Background: Healthcare workers (HCWs) are at the highest percentage of getting exposed to percutaneous injuries. Those exposures include blood and body fluids through contaminated needle sticks and sharps.
Methodology: The cross-sectional study was conducted among 404 HCWs in a tertiary care hospital at Swat. A self-administer questionnaire was used to collect the data and data was analyzed through Statistical Package for the Social Sciences (SPSS) software V 22.
Result: As per the study, among the 404 HCWs, a 62.1% rate of needle stick injuries (NSIs) within the past year has been suffered; a greater impact has been imposed on nursing staff (63.7%). Other gaps identified were low awareness regarding safety policies (28.7%), improper use of personal protective equipment [PPE] (35.1%), and lack of training (29%). Recapping needles (88.3%) was highlighted as a critical risk factor, while only 26.2% of the injuries were reported. The findings lay out urgent needs for better training, compliance with safety standards, and reporting of injuries for the protection of these caregivers.
Conclusion: NSIs should not be encouraged by any organization. Tertiary care health setups should be aware of and responsible for the occupational health and safety of HCWs, and they should also be conscious of their own health. Frequent training and education sessions, workshops, or symposiums should be held to educate healthcare professionals (HCPs); evaluate their competencies and the effectiveness of the training programs; pre and post-tests should be conducted to monitor effectiveness; vaccination programs should also be conducted for HCPs to protect and prevent them from healthcare workplace hazards.

Needle stick injuries, Healthcare professionals, Prevention, Sharps injury risk, Bloodborne pathogen exposure.

HCWs are at the highest percentage of getting exposed to percutaneous injuries. Those exposures include blood and body fluids through contaminated needle sticks and sharps. These injuries become critical occupational hazards and cause morbidity and even mortality because of the involvement of infections with blood-borne pathogens among HCWs.[1, 2]

According to Non-Suicidal Self-Injury (NSSI) research, almost three million out of thirty-five million healthcare providers experience NSIs every year, worldwide.[3] Despite the economic development in the countries, several countries have reported these injuries, particularly in healthcare facilities.[4-5] Moreover, NSSI has a presence where more than 20 kinds of pathogens have a considerable risk of being transmitted to human bodies, particularly to healthcare providers and facilitators. Those pathogens include hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV).[6] Furthermore, as per World Health Organization (WHO) estimation, 40% of HCWs get infected with HBV and HCV, and 2 -3 % of HCWs get infected with HIV due to exposure to sharps.[3] It has also been reported that HCWs at healthcare facilities do not follow proper infection control techniques, for instance, during long working hours [7,8,9], workers with less working experience [10] still perform recapping of the needle.[11] Moreover, they do not realize the importance of using personal protective equipment. The reason for such mishandling is probably the inappropriately trained HCWs for risk control.[11,12]

A cross-sectional study was conducted among 404 HCWs at Saidu Teaching Hospital, Swat, including various roles such as clinicians, nurses, and paramedics. Permission was obtained from hospital management, and informed consent was secured from participants. Data were collected using a structured questionnaire, approved by the supervisor and Ethics Review Board (ERB), focusing on NSIs defined as cuts or pricks from needles previously used on patients. The study included HCWs with percutaneous exposure to contaminated devices but excluded injuries from unused sharps due to minimal risk. The aim was to assess NSIs incidents and preventive practices among staff handling needles.

Data collection procedure: Our research team conducted a study at a tertiary care hospital in Swat to collect data on NSIs among HCWs. The study included participants of both genders, with no age restrictions, focusing on individuals directly involved in patient care. The primary objective was to analyze the incidence of NSIs and identify which categories of HCPs are at higher risk. The data collected pertained to employees working at the hospital up to September 2024.

A total of 700 participants were initially targeted for the study, and informed consent was obtained from everyone, ensuring confidentiality. However, only 500 forms were returned, as some participants declined to participate or had left their positions. Out of these, 96 forms were excluded due to incomplete or improperly filled responses. Consequently, the final sample size for the study was 404 participants. Through this data, we assessed the participants’ knowledge, skills, and practices regarding NSIs, as well as the incidence ratio among HCWs. This study provides valuable insights into the risks and preventive measures associated with NSIs in a hospital setting.

Data analysis: The data was entered and analyzed using SPSS version 22. Descriptive statistics summarized demographic characteristics, while inferential tests, chi-square, and t-test determined associations between NSIs occurrences and preventive practices. A p-value < 0.05 was considered significant, and results were presented in tables and charts for better interpretation.

Ethical consideration: The research proposal was approved by the ethical committee of Saidu Teaching Hospital, and oral & written consent was obtained from the Director of Operations & Nursing Services after explaining the study’s purpose. Participation was voluntary, and anonymity was assured as no names appeared on the questionnaires. The study’s benefits were explained, and confidentiality was ensured. Participants signed consent forms before taking part, with the right to withdraw at any time without penalty. Contact details were provided for any queries.

Demographic characteristics: The study comprised a total of 404 participants. Among this group, 61.62% comprised nursing staff, which included both trainee nurses and midwives. Doctors accounted for 27.96%, consisting of consultants and house officers, while the remainder of the participants belonged to ancillary staff categories. Gender distribution revealed that approximately 66% of participants were female. Regarding age, 52% of the participants fell within the range of 24 to 30 years. Moreover, a significant portion of the sample, 47.3%, reported having work experience spanning from 2 to 4 years. (p <0.001)

Table 1: Demographic data of participants

The study reveals a concerning statistic regarding NSIs among HCWs, indicating that 62.10% of these individuals have sustained at least one injury within the past year. A significant contributing factor to these injuries is the recapping of needles, which is reported to be a practice among 88.30% of those injured.

