AWARENESS AND PRACTICE OF INJECTION SAFETY AMONG THE STAFF NURSES WORKING IN EL-BEYDA MEDICAL CENTER

Background: Needlestick injuries (NSIs) are a major occupational hazard for health care workers(HCWs), particularly nurses, and are an important route of transmission for blood-borne infectionssuch as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV).Injection safety remains a neglected area in many low- and middle-income countries, and data fromLibyan hospitals are scarce. Objectives: To assess nurses’ awareness and practices related to injection safety, to determine theprevalence and patterns of NSIs, and to identify selected factors associated with NSIs among nursesworking in El-Beyda hospitals, Libya. Methods: A hospital-based cross-sectional study was conducted among 220 nurses working indifferent departments of El-Beyda hospitals. Data were collected using a structured, self-administeredquestionnaire and an observation checklist. The questionnaire assessed socio-demographic andprofessional characteristics, awareness of injection safety, self-reported injection practices, historyand circumstances of NSIs, HBV vaccination status, and previous training. Descriptive statistics wereused to summarize the data, and the chi-square (χ²) test was applied to examine associations betweenNSI occurrence and selected variables. A p-value of <0.05 was considered statistically significant. Results: Most participants were female (77.0%) and aged 20–30 years (43.18%). Overall, nursesdemonstrated generally good awareness of injection safety; the majority recognized that NSIs cantransmit blood-borne infections and were aware of key preventive measures such as handwashing,glove use, and proper sharps disposal. Nevertheless, unsafe injection practices were common. Morethan three-quarters of nurses reported always or frequently recapping needles after use, a considerableproportion reported bending needles before disposal, and nearly one-third admitted occasional reuseof syringes or needles. Only about one-third always used gloves when administering injections.The prevalence of NSIs was high: approximately 66.8% of nurses reported having experienced at leastone NSI, and more than one-third reported multiple NSIs. Hasty work and needle recapping were themost frequently reported contributing factors, followed by lack of precautions during blood drawingand intravenous (IV) insertion. HBV vaccination coverage was very low; only 22.27% of nursesreported being vaccinated against HBV. None of the nurses reported formally documenting their NSIsthrough an institutional reporting system.There was a statistically significant association between NSI occurrence and years of work experience(χ² = 8.270, p = 0.016), with the highest NSI prevalence observed among nurses with 5–9 years ofexperience. Awareness level was also significantly associated with NSIs (χ² = 6.665, p = 0.036),although higher awareness was paradoxically linked to higher reported NSI prevalence, likelyreflecting reporting bias. No significant associations were found between NSIs and academicqualification, previous training on injection safety, or regular supervision (p > 0.05). Conclusion: Despite generally good awareness of injection safety among nurses in El-Beydahospitals, unsafe practices and a high prevalence of needlestick injuries persist. The combination offrequent NSIs, extremely low HBV vaccination coverage, and almost complete absence of NSIreporting indicates a serious and preventable occupational health problem. There is an urgent need for comprehensive interventions, including mandatory HBV vaccination for all at-risk staff, practicalskills-based training focused on eliminating needle recapping and other unsafe practices, ensuringadequate supplies of personal protective equipment and safety boxes, and establishing a simple,non-punitive NSI reporting and follow-up system to protect nurses and improve patient safety.