Skip to main content
Download PDF

Prevalence of needle-stick injury in Iranian nurses: an updated systematic review and meta-analysis of observational studies

BMC Nursing volume 23, Article number: 268 (2024) Cite this article

Abstract

Background

The aim of this study was to conduct a systematic review and meta-analysis to estimate the prevalence of needle-stick injury among Iranian nurses.

Methods

We conducted a systematic review and meta-analysis to estimate the prevalence of needle-stick injury among Iranian nurses. A comprehensive search of Web of Science, PubMed, Scopus, Scientific Information Database, and MagIran was performed, yielding 29 observational articles comprising 8842 nurses. The studies ranged from 2006 to 2023, with sample sizes varying from 68 to 1555 individuals. Methodological quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist. The pooled prevalence was calculated using the random-effects model, and subgroup analyses were conducted based on hospital type and gender. The data was analyzed using Stata software version 16.

Results

The pooled prevalence of needle-stick injury among Iranian nurses was found to be 46% (95% Confidence Interval [CI]: 39-53%). Subgroup analysis revealed significant difference in prevalence between teaching hospitals (47%; 95% CI: 39-54%) and military hospitals (38%; 95% CI: 31.1-44%). The prevalence of NSI in region 1 (Tehran and surrounding provinces) and other regions was 45.1% (95% CI: 37-54%) and 49.17% (95% CI: 36.5-61.7%). Gender-based analysis showed higher prevalence in women (58%; 95% CI: 44-71%) compared to men (55%; 95% CI: 43-66%).

Conclusion

Needle stick injuries has a high prevalence among Iranian nurses, especially nurses working in teaching hospitals. Therefore, it seems necessary to use interventions to reduce it.

Peer Review reports

Introduction

Needle-stick injury (NSI) poses a significant occupational hazard for healthcare workers, particularly nurses, involving the unintended penetration of a needle into the skin [1]. While NSI is preventable, its occurrence exposes individuals to over 20 different blood-borne pathogens [2]. Annually, more than two million healthcare workers, facing potential exposure to blood-borne infectious diseases such as hepatitis B and C, and human immunodeficiency virus (HIV) [3] undergo NSIs. Additionally, NSI has been implicated in the transmission of other infections, including diphtheria, herpes, malaria, and syphilis [4]. Beyond the physical risks, victims may encounter psychiatric complications such as post-traumatic stress disorder and psychological distress [5].

The repercussions of NSI extend beyond the individual health worker, impacting their well-being and creating fear and anxiety that can diminish the quality of life and care they provide. The economic, clinical, and human burden of these injuries necessitates careful consideration by healthcare managers [6, 7]. In resource-limited healthcare settings like Iran, the economic burden of NSI is particularly pronounced [7, 8]. Contrary to expectations, the costs associated with NSIs, both direct and indirect, are considerably high, while the costs of prevention remain comparatively low [9, 10]. In Japan, for instance, the estimated costs of NSIs are substantial, averaging $577 per injury and escalating to $1333, $936, and $2743 if infected with hepatitis B and C, and HIV, respectively [11]. Despite the potential benefits of rapid and accurate NSI reporting for treatment, more than half of Iranian nurses refrain from reporting their injuries due to various reasons [12].

A recent study on the prevalence of NSI in Iranian hospitals indicated a noteworthy prevalence rate of 42.5% among healthcare workers [13]. Given the occupational nature of nursing, nurses appear to be more susceptible to NSI than their counterparts in other healthcare professions [14, 15]. Notably, various studies in Iran have reported divergent prevalence rates of NSI among nurses, ranging from 26–81% [16, 17]. To address this issue, it is crucial to establish a clear understanding of the current prevalence of NSI among Iranian nurses. Consequently, this systematic review and meta-analysis aim to provide a comprehensive estimate of the overall prevalence of NSI in this specific population.

Methods

This study was a systematic review and meta-analysis based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines but its protocol was not recorded in the international prospective register of systematic reviews (PROSPERO).

Search strategy

In this study, studies that were published in English and Persian from 2006 till July 2023 were included. Studies that the prevalence of NSI among Iranian nurses without a time limit was investigated. For this purpose, databases, Web of Science, PubMed and Scopus, Scientific Information Database (SID), MagIran were searched with the following keywords: “needlestick injuries” OR “needle? stick Injur*” OR “needle? stick*” OR “sharps injur*” AND “health Personnel” OR “health personnel” OR “health care provider*” OR “healthcare worker*” OR “health care professional*” OR “nurse AND “Iran” OR “Iran*” OR “Islamic Republic of Iran”. The sources of the collected articles were also reviewed for access to other articles to ensure that all potentially relevant articles were collected.

