Assessment of Knowledge and Compliance with Protective Measures against Needle Stick Injuries among Doctors in a Tertiary Care Hospital: A Cross-Sectional Study

Abstract

Background: Needle stick injuries (NSIs) pose a significant occupational risk to healthcare workers (HCWs), particularly in low- and middle-income countries (LMICs) like Pakistan. Despite global guidelines, knowledge and compliance gaps persist, increasing exposure to blood-borne pathogens. Objective: To assess knowledge and observed compliance with Needle stick injury preventive measures among doctors in a tertiary care hospital and identify barriers to adherence. Methodology: A cross-sectional study was conducted among 350 doctors at Bahawal Victoria Hospital, Bahawalpur, from October 2023 to March 2024. Data were collected via structured questionnaires evaluating knowledge, self-reported compliance, and barriers alongside direct observational audits. Chi-square test and multivariable logistic regression analyzed associations between compliance, demographic factors, and workplace variables. Results: While 64.3% of participants demonstrated adequate knowledge, observed compliance was only 47.4%. Medical doctors showed higher compliance (53.6%) than surgical staff (41.2%) (p=0.003). Formal NSI training significantly improved adherence (62.8% vs. 34.7%; p=0.001). Key barriers included heavy workload (42.3%), lack of training (31.7%), and inadequate safety-engineered device (SED) supply (28.6%). Multivariable analysis revealed that NSI training (adjusted OR: 2.8; 95% CI: 1.9–4.2) and medical specialty (OR: 1.7; 95% CI: 1.2–2.5) were strong predictors of compliance, while high workload reduced adherence by 40% (OR: 0.6; 95% CI: 0.4–0.9). Conclusion: A significant knowledge-compliance gap exists among HCWs, driven by systemic factors such as insufficient training, workload pressures, and SED shortages. Strengthening institutional training programs, ensuring SED availability, and optimizing staffing ratios are critical to reducing NSI risks in resource-limited settings.