Safety and Health Management System, Safety Climate, and Accident Occurrences in Hospitals: The Study of Needlestick, Sharp Injuries and Recidivism Rates

Jafar Akbari, Ahmad Ghadami, Mohammad Reza Taheri, Nasrin Khosravi, Shirin Zamani


Background: Hospital Safety and Health Management System (HSH‑MS) and Hospital Safety Climate (HSC) are the significant elements to develop safe work practices. The current study aimed to examine the dimensions of HSH‑MS and HSC and the association with the prevalence of Needlestick and Sharp Injury (NSI) and NSI recidivism.

Materials and Methods: A cross‑sectional study was conducted among 1070 nurses in Iranian hospitals (89% response rate).

Results: More than 54% (n = 579) had sustained at least 1 NSI in the previous year. The NSI recidivism rate was 8.6% and recidivists were more likely to be younger, female, married, with higher Body Mass Index (BMI), and on night shift. Two aspects of HSH‑MS including management leadership and employee participation were associated with the incidence of NSIs Odds Ratio (OR): 1.91 and 95% Confidence Interval (CI): 0.69–1.21; OR: 1.29 and 95% CI: 0.92–1.82) and NSI recidivism rate (OR: 1.98 and 95% CI: 0.55–1.74; OR: 1.12 and 95% CI: 0.83–1.49). Furthermore, three dimensions of HSC comprising management support (OR: 1.02 and 95% CI: 0.93–1.11 for NSIs; OR: 1.21 and 95% CI: 0.77–1.22 for NSI recidivism), absence of job hindrances (OR: 1.06 and 95% CI: 0.98–1.16 for NSIs; OR: 1.11 and 95% CI: 0.96–1.30 for NSI recidivism) and cleanliness/orderliness (OR: 1.07 and 95% CI: 0.98–1.08 for NSIs; OR: 0.84 and 95% CI: 0.87–0.97 for NSI recidivism) were correlated with reduced NSIs risk.

Conclusions: This study suggests that HSH‑MSs and employees’ safety climate are significant factors, which are correlated with not only the prevalence of recurrent NSIs but also the single NSI in hospitals.


Hospital safety climate, hospital safety and health management system, needlestick and sharp injuries, recidivism rate

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