Selection of studies and data extraction

We reviewed all studies published in Persian and English that examined the prevalence of NSI in Iranian nurses. Inclusion criteria were: observational studies, access to the full text of the article, performing a study on nurses, and the existence of essential information in the article. In some studies, the prevalence of NSI was observed in all healthcare workers. Those articles were reviewed, and if the prevalence was reported separately in nurses, we would record it, and if the data were presented separately, we would calculate the prevalence in nurses. Studies performed on other healthcare workers or students and studies that did not report an outbreak, or whose full text was not available, were excluded. According to the inclusion and exclusion criteria, the two researchers independently reviewed the titles and abstracts of the articles and separated the relevant items (first author, year of publication, sample size, mean age of nurses, and place), and recorded the information required for analysis in a pre-prepared form. Disagreements between the two reviewers were resolved by discussion.

Quality assessment

The included studies underwent an evaluation of their methodological quality and risk of bias using The Joanna Briggs Institute Critical Appraisal tool designed for cross-sectional studies. This checklist focuses on evaluating the quality of cross-sectional studies, covering 9 domains. An overall score exceeding 7 indicates high quality, while a score between 4 and 6 suggests medium quality, and a score below 3 indicates poor quality [17].

Statistical analysis

Given that the prevalence of NSI had a normal distribution, we calculated the variance of each study through the variance of the normal distribution, as var \((\bar x) = {\raise0.7ex\hbox{${{\sigma ^2}}$} \!\mathord{\left/{\vphantom {{{\sigma ^2}} n}}\right.\kern-\nulldelimiterspace}\!\lower0.7ex\hbox{$n$}}\). The weight of each study was proportional to its inverse variance. I [2] index and Cochran’s Q test were used to evaluate the heterogeneity of data. If the I [2] index is more than 50%, or the probability value of the Q test is significant, the random-effects model is used, otherwise, the fixed effects model is used. This index can estimate the observed differences between studies due to heterogeneity. A value of 0% indicates no heterogeneity and a value of 100% indicates the highest level of heterogeneity [18]. To calculate the prevalence of NSI by hospital type and gender, subgroup analysis and to investigate the relationship between the prevalence of NSI and the year of publication and sample size, meta-regression was used. All analyzes were performed with STATA version 16.

Results

A total of 29 articles were obtained. Seventy-seven articles were removed due to duplication and 232 articles remained. The two authors independently reviewed the titles and abstracts of the articles, excluded 198 unrelated articles, and reviewed the full text of the remaining 34 articles. Five studies were omitted due to failure to report essential information (Fig. 1).

Fig. 1
figure 1

Articles selection process

Full size image

Characteristics of included studies

A total of 29 observational articles performed on 8842 nurses were analyzed. The earliest and latest articles were published in 2006 and 2023, respectively. The sample size in included studies ranged from 68 to 1555 people. Three studies were conducted in military hospitals and the rest in teaching hospitals. In terms of methodological quality, all studies had the lowest bias (Table 1).

Table 1 Characteristics of the included studies in the meta-analysis of the prevalence of NSI among nurses in Iran, 2023
Full size table

Prevalence of NSI

The prevalence of NSI in selected studies ranged from 19.8 to 81.3%. The pooled prevalence of NSI using the random-effects model was 46% (95% Confidence interval [CI]: 39-53%) (Fig. 2). The results of subgroup analysis showed that the prevalence of NSI in teaching hospitals (47%; 95% CI: 39-54%) was significantly higher than in military hospitals (38%; 95% CI: 31.1-44%) (p = 0.04, Q = 4.06). Also, the pooled prevalence of NSI in studies conducted in region 1 (Tehran and surrounding provinces) was 45.1% (95% CI: 37-54%) and in other regions was 46.5% (95% CI: 36.5-61.7%) (p = 0.437, Q = 0.05) (Table 2).

Quality assessment

The quality of 29 included articles were high or medium that it was according to the number of the overall score of their quality assessment. Articles were high quality had an overall score exceeding 7 indicates and articles were medium quality had a score between 4 and 6 suggests medium quality. The prevalence of NSI in high (n = 7) and medium (n = 22) quality studies was 46.1% (95% CI: 30.6-61.6%) and 45.6% (95% CI: 39.6-51.7%), respectively (p = 0.956).

