Reducing needle stick injury in an indian tertiary care hospital over a decade: lessons learned using a quality improvement approach

Needle stick injuries (NSIs) remain a significant occupational hazard among healthcare workers (HCWs), exposing personnel to blood-borne pathogens. Evidence regarding long-term NSI trends and the effectiveness of sustained prevention strategies in resource-constrained healthcare settings remains limited. This study evaluated the epidemiology of NSIs over a 14-year period at a tertiary care teaching hospital in India and the impact of implemented quality-improvement (QI)-driven prevention intervention. A retrospective observational surveillance study was conducted between January 2010 and December 2023 at a 400-bed tertiary care hospital. The study included all reported NSIs ( n = 910) among doctors, nurses, technicians, and housekeeping attendants. Both contaminated and non-contaminated percutaneous injuries caused by needles and other sharp devices were analyzed. Information regarding healthcare worker category, mechanism of injury, source device, and intervention outcomes was obtained from institutional surveillance records. Descriptive statistics were used to summarize injury patterns. Differences between HCW were assessed using the chi-square test, while temporal trends in annual NSI counts were evaluated using quasi-poisson regression. Statistical significance was defined as p < 0.05. A total of 910 NSIs were reported during the study period. Nurses ( n = 395, 43.4%) accounted for the largest proportion NSI among HCW categories (χ² = 82.29, p < 0.001). Surgical needles and blades, sharps disposal activities, and blood collection procedures were the most common causes of injury. Trend analysis demonstrated a significant decline in NSI occurrence over time, corresponding to an average annual reduction of 3.6% (incidence rate ratio 0.964, p = 0.024). Introduction of safety intravenous cannulas, safety lancet devices, improved sharps disposal practices, continuous staff education, and QI initiatives were associated with substantial reductions in procedure-specific injuries. No occupational seroconversion was identified among exposed healthcare workers during the study period. A sustained, multifaceted occupational safety program integrating surveillance, infection prevention and control measures, QI methodology, and safety-engineered devices (SED) was associated with a significant reduction in NSI over time. These findings highlight the value of combining engineering controls with continuous monitoring and staff engagement to strengthen healthcare worker safety in resource-limited settings.