Evaluation of Post-exposure prophylactic measures after needle stick injury

Introduction: Needle stick injury (NSI) is a percutaneous piercing wound typically inflicted by sharp medical instrument. According to study in Baltimore USA, 99% of post-graduate residents suffered a NSI by the 5th year of their training and 53% of these NSI's involved a high risk patient. While it has the potential of transferring many microbes, transmission of Hepatitis B, C and Human Immunodeficiency Virus is important. It was estimated by WHO that annually because of NSI there were 66,000 infections with HBV, 16,000 with HCV, and 1,000 with HIV worldwide. Objectives: An Evaluation of Post Exposure Prophylactic (PEP) Measures taken by Dental Surgeons in Rawalpindi and Islamabad after Needle Stick Injury.

Materials and methods: A cross-sectional study was carried out in dental hospitals across Rawalpindi and Islamabad. Non-probability convenience sampling technique was adopted. A specially designed questionnaire with close ended questions was utilized. Data was analyzed using SPSS 18 (SPSS Inc, Chicago, IL, USA).

Results: A total of 110 dentists took part in the study. More than 89% of them took immediate steps of international PEP guidelines like checking the depth and contamination of the wound and rinsing with soap and water whereas less than 80 % encouraged bleeding from the site. Only 25% reported NSI to concerned authorities. More than 70% assessed the patient by asking about previous HCV, HBV and HIV infections, previous drug abuse and blood transfusion. More than 60% assessed the patient serologically. Self-screening was done by only a third these dental surgeons.

Conclusion: Dentists in Rawalpindi and Islamabad take adequate immediate measures after NSI but lack in patient risk assessment, self screening and reporting of the incident to the higher authority.