Fig. 2
figure 2

Funnel plots of the pooled prevalence of the NSI among the Iranian nurses

Full size image
Table 2 The results of subgroup analysis
Full size table

The prevalence of NSI in men and women was also reported separately in nine studies. Accordingly, the prevalence of NSI in men and women was 55% (95% CI: 43-66%) and 58% (95% CI: 44-71%), respectively. The prevalence of NSI was higher in men in region 1 than in other regions (57.2% vs. 50.8%); but the prevalence of NSI in women in region 1 was lower than in other regions (55% vs. 61.2%). The present meta-analysis was highly heterogeneous due to differences in study quality, study methodology, and sample size between studies (I2 = 97.2%, p = 0.01). Therefore, we used the random-effects model to adjust the observed variability. The results of meta-regression showed that there was no relationship between the prevalence of NSI and the year of publication of articles and the sample size of articles.

Publication bias

To evaluate the publication bias, we used funnel plots and Egger’s test, in which each point on the funnel plot represents a separated study, and the symmetrical distribution indicates that there is no publication bias. According to Egger’s test, the publication bias was not significant (p = 0.833) (Fig. 3).

Fig. 3
figure 3

Publication bias

Full size image

Discussion

The results of this study indicate that nearly half of Iranian nurses have experienced NSIs. This prevalence rate is higher than those reported by two separate studies conducted in Turkey and Qatar, which found that 30.1% and 20.9% of nurses, respectively, had experienced NSIs [48, 49].

Xu et al. in 2022 conducted a systematic review and meta-analysis study into the prevalence of NSIs among nursing students. The results showed that nursing students reported a notable 35% prevalence of NSIs. Furthermore, regional variations were observed, with Asia exhibiting the highest prevalence at 39.7%, highlighting differences in the incidence of NSIs among nursing students across geographical areas [50]. In another systematic review and meta-analysis study that was done by Dechasa Adare Mengistu et al. in 2021, the global combined prevalence of needle stick injuries among healthcare professionals throughout their career and in the preceding year was 56.2% (95% CI: 47.1, 64.9) and 32.4% (95% CI: 22.0, 44.8), respectively [51]. And a comprehensive systematic review and meta-analysis by Abdelmalik et al. (2023) underscore the global prevalence of NSI among nurses, revealing an overall pooled prevalence of 40.97%. Their study further delineates variations in NSI prevalence based on World Health Organization (WHO) regions, socioeconomic development index (SDI), and the developmental status of countries. In particular, Southeast Asia exhibited the highest prevalence at 49.9%, while the United States of America reported the lowest at 25.1%. Additionally, the study highlights a distinction between developed (30.5%) and developing countries (46.6%), with low-middle SDI countries experiencing the highest NSI prevalence at 48.9% [52].

The high prevalence of NSIs in Iran may be due to factors such as the shortage of nursing staff caused by retirement and immigration, which leads to the employment of newly graduated nurses who lack clinical and nursing experience. It is important to note that the high prevalence of NSIs in Iran is not limited to nurses, but also affects other healthcare workers. A meta-analysis by Ghani Gheshlagh et al. (2018) revealed that 44% of nurses and 41% of other healthcare workers had experienced NSIs [13]. These findings show an increase in the prevalence of NSIs compared to previous meta-analyses. Moreover, the prevalence of NSIs is higher among female nurses than male nurses, which may be attributed to the higher levels of occupational stress experienced by women.

The prevalence of NSIs in female nurses was higher than that of male nurses in our study. We attributed this finding to the high level of occupational stress experienced by women. This result is consistent with a systematic review and meta-analysis by Hassanipour et al. (2021), which examined the prevalence of NSIs among healthcare workers and found that it was higher in women than in men [53]. The reason for the high prevalence of NSIs in women may be due to their busyness and responsibility [32]. However, some other studies have reported that the prevalence of NSIs is higher in men than in women [54,55,56]. These conflicting results indicate that NSIs are very common among nurses, regardless of their gender. Teaching hospitals had a higher prevalence of NSI than military hospitals. According to the Iranian Ministry of Health’s guidelines, nursing graduates are required to work in teaching hospitals for one to two times the length of their studies. The high prevalence of NSI in teaching hospitals could be due to the large number of inexperienced nurses working there.

Considering the lack of relationship between the year of publication of articles and the prevalence of NSIs, it can be inferred that NSIs have not changed significantly from 2006 to 2023. In other words, the general policies regarding the prevention and reduction of NSIs have not been effective in this 17-year period.

