Comparing risk changes of needlestick injuries between countries adopted and not adopted the needlestick safety and prevention act: A meta-analysis

Objectives: To determine whether countries that adopted the Needlestick Safety and Prevention Act (NSPA) achieved a reduced risk of needlestick injuries (NSIs). Method: In this meta-analysis, 3 international databases (Embase, PubMed, and MEDLINE EBSCO) and 1 Chinese database (Airiti Library) were searched using appropriate keywords to retrieve relevant articles, including multiyear NSI incidences that were published after 2010. The Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies was used to evaluate article prevalence. A binary random-effects model was used to estimate risk ratio as summary effect. A log scale was used to evaluate differences in risk ratios of NSIs between countries that adopted versus those that did not adopt the NSPA. Results: In total, 11 articles were included in the meta-analysis from 9 countries, and NSI incidence rates were surveyed between 1993 and 2016. The risk ratios of NSIs in countries with and without the NSPA were 0.78 (95% CI, 0.67-0.91) and 0.98 (95% CI, 0.85-1.12), respectively, and the ratio of risk ratios was 0.79 (95% CI, 0.65-0.98). Reduction in NSI incidence was more prominent in nurses than in physicians. Conclusions: Our findings suggest that the mandatory use of safety-engineered medical devices in countries that adopted the NSPA had lower NSI incidence in healthcare workers compared with countries without needlestick safety and prevention regulatory policies. Further studies are needed to develop preventive strategies to protect against NSIs in physicians, which should be incorporated into the standards of care established by national regulatory agencies.