Objective To explore the effects of healthcare failure mode and effects analysis (HFMEA) on needlestick injuries prevention in nurses. Methods A total of 1 082 nurses were selected from January to December 2015 in a grade three hospital and 1 105 nurses from January to December 2016. From January to December 2016, the needle withdrawal process when finishing infusion was managed with HFMEA. The potential failure mode of needlestick injuries was found by "brainstorming method". The risk priority number (RPN) was assessed according to the harm score matrix. A total of 9 failure modes (RPN≥ 8) were reformed and carried with quality control. The score of RPN and the incidence of needle puncture standardization were compared before and after HFMEA. Results After applying HFMEA, the RPN of failure modes of needlestick injuries during needle withdrawal process all dropped to targeted value (under 8). The total RPN decreased from (81.08±26.68) to (48.46±12.48) (t'=2.854, P<0.05). Except for centrally separating needle head, RPN of other failure modes all significantly reduced (P<0.05). The RPN involving poor technique, rescue and emergency needle withdrawal, nonstandard medical wastes classification, low adaptability degree of patients, push-back needle head in infusion bag, needle cap sheathed by both hands all declined more obvious. The standardized incidence of needlestick injuries in total flow decreased from 0.062 cases per FTE year before implementing HFMEA to 0.038 cases per FTE year (χ2=6.698, P<0.01). Conclusions Application of HFMEA in management of needle withdrawal process in nurses can prospectively control nonstandard operative behavior and optimize process so as to effectively reduce the risk of needlestick injuries.

Objective: To understand the status of blood-borne occupational exposure and protection among health care workers (HCWs) in dental practice, and provide evidence for making effective prevention. Methods: From April 1 to 15, 2019, a stratified random sampling method was conducted to investigate the data of blood-borne occupational exposure among 221 dental HCWs in 2018, and Chi-squared Test was used to evaluate the differences of status on occupational exposure and protection among different professionals, such as nurses, doctors and trainees, and among different-grade hospitals. Results: A total of 166 HCWs were exposed to occupational exposure 269 times, with the annual incidence of 75.11% (166/221) , and 37.55% (101/269) of exposures were reported. However, all source patients of exposures had failed to be traced. 89.59% (241/269) of exposures were sharp injuries. The top three instruments caused injuries were syringe/bilan needles, suture needles and vehicle needles, accounting for 35.68% (86/241) 、16.60% (40/241) and 16.18% (39/241) , respectively; and the top three exposure operations were removal/disposal of needles or instruments, suture/assisting suture and injection of anesthetic, accounting for 37.17% (100/269) 、22.30% (60/269) and 17.84% (48/269) , respectively. There were statistically significant differences among different professionals in occupational exposure frequency, reporting rate, the types of instruments caused injuries, exposure operations and hepatitis B vaccinated time (P<0.01) . The compliance rate of standard precautions, safe operation, post-exposure reporting and prevention, and training on occupational protection were generally poor among HCWs, with significant differences in different-grade hospitals (P<0.01) . Conclusion There is a high incidence, low reporting rate and poor self-protection of blood-borne occupational exposure among dental HCWs. Strongly suggesting that standard precautions, safe use and disposal of oral instruments, active post-exposure report and prevention must be improved for everyone.