Sharps injury (SI) rates in small, rural hospitals vs. large, urban hospitals: Results of a statewide survey

We surveyed infection control practitioners in all Iowa hospitals and the largest chronic care facilities (N = 135) in 1996-97 to identify organizational and management characteristics that are associated with low SI rates. Respondents (N = 89,66%) reported on workforce characteristics (including employee numbers and employee FTEs), surrogate denominator data (i.e., CBCs and surgical procedures performed; needles purchased) and SI recorded over the previous year. SI rates were calculated by occupation and by hospital size (<200 beds and >200 beds). An average of 57 SI per 1,000 employees was reported. SI rates were lower than the mean for nursing assistants (30/1,000 NAs), housekeepers (39/1,000 housekeepers) and MDs (48/1,000 MDs). SI rates were highest for RNs and LPNs (62/1,000 RNs/LPNs), lab technicians (99/1,000 lab techs), and patient-care technicians/EMTs (122/1,000 pt-care technicians). Hospitals with £200 beds (N = 61) had an overall SI rate of 63/1,000 employees, while >200 bed hospitals (N = 13) had 45/1,000 employees. When SI rates were compared in small versus large hospitals, rates were higher in larger hospitals only among patient-care technicians and nursing assistants. All other occupations reported higher SI rates in small hospitals. We conclude that smaller, more rural hospitals in Iowa have higher reported SI rates than larger, more urban institutions. These findings are consistent across most occupations. Further study is needed to determine if differences reflect program factors or alternate approaches to surveillance, case-finding, or reporting.