Strengths of the study

In conducting this systematic review and meta-analysis on the prevalence of needlestick injuries (NSI) among Iranian nurses, several strengths contribute to the credibility and reliability of the findings.

  1. 1.

    Comprehensive Search Strategy: Our study employed a thorough search strategy encompassing diverse databases and languages, ensuring the inclusion of a wide array of relevant studies on NSI prevalence among Iranian nurses.

  2. 2.

    Clear Inclusion Criteria: Well-defined inclusion criteria, including specific study types, language parameters, and a defined timeframe, enhance the transparency of study selection, providing a solid foundation for the research.

  3. 3.

    Adherence to PRISMA Guidelines: The adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines underscores the methodological rigor of our study, reinforcing the systematic and transparent nature of our approach.

  4. 4.

    Methodological Quality Assessment: Utilizing the Joanna Briggs Institute Critical Appraisal tool for cross-sectional studies to assess methodological quality and bias adds a layer of robustness to the study, ensuring a critical evaluation of the included articles.

  5. 5.

    Statistical Rigor: The use of advanced statistical methods, including subgroup analysis, meta-regression, and consideration of heterogeneity, not only reflects the depth of our analysis but also contributes to the validity of the pooled prevalence estimate.

Limitations of the study

While our study provides valuable insights into NSI prevalence among Iranian nurses, it is important to acknowledge certain limitations that may influence the interpretation of our findings.

  1. 1.

    Protocol Registration Absence: The absence of our study protocol in the international prospective register of systematic reviews (PROSPERO) limits the transparency of our methods, potentially impacting the reproducibility of our study.

  2. 2.

    Language Bias: Our study’s inclusion of articles only in English and Persian may introduce language bias, potentially excluding pertinent studies published in other languages.

  3. 3.

    Heterogeneity Effect: The identified high heterogeneity in our study, addressed through the use of a random-effects model, underscores the variability between studies, potentially impacting the reliability of the pooled prevalence estimate.

Overall GRADE assessment

Considering the GRADE [57] approach, the quality of evidence for the study results varies across domains. While the study exhibits strengths in addressing publication bias and heterogeneity, limitations related to study protocol registration, language bias, and regional focus contribute to a moderate overall quality of evidence. The transparency in reporting these considerations enhances the reader’s ability to critically evaluate the reliability and generalizability of the presented results.

GRADE assessment of study results

1. Study limitations

  • Assessment: The study clearly outlines its inclusion criteria, methodology, and statistical analyses. However, the absence of a registered protocol in PROSPERO and the focus on studies published in English and Persian may introduce limitations.

  • GRADE Evaluation: Low to moderate quality.

2. Inconsistency

  • Assessment: The study acknowledges high heterogeneity, which is appropriately addressed using a random-effects model. Subgroup analyses were conducted to explore potential sources of variability.

  • GRADE Evaluation: Moderate quality.

3. Indirectness

  • Assessment: The study primarily focuses on Iranian nurses, potentially limiting generalizability to a global context. The regional and hospital-type variations are considered in subgroup analyses.

  • GRADE Evaluation: Moderate quality.

4. Imprecision

  • Assessment: The study provides a large sample size and a narrow confidence interval for the pooled prevalence estimate. However, variability in sample sizes across individual studies is noted.

  • GRADE Evaluation: Moderate to high quality.

5. Publication bias

  • Assessment: Publication bias was assessed using funnel plots and Egger’s test, and the results indicated no significant bias.

  • GRADE Evaluation: High quality.

Overall GRADE assessment

Considering the GRADE approach, the quality of evidence for the study results varies across domains. While the study exhibits strengths in addressing publication bias and heterogeneity, limitations related to study protocol registration, language bias, and regional focus contribute to a moderate overall quality of evidence.

Conclusion

NSI is highly prevalent in Iranian nurses, so that nearly half of them have experienced NSI. The highest prevalence of NSI was related to female nurses and nurses working in teaching hospitals. Considering the high prevalence of NSI among nurses, it seems necessary to hold training courses on dealing with job risks, minimizing the stress of the work environment, and employing less experienced nurses alongside experienced nurses.

Data availability

Data will be made available on request.

Abbreviations

CI:

Confidence Interval

HIV:

Human Immunodeficiency Virus

NSI:

Needle Stick Injury

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

PROSPERO:

The International Prospective Register of Systematic Reviews

SID:

Scientific Information Database

STROBE:

STrengthening the Reporting of OBservational Studies in epidemiology

References

  1. Al Qadire M, Ballad CAC, Al Omari O, Aldiabat KM, Shindi YA, Khalaf A. Prevalence, student nurses’ knowledge and practices of needle stick injuries during clinical training: a cross-sectional survey. BMC Nurs. 2021;20(1):1–7. https://0-doi-org.brum.beds.ac.uk/10.1186/s12912-021-00711-2.

