P.3.33 Knowledge, attitudes, behavior toward needle stick injuries amongst junior doctors in a singaporean hospital – a mixed-methods approach

Introduction Needlestick injuries (NSI) are common healthcare-related injuries, and possible repercussions include blood-borne infections. Despite that, a large proportion of NSIs are not reported. This study aims to estimate the prevalence of under-reporting, and to evaluate the knowledge, attitude and behavior towards NSIs amongst junior doctors in a Singaporean tertiary hospital. Methods An explanatory sequential mixed-methods design was employed. Quantitative data were collected through questionnaires completed by 100 junior doctors (response rate 66.7%). 99 survey responses (1 had missing data) were tabulated. Descriptive statistics and bivariate analysis were performed to analyse socio-demographic characteristics, NSI history, and NSI reporting practices. Qualitative data were collected through 12 in-depth interviews. Participants were purposively recruited and semi-structured topic guides were developed using the Health Belief Model (HBM). Data analysis was done based on a thematic, inductive approach. Results 51.5% of respondents had history of NSI. Amongst respondents with past NSI, 31.4% did not report. NSI reporters were 1.52 times as likely to be aware of how to report as compared to non-reporters (p=0.033). NSI reporters were 1.63 times as likely to feel that reporting benefits their health as compared to non-reporters (p=0.006). NSI reporters were 83% more likely to report a clean needle injury (p=0.021). For non-reporters, the main reasons for not reporting were low risk of transmission (41.2%) and lack of time to report (35.2%). Themes identified in qualitative study include perceived benefits, perceived barriers, perceived threat, cues to action, organisational culture and recommendations. Recommendations suggested were to change organisational culture, change reporting process, provide reminders and improve lessons on reporting. Conclusion Under-reporting of NSI may have significant implications to patients, healthcare workers themselves and to the system. Solving this will require recognition that under-reporting is a significant public health problem, then subsequently addressing factors, and instituting targeted interventions to improve reporting rate.