Comparing Devices and Training for Needlestick-Injury Prevention: A SystematicReview

Abstract

Background:
Needlestick injuries are frequent among nurses and dental assistants and carry substantial risk of blood borne infection. Safety engineered devices and education programmes are both promoted for prevention, yet their comparative effectiveness and feasibility for these staff groups remain uncertain.
Methods:
Studies that evaluated safety engineered needle devices, education or combined interventions to reduce needle related injuries in nurses or dental assistants were identified through PubMed and supplementary databases from inception to August 2025. Clinical trials, quasi experimental studies and cohort designs reporting injury incidence or rates were eligible. Thirteen studies met inclusion criteria, of which ten were clinical trials or cohort studies. Risk of bias was appraised with design appropriate tools, and findings were
synthesised narratively.
Results:
Safety engineered devices consistently reduced injury rates, typically by 40-60 percent relative to conventional needles, for example from 3.39 to 1.50 injuries per 100 full time equivalent staff, or with relative risks around 0.3-0.6. Education alone improved knowledge and reported safe practices but produced smaller and sometimes transient reductions, for example self-reported injury prevalence falling from 40 percent to 15 percent over 3-6 months. Interventions that combined devices and training achieved the largest effects, with odds ratios around 0.3 compared with usual practice. Heterogeneity in design, outcome definition and follow up limited formal pooling.
Conclusions:
Evidence indicated that passive safety engineered devices substantially reduced needle related injuries, and that combining such devices with structured training offered the greatest protection for nurses and dental assistants. Education alone was beneficial but less effective and required repetition to sustain impact.