    Article  Google Scholar 

  2. Singru SA, Banerjee A. Occupational exposure to blood and body fluids among health care workers in a teaching hospital in Mumbai, India. Indian J Community Medicine: Official Publication Indian Association Prev Social Med. 2008;33(1):26–32. https://0-doi-org.brum.beds.ac.uk/10.4103/0970-0218.39239.

    Article  Google Scholar 

  3. Pervaiz M, Gilbert R, Ali N. The prevalence and underreporting of needlestick injuries among dental healthcare workers in Pakistan: A systematic review. International journal of dentistry. 2018;2018. https://0-doi-org.brum.beds.ac.uk/10.1155/2018/9609038.

  4. Canadian Centre for Occupational Health and, Nasi S-CCOHS. 2015, http://www.ccohs.ca/oshanswers/diseases/needlestick_injuries.html.

  5. Naghavi S, Shabestari O, Alcolado J. Post-traumatic stress disorder in trainee doctors with previous needlestick injuries. Occup Med. 2013;63(4):260–5. https://0-doi-org.brum.beds.ac.uk/10.1093/occmed/kqt027.

    Article  CAS  Google Scholar 

  6. Jackson AP, Almerol LA, Campbell J, Hamilton L. Needlestick injuries: the role of safety-engineered devices in prevention. Br J Nurs. 2020;29(14):S22–30. https://0-doi-org.brum.beds.ac.uk/10.12968/bjon.2020.29.14.S22.

    Article  PubMed  Google Scholar 

  7. Rezaei S, Hajizadeh M, Zandian H, Fathi A, Nouri B. Period prevalence and reporting rate of needlestick injuries to nurses in Iran: a systematic review and meta-analysis. Res Nurs Health. 2017;40(4):311–22. https://0-doi-org.brum.beds.ac.uk/10.1002/nur.21801.

    Article  PubMed  Google Scholar 

  8. Zhang L, Ai Y, Liu J, Yue N, Xuan J, Bal V, et al. Economic burden of needlestick injuries among healthcare workers in China. J Med Econ. 2020;23(7):683–9. https://0-doi-org.brum.beds.ac.uk/10.1080/13696998.2020.1737534.

    Article  PubMed  Google Scholar 

  9. Cooke CE, Stephens JM. Clinical, economic, and humanistic burden of needlestick injuries in healthcare workers. Med Devices. 2017;10:225. https://0-doi-org.brum.beds.ac.uk/10.2147/MDER.S140846.

    Article  Google Scholar 

  10. Mannocci A, De Carli G, Di Bari V, Saulle R, Unim B, Nicolotti N, et al. How much do needlestick injuries cost? A systematic review of the economic evaluations of needlestick and sharps injuries among healthcare personnel. Infect Control Hosp Epidemiol. 2016;37(6):635–46. https://0-doi-org.brum.beds.ac.uk/10.1017/ice.2016.48.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Kunishima H, Yoshida E, Caputo J, Mikamo H. Estimating the national cost burden of in-hospital needlestick injuries among healthcare workers in Japan. PLoS ONE. 2019;14(11):e0224142. https://0-doi-org.brum.beds.ac.uk/10.1371/journal.pone.0224142.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Ghanei Gheshlagh R, Nazari M, Baghi V, Dalvand S, Dalvandi A, Sayehmiri K. Underreporting of needlestick injuries among healthcare providers in Iran: a systematic review and meta-analysis. J Hayat. 2017;23(3):201–13.

    Google Scholar 

  13. Ghanei Gheshlagh R, Aslani M, Shabani F, Dalvand S, Parizad N. Prevalence of needlestick and sharps injuries in the healthcare workers of Iranian hospitals: an updated meta-analysis. Environ Health Prev Med. 2018;23(1):1–11. https://0-doi-org.brum.beds.ac.uk/10.1186/s12199-018-0734-z.

    Article  Google Scholar 

  14. Amira C, Awobusuyi J. Needle-stick injury among health care workers in hemodialysis units in Nigeria: a multi-center study. Int J Occup Environ Med. 2014;5(1):1.

