Reply to comments on ACIPC Sharps Injury Survey

[Terry Grimmond]

Dear ACIPC colleagues,

The comments from Cath Murphy, Irene Wilkinson and Joe-Anne Bendall are
worthy and welcome and we the investigators would like to address each
point as we need and value your support and participation

*Intended purpose*. To obtain national sharps injury exposure data to
facilitate informed discussion on the resources needed for reducing SI
among Australian HCW.

*Study Background*. Australia has no national sharps injury (SI) database
enabling incidence estimates or comparison with other countries. Apart from
Cath Murphys own work there has been no SI peer-reviewed studies in the
last 10 years. As Cath says, Australia is notoriously difficult to obtain
SI incidence data. We simply do not know how many injuries are occurring
annually. Several states collect SI rates annually but do not publish them,
apart from the valuable quarterly reports from HISWA in WA. Requests for SI
information to state health departments are met somewhat coolly and require
many administrative hoops to be met. Reliable, national incidence data is
urgently needed.

*Request to ACIPC*. The ACIPC Sharp Injury Study commenced out of a
discussion at Sharps Alliance, a group formed several years ago by Cath
Murphy for raising awareness and lobbying for greater resources to reduce
HCW exposures (Terry is Aust Soc for Microbiology rep and Nicole is an
ACIPC rep on the group). Our research proposal was put to the ACIPC
Research Committee who vetted and approved it as a one-time survey, and
approved use of ACIPC Survey Monkey and use of Infexion Connexion.. As part
of the submission we stipulated: Member names would not be supplied by the
College; all data would be published anonymously; the results would be
submitted only to the Colleges journal for publication.

We believe our members are interested in reducing SI – at the ACIPC
conference session last Nov, where preliminary survey data was presented,
there was standing-room only so we are certain there is high interest among
ACIPC members.

*Study Methodology & potential bias*. Obtaining contact details and writing
to several hundred individual hospitals is extremely labour intensive.
Without funding, using ACIPC members is the most efficient mode possible
and association members is a mode oft used in overseas surveys. One of
us (TG) has conducted five national studies in USA using the US Assoc of
Occup Health Professionals, resulting in large exposure studies being
published annually. It is this research model we are using with ACIPC,
however, unlike USA, Australia does not have an association of healthcare
OSH professionals so ACIPC members is the closest we can get to accessing
exposure data. And using ACIPC members is one of few modes available for
obtaining incidence in the non-hospital sector. Apart from surveying all
249,000 members of the ANMF (an additional 52,000 registered nurses are not
members), ACIPC represents our best option for exposure data for all HCW
work groups.

Do member-surveys introduce bias? Yes. This is a limitation in all member
surveys and we are striving for a large number of responses to try and
reduce this bias.

And, as Irene stated, hospital permission may be needed prior to releasing
their SI data, and several hospitals have requested a formal request which
we have supplied.

The issue of low response is definitely related to IPC workloads and the
need for some of the data to come from other departments. Members of the
ACIPC Research Committee are also conscious of this and stated in their
approval, ***As you can appreciate, there are an increasing number of
requests for access to ACIPC members via ACIPC for research purposes. Each
request must be taken on merit and reviewed in larger context of what is
reasonable and in the interests of the members and the College.*

*Integrity of study and authors*: The study is in no way aligned with any
commercial entity or purpose; none of the investigators are being
remunerated or funded for the study; the study was vetted by the ACIPC
Research Committee, use of ACIPC Survey Monkey and Infexion Connexion was
approved by ACIPC Exec; the study has IRB approval, and publication in the
Colleges journal is a stipulation. We briefly summarised this on the
College website and hope this extra detail may satisfy members as to the
studys integrity and purpose, and prompt greater participation.

We have worked hard to get the study off the ground and hope our 2nd call
will gain sufficient responses to reduce bias and enable us to publish
scientific data to enable informed decisions on this vital issue of HCW
safety.

We truly appreciate all comments, and together, hope we can make this a
representative survey. But as Cath and Irene say, we need far more
responses!

Kind regards,

*Terry Grimmond *

FASM, BAgrSc, GrDpAdEd

Consultant Microbiologist

Grimmond and Associates

Ph (NZ): +64 7 855 3212

Mob (NZ): +64 274 365 140

E: terry@terrygrimmond.com

*Nicole Vause*
RN, Masters Adv. Prac. (IC&P), Grad. Cert. (IC&P), CICP.

Clinical Practice Consultant in Infection Prevention & Control
Mount Gambier & Districts Health Service, South East Health Service,
Country Health SA Local Health Network.

E: nicole.vause@health.sa.gov.au

*Jane Woodley*

Worker Health Clinical Service Consultant

Workforce Directorate|Workforce Health

Southern Adelaide Local Health Network|SA Health
Ph*:* (08) 8204 4322

E: jane.woodley@health.sa.gov.au

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