Knowledge and compliance as factors associated with needlestick injuries contaminated with biological material: Brazil and Colombia

La-Rotta, Ehideé Isabel Gómez; Garcia, Clerison Stelvio; Pertuz, Carlos Morales; Miquilin, Isabella de Oliveira Campos; Camisão, Agnes Raquel; Trevisan, Danilo Donizetti; Aoki, Francisco Hideo; Correa-Filho, Heleno Rodrigues

doi:10.1590/1413-81232020252.04812018

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FREE THEMES • Ciênc. saúde coletiva 25 (2) • Feb 2020 • https://doi.org/10.1590/1413-81232020252.04812018 copy

Knowledge and compliance as factors associated with needlestick injuries contaminated with biological material: Brazil and Colombia

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This was a cross-sectional study to start a cohort in two University Hospitals of two countries – Brazil and Colombia – for assessing the prevalence of needlestick and sharps injuries (NSI), the level of compliance with standard precautions (SPs), and knowledge on blood borne pathogens and associated factors among health students and professionals, within the framework of the implementation of the NR-32 standard. We created compliance scales based on 12 and 10 questions, for assessing knowledge. We used the Multinomial Poisson-Tweedie Regression to evaluate the relationship between knowledge and compliance with SPs within NSI. We evaluated 965 individuals (348 students and 614 professionals). The mean score points for level of knowledge was 10.98, with a median of 11 (10; 12) and α-Cr of 0,625. Compliance with SP had a mean of 30.74 and median of 31 (28; 34), with a α-Cr coefficient of 0.745, associated with country, group (student) and risk perception. Among the factors associated with the report of NSI, we singled out knowledge and compliance, country of origin, and full vaccination scheme against the Hepatitis B virus. We concluded that the level of knowledge and compliance were adequate among participants, but better among Brazilian participants, and it was associated with NSI reporting.

Key words
Knowledge; Guideline compliance; Occupational accident; Perception; Risk

Variables	N	Brazil n = 524 (%)	Colombia n = 441 (%)	p
Gender				0.671
Female	707	381 (53.9)	326 (46.1)
Male	258	143 (55.4)	115 (44.6)
Age				0.354 ^* * ANOVA for the comparison of means in independent samples).
Median (25.75 percentiles)		30 (23 .39)	30 (25 .41)
Mean ± SD	965	32.75 ± 10.81	33.39 ± 10.81
Minimum		20	19
Maximum		64	72
Skin color				0.001
White	688	417 (60.6)	271 (39.4)
Black - Brown	118	76 (64.4)	42 (35.6)
Yellow (Asian)	25	23 (92.0)	2 (8.0)
Indian - Mixed Ethnicity	92	1 (1.1)	91 (98.9)
Does not know	42	7 (16.7)	35 (83.3)
Marital status - Risk				0.001
Single/Widowed/Divorced	650	328 (50.5)	322 (49.5)
Married/Stable Relationship	315	196 (62.2)	119 (37.8)
Number of children				0.004
Without children	631	364 (57.7)	267 (42.3)
With children	333	160 (48.0)	173 (52.0)
Household income				0.001
(MMW monthly minimum wage)
< 1 MMW	24	2 (8.3)	22 (91.7)
1 a 5 MMW	399	135 (33.8)	264 (66.2)
6 a 20 MMW	403	295 (73.2)	108 (26.8)
21 or more MMW	90	65 (72.2)	25 (27.8)
Does not know	49	27 (55.1)	22 (44.9)
Risky sexual behavior				0.561
Yes	515	285 (55.3)	230 (44.7)
No	445	237 (53.3)	208 (46.7)
Knowledge				0.001
Good	918	513 (55.9)	405 (44.1)
Bad	47	11 (23.4)	36 (76.6)
Compliance with SPs				0.001
Good	745	439 (58.9)	306 (41.1)
Bad	197	73 (37.1)	124 (62.9)
Risk perception				0.986
High	249	135 (54.2)	114 (45.8)
Low	689	374 (54.3)	315 (45.7)
Training				0.486
Yes	133	76 (57.1)	57 (42.9)
No	809	436 (53.9)	373 (46.1)
Accident				0.686
Yes	103	54 (52.4)	49 (47.6)
No	862	471 (54.6)	392 (45.4)

