Research Proposal for HREC Approval - NURBN3022

This research proposal aims to evaluate the efficacy of training and safety devices in reducing needle stick injuries in healthcare settings. The target population for this study are nurses. The research methodology includes mixed method study design and data collection techniques like survey. The recruitment strategy involves purposive sampling technique.

Sample Application for
HREC Approval
(NURBN3022)
Total word limit for this assessment item is 2000 words
1. PROJECT DETAILS
Project title:
DO TRAINING AND NEEDLE SAFETY DEVICES PREVENT NEEDLE STICK INJURIES IN
HEALTH CARE SETTINGS?
What type of project is this? (Tick as many as apply)
Masters project Clinical Trial Postgraduate Diploma
Undergraduate Student Research Project Honours
PhD Staff Research Project Other
Through which School/Section is the research to be conducted?
2. RESEARCHERS
Principal Researcher (STAFF MEMBER ONLY)
Title & Name: Dr Joanne Porter
Position: Senior Lecturer
School/Section: School of Nursing, Midwifery and Healthcare
Phone number: 51 236996
Email address: [e-mail]
Please list academic qualifications: PhD, MN, GradDipCC, GradDipHSM, GradCertHeD,
BN, RN
Describe what this researcher will do in The lead researcher will be an expert guide though all
the context of this project: aspects of the project.
Include a brief summary of relevant Supervision of higher degree students, multiple
experience for this project: publications to peer reviewed journals and successful
competitive grants applications.
Student/Other Researcher/s
Title & Name:
Position:
School/Section:
Phone number:
Email address:
Student ID number:
Please list academic qualifications:
Describe what this researcher will do in
the context of this project:
Include a brief summary of relevant
experience for this project:
1

Sample Application for
HREC Approval
(NURBN3022)
3. LAY DESCRIPTION
Provide a brief outline of the project describing in everyday, jargon-free language the key aspects of
the research (e.g., who will be participating, what information will be collected and by what means,
what participants will be required to do, etc.) and the key research aims. (300 words max.)
The main purpose of this research project is to find out whether training and needle safety devices can prevent needle
stick injuries in the health care setting or not. Needle stick is a type of accidental piercing wounds caused by the
penetration of contaminated sharp instruments. Research on this topic is important because health care staffs often need
to handle needles and sharp devices while caring for patients and they are at high risk of transmission of HIV virus,
HBV and HCV infection through infected bloods. Transmission of HCV and HBV can impair quality of life and
increase substance cost in the long term (Cooke & Stephens, 2017). Findings solution to address the issue is needed as
it can lead to clinical, economic and humanistic burden in health care setting. Research evidences shows wide range of
evidence for the use of safety engineered devices and training sessions to prevent needle stick injuries (Schuurmans et
al., 2018). Hence, this research aims to understand whether combination of both intervention can reduce needle stick
injuries and reduce cost associated with the injury among health care professionals or not.
To evaluate the effectiveness of training and safety devices, the target population for this study are nurses. Nurses will
be been taken as one of the health care professional for the study because they are the one who are most likely to be
involved in handling needles which administering medication and giving injections to patient ( Griswold et al., 2013).
Providing training is also considered important because of underreporting of needle stick injuries (Nagandla et al.,
2015). Therefore, nurses will be recruited from at least two health care institutions after taking informed consent for
research.
It is planned to conduct a primary research using survey as the method of investigation. The survey will be conducted in
two phases: The first survey will be conducted to understand training needs of nurses before the implementation of the
two interventions and the second survey will be done after the intervention to evaluated changes in the rate of needle
stick injuries and competency of staffs in preventing injuries. Quantitative information will be collected regarding the
rate of needle stick injuries before and after the intervention. Furthermore, quantitative information will be collected by
means of open ended question to understand participant’s perspective regarding the effectiveness of implemented
intervention in reducing needle stick injuries and increasing confidence in effectively handling sharp equipments and
needles. On the whole, it can be said that the by using mixed method research study, the main aim of the research will
be to find out the efficacy of training and safety devices in reducing rate of needle stick injuries in healthcare setting.
4. RESEARCH AIMS & SIGNIFICANCE
State the aims, key research questions, and significance of the project. Also provide a brief
description of the relevance of your proposed project to current research, supported by the
literature. (500 words max.)
Aim: The main aim of the research is to evaluate the efficacy of training and safety device in reducing needle stick
injuries in health care setting.
Research question: The research question for the project is ‘Do training and needle safety devices prevent needle stick
injuries in health care settings?’.
Significance of the project:
The significance of the project is understood from the prevalence of accidental needle stick injuries worldwide and high
incidence reported regarding the underreporting of such injuries in clinical setting. Needle stick injuries has been
reported by about 14.9% to 69.4% workers and the rate differs based on country, setting and type of methods used to
estimate prevalence. Exposure to contaminated sharps has contributed to 37 to 39% of cases of HBV and HCV among
health care workers. Among different types of equipments, hypodermic injections are most common cause of needle
stick injuries (Cooke & Stephens, 2017). Hence, the rate and extent of the problem is understood from the overview of
prevalence rate worldwide. Bhardwaj et al., (2014) gave an overview of prevalence rate in Malaysia and the extent to
which health care staffs avoid reporting about injuries. The article revealed that prevalence of needle stick injury was
32% in Malaysia and the majority of this injuries occurred while assistant health care staffs in operation theatre.
Another major finding of the study was that medical students ignored reporting about injuries because of lack of clear
guideline on reporting process and poor attitudes towards preventing occupational hazards. Therefore, this issue shows
the importance of the project in establishing a culture of safety and preventing occupational injury. The Centre of
Disease Control has recommended employing strategies in workplace to prevent staffs attitude towards safety measures
and educating frontline workers about health care professionals (CDC 2012). Considering this recommendation, the

