In brief
This study from Croatia found that nurses in tertiary healthcare settings reported sharps injuries more frequently than those in secondary care. Crucially, regular use of protective equipment was strongly linked to injury reporting; irregular or non-use was common among under-reporters.
What this article is about
Quick Answer
This study from Croatia found that nurses in tertiary healthcare settings reported sharps injuries more frequently than those in secondary care. Crucially, regular use of protective equipment was strongly linked to injury reporting; irregular or non-use was common among under-reporters. The main reason for not reporting was low perceived infection risk. These findings highlight the importance of organizational culture and safety practices in improving sharps injury surveillance and prevention.
Student takeaways
Key Takeaways
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Student summary
Why This Research Matters
This research article, titled '323 Changing Outbreaks in Long Term Care from Crisis to Control,' investigates the factors influencing sharps injury reporting and protective equipment use among nursing professionals in Croatia. The study highlights a significant public health concern: despite mandatory regulations for occupational safety and infection prevention, sharps injuries remain prevalent in healthcare settings due to underreporting and inconsistent adherence to using personal protective equipment (PPE). To understand these issues better, the researchers conducted a national-level cross-sectional survey in May 2024. This method involved an anonymous online questionnaire targeting nursing professionals who had experienced at least one sharps injury within the preceding five years.
The study's methodology was designed to capture various aspects of this problem. It collected data on participants' sociodemographic characteristics, their behavior regarding reporting sharps injuries, and their practices concerning PPE use and safety devices. To analyze the data, descriptive statistics were employed for characterizing the sample population. Group differences in reporting behaviors and equipment usage across different healthcare levels or educational backgrounds were tested using appropriate statistical methods: Mann-Whitney U tests for comparing continuous variables between independent groups (e.g., mean years of experience), chi-square tests for categorical variable comparisons (e.g., frequency of injury reporting by healthcare level), and point-biserial correlation to assess the strength of association between two variables, one being dichotomous or binary. Statistical significance was determined using a conventional threshold of p < 0.05 with a two-tailed approach.
The findings from this study provide valuable insights into the complexities surrounding sharps injury management in Croatian nursing settings. The research identified several key correlations and differences. Firstly, there were notable variations in sharps injury reporting rates based on the healthcare level where nurses worked: those employed in tertiary healthcare institutions reported injuries more frequently than their counterparts in secondary care facilities, where partial or non-reporting was observed to be more common (p = 0.048). Secondly, educational attainment appeared to play a role in PPE usage patterns; nurses with undergraduate or graduate education were found to use protective equipment more regularly compared to those who had only completed secondary-level education (p = 0.028).
A particularly strong and significant association was observed between the regular use of protective equipment and the practice of reporting sharps injuries: irregular or non-use of PPE was markedly more common among nurses who partially reported or did not report their injuries, whereas consistent PPE use predominated among those who fully reported such incidents (p < 0.001). This suggests that a culture of safety, potentially reinforced by proper equipment usage and reporting, is crucial.
The study also explored the reasons behind non-reporting behaviors. The most frequently cited reason for not reporting sharps injuries was a low perceived infection risk associated with the specific injury event. This finding underscores an important psychological aspect influencing occupational health practices – nurses' individual assessment of risk can significantly impact their decision-making regarding incident disclosure.
In conclusion, this research demonstrates that sharps injury reporting is intricately linked to both institutional context and preventive behaviors. The higher rates of reporting in tertiary care settings, alongside the strong correlation between consistent PPE use and full reporting, highlight the importance of organizational culture and safety practices. The authors suggest that effective infection prevention strategies should integrate robust reporting systems with targeted interventions aimed at promoting the consistent and correct use of personal protective equipment, particularly within secondary-level healthcare environments. Such an integrated approach is proposed to enhance surveillance capabilities and ultimately reduce preventable occupational exposures for nursing professionals.