Variables	Simple Analysis			Multivariate Analysis
Variables	ß	95%CI	p-value	ßajud ^* * Adjusted for Age and gender.	95%CI	p-value
Age in years	0.001	-0.001 - 0.001	0.538
Gender		-0.007 to -0.002	0.091
Female	0
Male	0.013
Marital status - Risk		0.004 - 0.004	0.004
Single/Widowed/Divorced	0
Married/Stable Relationship	0.019
Children		0.007 - 0.060	0.012	0.029	0.006-0.05	0.013
Yes	0
No	0.031
Country		0,07 a 0,05	0.001	0.069	0.05 a 0.08	0.001
Brazil	0.064
Colombia	0
Group		-0.004 - 0.029	0.139
Professionals	0
Students	0.012
Sexual Risk		-0.016 - 0.016	0.985
Yes	0
No	0.001
Hepatitis B vaccine		-0.073 - 0.015	0.003	-0.042	-0.067 to -0.018	0.001
Yes	0
No	-0.044
AntiHBs Realization		-0.045 - 0.006	0.010	-0.027	-0.046 to -0.009	0.004
Yes	0
No	-0.025
Accidents with BM		-0.042 to -0.005	0.014	-0.022	-0.040 to -0.004	0.017
Yes	0
No	-0.023
Training		-0.004 to 0.026	0.167
Yes	0
No	0.011
Scale of compliance	0.001	-0.002 to 0.002	0.758
Risk Perception Scale	0.003	0.0042 to 0.009	0.127

Variables	Univariate Analysis			Multivariate Analysis
Variables	ß	95%CI	p-value	ßajud ^* * Adjusted for Age and gender.	95%CI	p-value
Age in years	0.00	-0.01-0.01	0.783
Gender
Female
Male	0.008	-0.015-0.031	0.483
Marital status - Risk
Single/Widowed/Divorced	-0.021	-0.004-0.002	0.077	-0.031	-0.058 a-0.003	0.027
Married/Stable Relationship	0
Children
Yes	0
No	-0.003	-0.024-0.018	0.819
Country
Brazil	0.57	0.029 to 0.086	0.001	0.067	0.048-0.086	0.001
Colombia	0			0
Group
Professionals	0
Students	0.037	0.019-0.056	0.001	0.058	0.048-0.086	0.001
Subgroup
Brazilian Professionals	0			0
Colombian Professionals	-0.064	-0.09 to -0.038	0.001	0
Brazilian Students	0.033	0.011-0.054	0.003	0.057	0.027-0.086	0.001
Colombian Students	-0.041	-0.07 to -0.026	0.001	0.038	0.055-0.072	0.025
Sexual Risk
Yes	0
No	-0.007	-0.025-0.014	0.504
Hepatitis B vaccine
Yes	0.064	0.033-0.095	0.045
No	0
AntiHBs Realization
Yes	0
No	-0.015	-0.033-0.095	0.168
Accidents with BM
Yes	-0.063	-0,099 a -0,026	0.001	-0.057	-0.093 to -0.021	0.001
No	0			0
Training
Yes	0
No	0.019	-0.009 to 0.048	0.183
Knowledge Scale	0.009	-0.001 to 0.018	0.070
Risk Perception Scale	0.008	-0.002 to 0.019	0.215	0.012	0.001-0.023	0.036

Variables	Previous Year (965)
Accident
Yes	103 (10.7)
No	862 (89.3)
Schedule
Daytime	43 (41.7)
Afternoon	26 (25.2)
Nighttime	18 (17.5)
Does' t Know/Remember	16 (15.5)
Day of the week
Monday	2 (1.9)
Tuesday	4 (3.9)
Wednesday	2 (1.9)
Thursday	8 (7.8)
Friday	9 (8.8)
Saturday or Sunday	8 (7.8)
Does' t Know/Remember	70 (67.9)
Day of the week
Monday to Friday	25 (24.3)
Saturday or Sunday	8 (7.8)
Does' t Know/Remember	70 (67.9)
Object caused the Accident
Needle	67 (65.0)
Catheter, Gelco and others	12 (11.7)
Scalpel	6 (5.8)
Wire and others	7 (6.8)
Blood and Fluids	11 (10.7)
Part of Body Affected
Fingers	70 (68.0)
Hand	23 (22.3)
Face	7 (6.8)
Arms	3 (2.9)
Reported the accident
Yes	76 (73,8)
No	27 (26,2)
Use of IPPs
Yes	72 (69.9)
No	31 (30.1)
Needlestick and sharps with safety device
Yes	11 (13.9)
No	68 (86.1)

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E-mail: cienciasaudecoletiva@fiocruz.br

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[1] Collaborations

EIG La-Rotta was the initiator of the project and designed the study with FH Aoki and HR Correa-Filho. CM Pertuz, DD Trevisan, AR Camisão and CS Garcia collected data. CM Pertuz, CS Garcia and IOC Miquilin assisted in data analysis and in writing the text in conjunction with EIG La-Rotta. EIG La-Rotta, HR Correa-Filho and FH Aoki wrote the manuscript. All authors read and approved the final manuscript.