Figure 1: Incidence and reporting practices of NSIs among HCWs

According to Table 2, there was a notable lack of knowledge and resources on the part of health professionals towards NSIs: only 28.7% were aware of the health and safety policies, 35.10% wore PPEs, and 37.10% claimed the presence of sharps boxes. Also, only 29% received training on NSIs prevention/treatment, and only 35.1% during the last two years had read the health and safety policy, even though about 75% were vaccinated against hepatitis B.

Table 2: Knowledge, practice, skills, and attitudes of HCPs toward NSIs

This table shows that 63.7% of NSIs happen in nursing. 70.1% of injuries involved the 25-30 age group, and 59.7% among females, since 52.9% had 2–6 years of experience in healthcare. The result reveals that only 26.2% of the injured HCPs filled out incident forms, 73.7% received verbal reports, and only 25.4% underwent training, whereas 32.6% were aware of organizational policies. Other gaps were found in the training, in knowing about the policies, and in formally reporting injuries.

Table 3: Association between demographics and sustained NSIs

NISs have a high prevalence among HCWs, with 62.10% sustaining injuries in the past year due to unsafe practices, particularly recapping needles (88.30%). The findings are consistent with a previous study that identified recapping as a leading cause of NISs. However, the reporting rate in the present study (reported formally for only 16.3% of the injuries) is significantly higher than that reported, wherein only 30% were reported. The exceedingly high underreporting rate indicates that there is a disconnect within HCW’s awareness of proper reporting practices.[13,14]

The demographic data imply that it affects nursing staff (63.7%) and females (59.7%). These findings corroborate the findings, which also recognized nurses as the most vulnerable group. More susceptible belonged to the age group of 25–30 years at 70.1%, and 52.9% with 2–6 years of service, implying that highly experienced HCPs are at risk in the opposite instance with low skill, where it was questioned whether beginners had an increased likelihood of NSIs. This difference might reflect differences in work practices or regional training quality.[15,16]

The study highlights such an enormous gap in knowledge and resources, containing, along with the weak backgrounds concerning orders, 28.7% of HCWs being aware of health and safety policies and 35.10% of those wearing personal protective equipment (example, gowns, aprons to prevent skin breaks), which is below the figures recorded (45% awareness of policies, with 50% use of PPE). In clinical areas where sharp boxes are unavailable, the situation worsens the risk, which underscores how access to resources plays a very critical role in the prevention of NSIs.[17,18]

Training and policy awareness remain among the greatest challenges. Only 29% of HCWs received training on NSI prevention, and 35.1% read the health and safety policy in the last two years. Compared with where 50% of HCWs were trained, this is shocking. Very few reports (26.2%) of incident forms have been completed, as opposed to verbal reporting (73.7%), indicating a need for Streamlined reporting mechanisms and better policy enforcement.[19]

Limitations: Limitations of the current study included possible bias in self-reporting, single-center design, and cross-sectional data collection, which affected the accuracy and generalizability of the data. The sample consisted mostly of nurses and females, which may have overlooked pertinent information from other groups. Some influencing factors, such as work overload, quality of training, and cultural influences, were not examined. Nevertheless, the study pointed out substantial gaps in NSI knowledge, reporting practices, and safety mechanisms that call for focused interventions and further research on this issue in healthcare settings.

In conclusion, this study reveals that there is an urgent need for targeted interventions. To address NSIs and reporting practices through more attention to staff training, Resource allocation, and enforcement of policies. The findings are congruent with some aspects of previous research; however, the higher rates of nonreporting and the lower amount of policy awareness in the present study suggest country-tailored challenges requiring tailored solutions. Filling these gaps needs to be made to ensure safety and promote a healthy workforce throughout the world.

Not reported

The work had no special funding.

Corresponding Author:
Nasar Mian
Department of Nursing
National College of Nursing, Swat, Pakistan.
Email: nasarmian819@gmail.com

Co-Authors:
Kausar Iqbal, Bibi Safia, Naseem Akhtar, Safdar Ali
Department of Nursing
Saidu Teaching Hospital Swat, Pakistan

Samina Nabi
Department of Nursing
THQ Hospital Lukki Marwat, Pakistan

Shamim Akhtar
Department of Nursing
Public Health School D.I.khan, Pakistan.

Shabana Nawaz, Aisha
Department of Nursing
DHQ Hospital Alpuri Shangla, Pakistan

Nasar Mian was responsible for data analysis. Kausar Iqbal, Bibi Safia, Samina Nabi, Naseem Akhtar, and Safdar Ali contributed to data collection. Shamim Akhtar, Shabana Nawaz, and Aisha were involved in both data collection and data analysis.

The research proposal was approved by the ethical committee of Saidu Teaching Hospital, Ref No IRB/SGTH/2025/12, and oral & written consent was obtained from the director of operations & nursing services after explaining the study’s purpose.

The authors declare no conflicts of interest.

https://doi.org/10.63096/medtigo30623133

Nasar M, Kausar I, Bibi S, et al. Understanding Needle Stick Injuries and Preventive Practices Among Healthcare Professionals at Tertiary Care Hospital Swat, Pakistan. medtigo J Med. 2025;3(1):e30623133. doi:10.63096/medtigo30623133 Crossref