OBJECTIVES: The objective of the study was i. to determine an effect size estimate of comparative efficacy of safety-engineered intravenous devices (SED) versus conventional intravenous devices in preventing accidental needle stick injuries (NSI) when used by healthcare workers to perform infusion therapies, and/or intravenous drug administration based on published literature and ii. to understand the projected impact of increased utilization of passive SED in infusions in Malaysia based on incidence-based estimates from literature and Malaysian healthcare data.

METHODS: A meta-analytic synthesis of published evidence pertaining to event rates of NSI prevention using SED for intravenous access was carried out using RevMan 5 software. Thereafter, a health system impact model was developed based on incidence rates from published studies, to evaluate projected changes in NSI rates in Malaysian public hospitals under the hypothesis of an increased proportional utilization of passive SED instead of non-SED over 5 years.

RESULTS: The meta-analysis demonstrated an odds ratio (OR) and risk ratio (RR) in favor of SED. Using a fixed effects model, OR was 0.09 (95% CI [0.06,0.14], p<0.00001), and with random effects model, OR was 0.14 (95% CI [0.07,0.28], p<0.00001). RR using fixed effects was 0.09 (95% [CI 0.06,0.14], p<0.00001) and with random effects RR was 0.14 (95% CI [0.07,0.28], p<0.00001) favoring SED. The health system projection model demonstrated the following trend in NSI episodes per year over 5 consecutive years: 1368, 1027 (24% reduction), 686 (50% reduction), 345 (75% reduction) and 4 (99% reduction). The model projected estimate of reduced annual NSI episodes resulting per 100,000 infusion therapies/intravenous drug procedures performed each year as: 21, 16,10, 5 and 1 NSI episode respectively over simulation period of 5 consecutive years.

CONCLUSIONS: The results demonstrate SED can prevent significant occupational hazards. NSI could also be reduced if passive safety devices were utilized in higher proportion in Malaysian public hospitals.