Education and training for preventing sharps injuries and splash exposures in healthcare workers

Background In healthcare settings, health care workers (HCWs) are at risk of acquiring infectious diseases through sharps injuries and splash exposures to blood or bodily fluids. Education and training interventions are widely used to protect workers' health and safety and to prevent sharps injuries. In certain countries, they are part of obligatory professional development for HCWs. Objectives To assess the effects of education and training interventions compared to no intervention or alternative interventions for preventing sharps injuries and splash exposures in HCWs. Search methods We searched CENTRAL, MEDLINE, Embase, NHSEED, Science Citation Index Expanded, CINAHL and OSH‐update (from all time until February 2016). In addition, we searched the databases of Global Health, AustHealth and Web of Science (from all time until February 2016). The original search strategy was re‐run in November 2019, and again in February 2020. In April 2020, the search strategy was updated and run in CINAHL, MEDLINE, Scopus and Web of Science (from 2016 to current). Selection criteria We considered randomized controlled trials (RCTs), cluster‐randomized trials (cluster‐RCTs), controlled clinical trials (CCTs), interrupted time series (ITS) study designs, and controlled before‐and‐after studies (CBA), that evaluated the effect of education and training interventions on the incidence of sharps injuries and splash exposures compared to no‐intervention. Data collection and analysis Two authors (SC, HL) independently selected studies, and extracted data for the included studies. Studies were analyzed, risk of bias assessed (HL, JL) , and pooled using random‐effect meta‐analysis, where applicable, according to their design types. As primary outcome we looked for sharps injuries and splash exposures and calculated them as incidence of injuries per 1000 health care workers per year. For the quality of evidence we applied GRADE for the main outcomes. Main results Seven studies met our inclusion criteria: one cluster‐RCT, three CCTs, and three ITS studies. The baseline rates of sharps injuries varied from 43 to 203 injuries per 1000 HCWs per year in studies with hospital registry systems. In questionnaire‐based studies, the rates of sharps injuries were higher, from 1800 to 7000 injuries per 1000 HCWs per year. The majority of studies utilised a combination of education and training interventions, including interactive demonstrations, educational presentations, web‐based informatio