Source abstract
Study Overview
Background: Sharps injuries remain a major occupational and infection prevention concern in healthcare settings, yet underreporting and inconsistent use of protective equipment persist despite mandatory regulations. Evidence on institutional and behavioral factors associated with reporting and preventive practices is limited. This study examined institutional, educational and behavioral correlates of sharps injury reporting among nursing professionals in the Republic of Croatia. Methods: We conducted a national-level cross-sectional survey in May 2024 using an anonymous online questionnaire. Eligible participants were nursing professionals who experienced at least one sharps injury in the previous five years. Data included sociodemographic characteristics, sharps injury reporting behavior, as well as the use of protective equipment and safety devices. Descriptive statistics were used for sample characterization. Group differences were tested using Mann-Whitney U and chi-square tests. Associations between organizational climate and reporting behavior were assessed using point-biserial correlation. Statistical significance was set at p < 0.05 (two-tailed). Result: A total of 215 participants met inclusion criteria; 88.4% were female, with a mean age of 36.4 years and a mean of 15.4 years of professional experience. Sharps injury reporting differed significantly by healthcare level: nurses working in tertiary healthcare institutions reported injuries more frequently than those in secondary care, where partial or non-reporting was more common (p = 0.048). Moreover, the use of protective equipment differed significantly by educational level, with more regular use reported by nurses with undergraduate or graduate education compared with those with secondary-level education (p = 0.028). A strong association was observed between regular use of protective equipment and sharps injury reporting: irregular or non-use of protective equipment was markedly more common among nurses who partially reported or did not report injuries, whereas regular use predominated among those who reported injuries (p < 0.001). The most frequently cited reason for non-reporting was low perceived infection risk associated with the injury. Conclusion: Sharps injury reporting is closely linked to both institutional context and preventive behavior. Higher reporting in tertiary care settings and the strong association between protective equipment use and reporting underscore the importance of organizational and safety culture factors. Infection prevention strategies should integrate reporting systems with interventions that promote consistent use of protective equipment, most notably in secondary-level healthcare settings, to strengthen surveillance and reduce preventable occupational exposures.
Evidence appraisal
Main Findings
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Practice transfer
Clinical Relevance
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Critical appraisal
Limitations
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Classroom use
Discussion Questions
- Discussion question 1: What does "323 Changing Outbreaks in Long Term Care from Crisis to Control" help nursing students evaluate?
- Discussion question 2: What does "323 Changing Outbreaks in Long Term Care from Crisis to Control" help nursing students evaluate?
- Discussion question 3: What does "323 Changing Outbreaks in Long Term Care from Crisis to Control" help nursing students evaluate?
- Discussion question 4: What does "323 Changing Outbreaks in Long Term Care from Crisis to Control" help nursing students evaluate?
- Discussion question 5: What does "323 Changing Outbreaks in Long Term Care from Crisis to Control" help nursing students evaluate?
- Discussion question 6: What does "323 Changing Outbreaks in Long Term Care from Crisis to Control" help nursing students evaluate?
- Discussion question 7: What does "323 Changing Outbreaks in Long Term Care from Crisis to Control" help nursing students evaluate?
- Discussion question 8: What does "323 Changing Outbreaks in Long Term Care from Crisis to Control" help nursing students evaluate?
- Discussion question 9: What does "323 Changing Outbreaks in Long Term Care from Crisis to Control" help nursing students evaluate?
- Discussion question 10: What does "323 Changing Outbreaks in Long Term Care from Crisis to Control" help nursing students evaluate?
Knowledge check
Quiz
1. What was the mean age of the participants in this study?
- 30.4 years.
- 32.1 years.
- 36.4 years.
- 40.5 years.
Rationale: The abstract states: 'A total of 215 participants met inclusion criteria; ... a mean age of 36.4 years...'
2. What was the most common gender among the study participants?
- Male
- Female
- Non-binary
- Gender not specified
Rationale: The abstract states: 'A total of 215 participants met inclusion criteria; 88.4% were female...'
3. Question 3: What should a nursing student evaluate when reading "323 Changing Outbreaks in Long Term Care from Crisis to Control"?
- Study design and limitations
- Only the title
- Social media reactions
- Advertising placement
Rationale: Research appraisal requires attention to design, sample, findings, and limits.
4. Question 4: What should a nursing student evaluate when reading "323 Changing Outbreaks in Long Term Care from Crisis to Control"?
- Study design and limitations
- Only the title
- Social media reactions
- Advertising placement
Rationale: Research appraisal requires attention to design, sample, findings, and limits.
5. Question 5: What should a nursing student evaluate when reading "323 Changing Outbreaks in Long Term Care from Crisis to Control"?
- Study design and limitations
- Only the title
- Social media reactions
- Advertising placement
Rationale: Research appraisal requires attention to design, sample, findings, and limits.
6. Question 6: What should a nursing student evaluate when reading "323 Changing Outbreaks in Long Term Care from Crisis to Control"?
- Study design and limitations
- Only the title
- Social media reactions
- Advertising placement
Rationale: Research appraisal requires attention to design, sample, findings, and limits.
7. Question 7: What should a nursing student evaluate when reading "323 Changing Outbreaks in Long Term Care from Crisis to Control"?
- Study design and limitations
- Only the title
- Social media reactions
- Advertising placement
Rationale: Research appraisal requires attention to design, sample, findings, and limits.
8. Question 8: What should a nursing student evaluate when reading "323 Changing Outbreaks in Long Term Care from Crisis to Control"?
- Study design and limitations
- Only the title
- Social media reactions
- Advertising placement
Rationale: Research appraisal requires attention to design, sample, findings, and limits.
9. Question 9: What should a nursing student evaluate when reading "323 Changing Outbreaks in Long Term Care from Crisis to Control"?
- Study design and limitations
- Only the title
- Social media reactions
- Advertising placement
Rationale: Research appraisal requires attention to design, sample, findings, and limits.
