Background: Needlestick injuries (NSIs) are a major occupational hazard for health care workers (HCWs), particularly nurses, and are an important route of transmission for blood‑borne infections such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). Injection safety remains a neglected area in many low‑ and middle‑income countries, and data from Libyan hospitals are scarce.
Objectives: To assess nurses’ awareness and practices related to injection safety, to determine the prevalence and patterns of NSIs, and to identify selected factors associated with NSIs among nurses working in El‑Beyda hospitals, Libya.
Methods: A hospital‑based cross‑sectional study was conducted among 220 nurses working in different departments of El‑Beyda hospitals. Data were collected using a structured, self‑administered questionnaire and an observation checklist. The questionnaire assessed socio‑demographic and professional characteristics, awareness of injection safety, self‑reported injection practices, history and circumstances of NSIs, HBV vaccination status, and previous training. Descriptive statistics were used to summarize the data, and the chi‑square (χ²) test was applied to examine associations between NSI occurrence and selected variables. A p‑value of <0.05 was considered statistically significant.
Results: Most participants were female (77.0%) and aged 20–30 years (43.18%). Overall, nurses demonstrated generally good awareness of injection safety; the majority recognized that NSIs can transmit blood‑borne infections and were aware of key preventive measures such as handwashing, glove use, and proper sharps disposal. Nevertheless, unsafe injection practices were common. More than three‑quarters of nurses reported always or frequently recapping needles after use, a considerable proportion reported bending needles before disposal, and nearly one‑third admitted occasional reuse of syringes or needles. Only about one‑third always used gloves when administering injections.
The prevalence of NSIs was high: approximately 66.8% of nurses reported having experienced at least one NSI, and more than one‑third reported multiple NSIs. Hasty work and needle recapping were the most frequently reported contributing factors, followed by lack of precautions during blood drawing and intravenous (IV) insertion. HBV vaccination coverage was very low; only 22.27% of nurses reported being vaccinated against HBV. None of the nurses reported formally documenting their NSIs through an institutional reporting system.
There was a statistically significant association between NSI occurrence and years of work experience (χ² = 8.270, p = 0.016), with the highest NSI prevalence observed among nurses with 5–9 years of experience. Awareness level was also significantly associated with NSIs (χ² = 6.665, p = 0.036), although higher awareness was paradoxically linked to higher reported NSI prevalence, likely reflecting reporting bias. No significant associations were found between NSIs and academic qualification, previous training on injection safety, or regular supervision (p > 0.05).
Conclusion: Despite generally good awareness of injection safety among nurses in El‑Beyda hospitals, unsafe practices and a high prevalence of needlestick injuries persist. The combination of frequent NSIs, extremely low HBV vaccination coverage, and almost complete absence of NSI reporting indicates a serious and preventable occupational health problem. There is an urgent need for comprehensive interventions, including mandatory HBV vaccination for all at‑risk staff, practical skills‑based training focused on eliminating needle recapping and other unsafe practices, ensuring adequate supplies of personal protective equipment and safety boxes, and establishing a simple, non‑punitive NSI reporting and follow‑up system to protect nurses and improve patient safety
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