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Gopar-Nieto R, Juárez-Pérez CA, Cabello-López A, Haro-García LC, Aguilar-Madrid G. Panorama De heridas por objetos punzocortantes en trabajadores intrahospitalarios. Revista médica Del Instituto Mexicano Del Seguro Social. 2015;53(3):356–61.

    PubMed  Google Scholar 

  16. Mehravar F, Samad Zade S, Rezapour Esfahani M, Zare M. The prevalence of injuries caused by contaminated and victorious instrument and the factors affecting it. Navid No. 2017;20(63):28–35.

    Google Scholar 

  17. Moola S, Munn Z, Tufanaru C, Aromataris E, Sears K, Sfetcu R, et al. Chapter 7: systematic reviews of etiology and risk. Joanna Briggs Inst Reviewer’s Man Joanna Briggs Inst. 2017;5:217–69.

    Google Scholar 

  18. Ades A, Lu G, Higgins J. The interpretation of random-effects meta-analysis in decision models. Med Decis Making. 2005;25(6):646–54. https://0-doi-org.brum.beds.ac.uk/10.1177/0272989X05282643.

    Article  CAS  PubMed  Google Scholar 

  19. Roozbeh J, Malekmakan L, Mashayekh M, Dehghani A, Ansari S, Akbarialiabad H, et al. Exposure to needle stick injuries among health care workers in hemodialysis units in the southwest of Iran: a cross-sectional study. BMC Health Serv Res. 2023;23(1):521.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Majdabadi MA, Yazdanirad S, Yarahmadi R, Abolghasemi J, Ebrahimi H. The impact of emotional intelligence and personality traits on the occurrence of unsafe behaviors and needle stick injuries among the nurses. Heliyon. 2022;8(6):e09584.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Rashidi R, Khoshnamvand M, Mohammadi R, Anbari K. The frequency and causes of occupational injuries caused by Needle Stick among nurses in educational hospitals in Khorramabad in 2020. Yafteh. 2021;22(4):107–19.

    Google Scholar 

  22. Joukar F, Mansour-Ghanaei F, Naghipour M, Asgharnezhad M. Needlestick injuries among healthcare workers: why they do not report their incidence? Iran J Nurs Midwifery Res. 2018;23(5):382–7. https://0-doi-org.brum.beds.ac.uk/10.4103/ijnmr.IJNMR_74_17.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Solale Ramzani S, Siavash E, Jamshid Yazdani C. Evaluation of the prevalence of needlestick injuries and related factors among nurses in Sari during 2017. J Health Res Community. 2018;4(3):34–41.

    Google Scholar 

  24. Ghasemi M, Khabazkhoob M, Hashemi H, Yekta A, Nabovati P. The incidence of needle stick and sharp injuries and their associations with visual function among hospital nurses. J Curr Ophthalmol. 2017;29(3):214–20.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Abareshi F, Hekmatshoar R, Zokaei M, Akrami R. Occupational exposure to needle stick and its risk factors among healthcare workers in one of Sabzevar’s hospital. Iran Occup Health. 2018;14(6):70–7. https://0-doi-org.brum.beds.ac.uk/10.1016/j.joco.2017.06.001.

    Article  Google Scholar 

  26. mehravar f. Zade ss, Esfahani mR, zare m. The prevalence of injuries caused by contaminated and victorious instrument and the factors affecting it. Navid no. 2017;20(63):28–35.

    Google Scholar 

  27. Jahangiri M, Rostamabadi A, Hoboubi N, Tadayon N, Soleimani A. Needle Stick injuries and their related safety measures among nurses in a University Hospital, Shiraz, Iran. Saf Health Work. 2016;7(1):72–7.

    Article  PubMed  Google Scholar 

  28. Hajivandi A, Ramavandi B, Rezaeeshiri A, Ahmadi B. A survey on the sharpand cutting wastes injury in nurses of the Bushehr city hospitals in the year 1392. J Urmia Nurs Midwifery Fac. 2015;13(6):490–7. https://0-doi-org.brum.beds.ac.uk/10.1016/j.shaw.2015.07.006.

    Article  Google Scholar 

  29. Mahmoudi N, Sepandi M, Mohammadi AS, Masoumbeigi H. Epidemiological Aspects of Needle Stick Injuries among nurses in a Military Hospital. Work. 2015;12(564):941–499.

    Google Scholar 

  30. Balouchi A, Shahdadi H, Ahmadidarrehsima S, Rafiemanesh H. The frequency, Causes and Prevention of Needlestick Injuries in nurses of Kerman: a cross-sectional study. J Clin Diagn Res. 2015;9(12):13–9. https://0-doi-org.brum.beds.ac.uk/10.7860/JCDR/2015/16729.6965.

