# Knowledge, Attitudes, and Practices of Nurses Regarding Needle Stick Injuries, HIV, and Hepatitis B Prevention in a Tertiary Care Center in Nagpur, India: A Cross-Sectional Study

## TL;DR

This study examines nurses' knowledge, attitudes, and practices regarding needlestick injuries and bloodborne disease prevention in a hospital in India, finding good awareness but gaps in safe practices.

## Contribution

The study provides new insights into nurses' KAP regarding NSIs and PEP adherence in a specific Indian hospital setting.

## Key findings

- 40.5% of nurses reported experiencing needlestick injuries.
- Only 31% of injured nurses received post-exposure prophylaxis.
- 24% of nurses still engaged in unsafe practices like recapping needles.

## Abstract

Introduction

Needlestick injuries (NSIs) pose serious health risks to healthcare workers, especially nurses, due to the potential transmission of HIV and Hepatitis B. Despite available guidelines for vaccination and post-exposure prophylaxis (PEP), awareness and adherence remain low, particularly in developing countries like India. Nurses face high NSI risk due to their frontline role in patient care, yet limited Indian studies assess their knowledge, attitudes, and practices (KAP) on this issue. This cross-sectional study was conducted among nurses at a tertiary care hospital in Nagpur using a validated questionnaire to evaluate KAP regarding NSI prevention and management. The findings aim to highlight existing gaps and support targeted interventions to reduce NSI-related infections and improve occupational safety among nurses.

Methods

A cross-sectional analytical study was conducted at a tertiary care hospital in Nagpur City, situated in the central part of India, from December 2023 to February 2024. Based on an assumed 50% prevalence, the calculated sample size was 216 nurses. A validated, self-administered online questionnaire assessing KAP related to needlestick injuries, HIV, and Hepatitis B was distributed via Google Forms (Google, Mountain View, California, US) to 500 nurses; 227 responded. Responses were scored and categorized into good, average, or poor knowledge. Data were analysed using Stata version 18 (StataCorp LLC, College Station, TX, US) with appropriate statistical tests. Ethical approval was obtained for the study.

Results

The prevalence of NSIs was 40.5% (92 out of 227 participants; 95% CI: 34.1%-47.2%). Good knowledge was observed in 203 (89.4%) for NSI, 159 (70%) for HIV, and 211 (93%) participants for Hepatitis B. However, 68 participants (30%) had only average or poor knowledge of HIV. No significant association was found between NSI occurrence and age, gender, experience, or marital status. Similarly, knowledge levels for NSI, HIV, and Hepatitis B were not significantly influenced by demographic factors. Attitudes were largely positive: 203 participants (92.6%) perceived the NSI risk as serious, and 214 (97.7%) believed NSIs are preventable. Most supported immediate reporting and PEP for HIV (204; 94.4%) and Hep B (201; 93%). Despite this, only 27 of 87 (31%) received PEP after injury. NSIs frequently involved hypodermic needles or lancets and occurred during disposal or recapping. However, unsafe practices persisted, with 53 of 219 (24%) of nurses recapping needles, a behaviour significantly associated with NSI incidence (p = 0.045). The most cited barriers to NSI reporting were time constraints (166; 78.3%) and lack of awareness about reporting procedures (98; 46%).

Conclusion

This study highlights that nurses possess good knowledge and positive attitudes toward NSI, HIV, and Hepatitis B. However, gaps remain in translating knowledge into safe practices and consistent PEP adherence. Strengthening training, reinforcing safety protocols, and fostering a supportive institutional environment are essential to reduce occupational risks and enhance healthcare worker safety.