Improving Knowledge of Needle-Stick Injury Prevention: A Two-Cycle Clinical Audit From Sudan

Background Needle-stick injuries (NSIs) remain a major occupational hazard for healthcare workers, exposing them to blood-borne infections. Globally recognized occupational health standards emphasize structured training, safe sharps handling practices, and timely access to post-exposure prophylaxis (PEP). This audit evaluated staff knowledge and awareness of NSI prevention and management in a Sudanese teaching hospital, aiming to identify gaps and assess the impact of targeted interventions. Methods A two-cycle clinical audit was conducted over twelve months (September 2024-August 2025) at Bashair University Hospital. A structured, self-administered questionnaire was distributed to doctors, nurses, and laboratory technicians in both cycles (n = 90 per cycle). The tool assessed knowledge of NSI risk pathogens, immediate first-aid response, PEP initiation, sharps disposal practices, vaccination awareness, and reporting procedures. Interventions included structured teaching sessions, posters, departmental reinforcement, and distribution of guideline summaries. Data were analyzed descriptively and compared between cycles. Results Knowledge of HBV as the most common pathogen improved substantially among doctors (15.8%→81.2%), nurses (15.8%→100%), and technicians (65%→100%). Awareness of immediate wound washing also improved, reaching 100% among nurses and technicians. Understanding of PEP as medication increased markedly (doctors: 52.6%→93.8%; nurses: 52.6%→100%; technicians: 25%→100%). However, awareness of formal reporting systems declined sharply among doctors (89.5%→12.5%) and technicians (50%→5%). Participation in refresher training fell across groups, while perceived training adequacy showed only partial improvement. Conclusion Targeted interventions improved healthcare workers' knowledge of NSI prevention and management; however, persistent gaps in training sustainability and reporting culture indicate that these gains may not be maintained without continued institutional support. Sustained improvement requires structured refresher programs, robust reporting systems, and administrative commitment to embedding sharps safety into routine practice.