    Article  Google Scholar 

  31. Mirzaei-Alavijeh M, Jalilian F, Karami-Matin B, Ghaderi A, Mahboubi M, Janizadeh R, et al. Needle-Stick and medication errors in emergency nurses are due to their job stresses? A descriptive study in Kermanshah Hospitals, Iran. J Biol Today’s World. 2014;3(8):185–8. https://0-doi-org.brum.beds.ac.uk/10.15412/J.JBTW.01030805.

    Article  Google Scholar 

  32. Ghanei Gheshlagh R, Zahednezhad H, Shabani F, Hameh M, Ghahramani M, Farajzadeh M, et al. Needle Sticks Injuries and its related factors among nurses. Iran J Nurs. 2014;27(89):21–9. https://0-doi-org.brum.beds.ac.uk/10.29252/ijn.27.89.21.

    Article  Google Scholar 

  33. Bijani B. Epidemiology and risk factors of needle stick injuries. Adv Nurs Midwifery. 2013;22(78).

  34. Rezaei Sh RRN, Tamizi Z, Fallahi Khoshkenab M, Mohamad Nejad E. An investigation in to occupational hazard faced by nurses in pediatrics hospitals of Tehran University of Medical Sciences, 2006–2009. Int J Community Based Nurs Midwifery. 2013;1(4):200–7.

    Google Scholar 

  35. Tirgar A, Gholami F. A survey on Needlestick Injuries and related occupational factors among the nurses. Mod Rehabilitation. 2012;1(2):31–8.

    Google Scholar 

  36. Ehsani SR, Mohammadnejad E, Hadizadeh MR, Mozaffari J, Ranjbaran S, Deljo R, et al. Epidemiology of needle sticks and sharp injuries among nurses in an Iranian teaching hospital. Archives Clin Infect Dis. 2012;8(1):27–30. https://0-doi-org.brum.beds.ac.uk/10.5812/archcid.14409.

    Article  Google Scholar 

  37. Mohammadi N, Allami A, Malek Mohamadi R. Percutaneous exposure incidents in nurses: knowledge, practice and exposure to hepatitis B infection. Hepat Mon. 2011;11(3):186–90.

    PubMed  PubMed Central  Google Scholar 

  38. Bijani B, Sotudehmanesh S, Mohammadi N. Epidemiological features of needle stick injuries among nursing staff. J Guilan Univ Med Sci. 2011;77:61–8.

    Google Scholar 

  39. Rahnavard FRMS, Seyed Fazelpour F, Kazemnejad Leili E. Study factors related to report the needle stick and sharps injuries report by nursing staffs of the Educational and Therapeutic Centers of Guilan University of Medical Sciences, Rasht. Holist Nurs Midwifery J. 2011;21(1):30–7.

  40. Khalooei AIA, Hamzavinejad S, Rahmanian K. Study on epidemiology of needle stick injury among nursing personnel of Kerman university hospital, Kerman, Iran in 2006–2007. J Jahrom Univ Med Sci. 2010;7(3):42–9.

    Google Scholar 

  41. Mohammadi Nejad EEBM, Ehsani SR, Deljoo R. Needlestick injuries and reporting among emergency nurses in Tehran University of Medical Science. Iran J Infect Disease Trop Med. 2010;48(15):49–54.

    Google Scholar 

  42. Kazemi Galougahi MH. Evaluation of needle stick injuries among nurses of Khanevadeh Hospital in Tehran. Iran J Nurs Midwifery Res. 2010;15(4):172.

    Google Scholar 

  43. Mohammad Nejad EEBM. Epidemiologic aspects of the nurse’s occupational exposure to sharp objects. Iran J Infect Dis Trop Med. 2009;45(14):47–50.

    Google Scholar 

  44. Jonaidi Jafari N, Shasti M, Izadi M, Ranjbar R, Ghasemi M. Evaluation of frequency of exposure to medical sharp devices among nurses of a university hospital. J Mil Med. 2008;10(2):119–28.

    Google Scholar 

  45. Azadi M. Needle stick injuries among clinical nurses. Iran J Nurs. 2007;20(49):6–14.

    Google Scholar 

  46. Askarian M, Shaghaghian S, McLaws M-L. Needlestick injuries among nurses of Fars province. Iran Annals Epidemiol. 2007;17(12):988–92. https://0-doi-org.brum.beds.ac.uk/10.1016/j.annepidem.2007.07.106.

