Die Krankheitserreger, deren Übertragung durch Nadelstichverletzungen (NSV) die größte Bedeutung haben, sind das Hepatitis-B-Virus (HBV), das Hepatitis-CVirus (HCV) und das Human-Immundefi zienz-Virus (HIV). Zielsetzung dieser Studie war es, die zum Thema Nadelstichverletzungen veröffentlichte Literatur kritisch zu bewerten und zusammenzufassen. Dabei lag der Schwerpunkt auf Studien, die Effektivität und Kosten aspekte der Ein führung sicherer Geräte und anderer präventiver Maßnahmen in Krankenhäusern evaluiert haben.
The pathogens of greatest concern transmitted by needlestick injuries (NSI) include hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV). This study aims to review and summarize literature on NSI, focusing on the effectiveness and cost aspects of safer devices and preventive measures in hospitals. A comprehensive search on MEDLINE yielded over 2,300 publications, from which 61 intervention studies were selected for a Quality Based Critical Review (QBCR). These studies were evaluated using quality indicators, alongside analyses of costs and benefits related to safer device implementation. Nurses and physicians, having the most patient contact, reported the highest NSI incidence, particularly in patient and operating rooms. However, underreporting complicates accurate risk estimates. Most intervention programs, despite varying methodological quality, indicated that engineering controls, especially safety-designed devices, effectively reduced reported NSI. Few studies examined the cost-effectiveness of such devices, suggesting that complete substitution may not be cost-neutral for hospitals. Methodological inconsistencies in these studies prevent firm conclusions, highlighting the need to consider societal and intangible costs and benefits in overall assessments.
