Blood Exposure Risk Awareness and Needlestick Injuries Associated with Insulin Pen Injectors among Nurses Working in Hospitals in Okinawa, Japan

Abstract

[Background・Methods] Insulin pens carry a risk of blood backflow into the cartridge during injection; thus, if a needlestick injury occurs between priming and injection, it can lead to blood exposure and bloodborne pathogen transmission. Hospital A has tried to prevent occupational infections through poster-based education and the adoption of new insulin needles with a one-handed recapping feature. Nurses unaware of the blood backflow risk may fail to report needlestick injuries occurring before insulin administration; however, blood exposure risk awareness among nurses in Okinawa Prefecture remains unclear. Therefore, this study aimed to clarify the current state of risk awareness among hospital nurses in Okinawa and to evaluate changes after educational interventions at Hospital A. An anonymous web-based survey was conducted, with valid responses divided into two groups: nurses from Hospital A (AN) and nurses from other facilities (ON). This study analyzed insulin administration procedures and blood exposure risk awareness.

[Results] Responses were obtained from 154 AN and 230 ON participants. A significant difference was observed in blood exposure risk awareness between the two groups (AN, 72.1% vs. ON, 37.0%; p<.001). Among those who recapped after priming, 44.3% of AN used one hand, whereas 48.4% of ON used both hands.

[Discussion] Among nurses from other facilities, needlestick injuries occurring during two-handed recapping after priming may go unreported owing to a lack of blood exposure risk awareness. By contrast, the higher awareness rate and safer recapping methods in the AN group than those in the ON group, suggest that the poster-based education was effective. In addition, the introduction of new needles with a one-handed recapping feature has had a positive impact. In the United States, posters are commonly used to raise awareness about blood backflow risks, whereas in Japan, such information is primarily limited to documents and is not frequently distributed. Continuous and visually engaging on-site education is required to effectively improve knowledge of these risks.