    Article  Google Scholar 

  47. Ebrahimi H, Khosravi A. Needlestick injuries among nurses. J Res Health Sci. 2007;7(2):56–62.

    CAS  PubMed  Google Scholar 

  48. Irmak Z. Needlestick and sharps injury among nurses at a state hospital in Turkey. Australian J Adv Nurs. 2012;30(2):48–55.

    Google Scholar 

  49. Shah SF, Bener A, Al-Kaabi S, Al Khal AL, Samson S. The epidemiology of needle stick injuries among health care workers in a newly developed country. Saf Sci. 2006;44(5):387–94. https://0-doi-org.brum.beds.ac.uk/10.1016/j.ssci.2005.11.002.

    Article  Google Scholar 

  50. Xu X, Yin Y, Wang H, Wang F. Prevalence of needle-stick injury among nursing students: a systematic review and meta-analysis. Front Public Health. 2022;10:937887.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Mengistu DA, Tolera ST, Demmu YM. Worldwide Prevalence of Occupational exposure to needle Stick Injury among Healthcare Workers: a systematic review and Meta-analysis. Can J Infect Dis Med Microbiol. 2021;2021:9019534.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Abdelmalik MA, Alhowaymel FM, Fadlalmola H, Mohammaed MO, Abbakr I, Alenezi A, et al. Global prevalence of needle stick injuries among nurses: a comprehensive systematic review and meta-analysis. J Clin Nurs. 2023;32(17–18):5619–31.

    Article  PubMed  Google Scholar 

  53. Hassanipour S, Sepandi M, Tavakkol R, Jabbari M, Rabiei H, Malakoutikhah M, et al. Epidemiology and risk factors of needlestick injuries among healthcare workers in Iran: a systematic reviews and meta-analysis. Environ Health Prev Med. 2021;26(1):1–16. https://0-doi-org.brum.beds.ac.uk/10.1186/s12199-021-00965-x.

    Article  Google Scholar 

  54. Habibzadeh H, Jafarizadeh H, Motaarafi H. A study on the risk factors of needle stick and contact with secretions from patients among the students of Urmia university of medical sciences. Nurs Midwifery J. 2016;14(6):496–503.

    Google Scholar 

  55. Miraki P, Bidarpoor F, Rostami S, Khairollahi S, Rahmani K. Occupational exposures and factors affecting its prevalence in Besat Hospital of Sanandaj in 2014. J Rafsanjan Univ Med Sci. 2015;14(7):535–48.

    Google Scholar 

  56. Moradi A, Mostafavi E. The prevalence and causes of needle stick injuries among the primary health care workers of Bahar city, Hamadan Province. Iran Occup Health. 2010;7(2):39–42.

    Google Scholar 

  57. Guyatt G, Oxman AD, Akl EA, Kunz R, Vist G, Brozek J, et al. GRADE guidelines: 1. Introduction—GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64(4):383–94.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Not applicable.

Funding

None.

Author information

Authors and Affiliations

  1. Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Aram Halimi

  2. Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Aram Halimi

  3. Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran

    Reza Ghanei Gheshlagh

  4. Department of Medical Librarianship and Information Sciences, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran

    Masoumeh Ansari

  5. Student Research Committee, School of Health Management and Information Sciences Branch, Iran University of Medical Sciences, Tehran, Iran

    Masoumeh Ansari

  6. Department of Midwifery, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran

    Seyedeh Soma Zakariaee

  7. Department of Medical-Surgical Nursing, Faculty of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Mitra Zandi

Authors
  1. Aram Halimi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Reza Ghanei Gheshlagh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masoumeh Ansari
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Seyedeh Soma Zakariaee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mitra Zandi
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AH, MZ, and SSZ contributed to the design and performing systematic review, RGG and MA checked the data and conducted data analyses, and RGG and MZ contributed to writing and editing the paper. All the authors read and confirmed the final version of the manuscript.

Corresponding author

Correspondence to Mitra Zandi.

Ethics declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Halimi, A., Gheshlagh, R.G., Ansari, M. et al. Prevalence of needle-stick injury in Iranian nurses: an updated systematic review and meta-analysis of observational studies. BMC Nurs 23, 268 (2024). https://0-doi-org.brum.beds.ac.uk/10.1186/s12912-024-01914-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://0-doi-org.brum.beds.ac.uk/10.1186/s12912-024-01914-z

Keywords

BMC Nursing

ISSN: 1472-6955

Contact us