10. Question 10: What should a nursing student evaluate when reading "323 Changing Outbreaks in Long Term Care from Crisis to Control"?
- Study design and limitations
- Only the title
- Social media reactions
- Advertising placement
Rationale: Research appraisal requires attention to design, sample, findings, and limits.
Study cards
Flashcards
What was the primary focus of this study?
The study examined institutional, educational and behavioral correlates of sharps injury reporting among nursing professionals in Croatia.
When was the survey conducted for this research?
The national-level cross-sectional survey was conducted in May 2024.
What type of questionnaire was used to collect data?
An anonymous online questionnaire was used.
Who were the eligible participants for this study?
Nursing professionals who experienced at least one sharps injury in the previous five years.
How many participants met the inclusion criteria?
A total of 215 participants met inclusion criteria.
What percentage of participants identified as female?
88.4% were female.
What was the mean age of the participants?
The mean age was 36.4 years.
How many years of professional experience did participants have on average?
Participants had a mean of 15.4 years of professional experience.
In which healthcare level were sharps injuries reported more frequently?
Sharps injury reporting differed significantly by healthcare level: nurses working in tertiary healthcare institutions reported injuries more frequently than those in secondary care, where partial or non-reporting was more common (p = 0.048).
How did educational level affect the use of protective equipment?
The use of protective equipment differed significantly by educational level, with more regular use reported by nurses with undergraduate or graduate education compared with those with secondary-level education (p = 0.028).
What was the strong association observed between protective equipment and reporting behavior?
A strong association was observed between regular use of protective equipment and sharps injury reporting: irregular or non-use of protective equipment was markedly more common among nurses who partially reported or did not report injuries, whereas regular use predominated among those who reported injuries (p < 0.001).
What was the most frequently cited reason for non-reporting?
The most frequently cited reason for non-reporting was low perceived infection risk associated with the injury.
What did the conclusion state about sharps injury reporting and institutional context?
Sharps injury reporting is closely linked to both institutional context and preventive behavior.
Where was higher reporting of sharps injuries observed according to the study?
Higher reporting in tertiary care settings.
Why are organizational and safety culture factors important, as per the conclusion?
Infection prevention strategies should integrate reporting systems with interventions that promote consistent use of protective equipment, most notably in secondary-level healthcare settings, to strengthen surveillance and reduce preventable occupational exposures.
What was one key finding regarding nurses' education level and PPE usage?
Nurses with undergraduate or graduate education reported more regular use of protective equipment compared with those with secondary-level education (p = 0.028).
How did the study describe the relationship between reporting behavior and institutional context?
Sharps injury reporting is closely linked to both institutional context and preventive behavior.
What statistical test was used for group differences in this study?
Group differences were tested using Mann-Whitney U and chi-square tests.
Which type of correlation analysis was used to assess associations between organizational climate and reporting behavior?
Associations between organizational climate and reporting behavior were assessed using point-biserial correlation.
What was the statistical significance threshold set for this study?
Statistical significance was set at p < 0.05 (two-tailed).
Search-ready answers
Frequently asked questions
What was the primary focus of the study titled '323 Changing Outbreaks in Long Term Care from Crisis to Control'?
The study focused on examining institutional, educational and behavioral correlates of sharps injury reporting among nursing professionals in the Republic of Croatia.
When was this research article published?
This research article was published on 2026-08-01.
What type of study is '323 Changing Outbreaks in Long Term Care from Crisis to Control'?
'323 Changing Outbreaks in Long Term Care from Crisis to Control' is a Journal article.
Which journal published the research on sharps injuries and reporting practices among Croatian nursing professionals?
The research was published in DOAJ (DOAJ: Directory of Open Access Journals).
What specific DOI can be used to locate '323 Changing Outbreaks in Long Term Care from Crisis to Control'?
The DOI for the article is 10.1017/ash.2026.10669.
Who are the authors of this research on sharps injury reporting practices?
The authors are Ivana ?eri ?avi? and Tomislav Meštrović.
What was one key finding regarding sharps injury reporting based on healthcare level in Croatia?
A key finding was that nurses working in tertiary healthcare institutions reported injuries more frequently than those in secondary care, where partial or non-reporting was more common (p = 0.048).
How did educational level influence the use of protective equipment among nursing professionals in this study?
The study found that the use of protective equipment differed significantly by educational level, with more regular use reported by nurses with undergraduate or graduate education compared with those with secondary-level education (p = 0.028).
What strong association was observed between protective equipment use and sharps injury reporting in this research?
A strong association was observed: irregular or non-use of protective equipment was markedly more common among nurses who partially reported or did not report injuries, whereas regular use predominated among those who reported injuries (p < 0.001).
What was the most frequently cited reason for sharps injury non-reporting by nursing professionals in this study?
The most frequently cited reason for non-reporting was low perceived infection risk associated with the injury.