intervention of training and safety devices has the potential to improve staff’s attitude towards safety and develop skills
and capacity to prevent injuries too.
There are also two rationale behind using two interventions to reduce the rate of needle stick injuries. Firstly, training
and education will be included as an intervention for research because of poor attitude of staffs towards reporting about
needle stick and sharp injuries. The study by Voide et al. (2012) particularly highlighted about rate of needle stick and
sharp injuries and the cause behind underreporting. Nurses and doctors were the health care staffs who were most
commonly involved in such injuries while performing invasive procedures. Despite high rate of injury, the rate of
reporting about the event was comparatively low. This is crucial issue and the cause behind underreporting revealed
lack of time and low risk of transmission of infection as the main cause behind reporting. Hence, the intervention of
training and education for staff is important to avoid missed opportunity for post exposure prophylaxis and promote
identification of hazardous procedures in clinical setting. In response to the high incidence of needle stick injuries, other
research papers have also recommended increasing awareness about the injuries and post exposure prophylaxis among
health care staffs (Kapoor et al., 2013). Jahangiri et al. (2016) also highlighted high prevalence of such injuries among
nurses and suggested planning training programs regarding use of personal protective equipment for the effective
prevention of needle stick injuries.
Hence, based on different issues identified related to the needle stick injuries, implementation of both training and
safety device is considered vital to improve the quality of life and health outcomes of health care staffs. To address the
above issue, training and education program is considered the most effective means to increase knowledge of health
care staffs. This project will enhance the content of the training program by using evidence based data related to cause
behind needle stick injuries and appropriate strategies needed to avoid them. Training and safety device can serve dual
purpose of eliminating both organizational and human barriers that contribute to such injuries.
Relevance to current research:
The research project is of relevance to current research because the research methodology has been planned after
identifying gaps or weakness in past research done on the topic. For instance, Sossai et al. (2016) investigated about the
efficacy of safety catheter devices in preventing occupational needle stick injuries. However, the gap found in this
research was that it did not have information on number of healthcare staffs who are at risk of exposure. Hence,
conducting survey before the implementation of program will help to understand level of knowledge and risk for target
sample and find out the type or extent of training needed. In addition, the use of safety device can further enhance the
efficacy of outcome as it increase support for staff’s who get injured because of faulty design of sharp containers.
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Sample Application for
HREC Approval
(NURBN3022)
5. RESEARCH METHODOLOGY
Provide an outline of the proposed method, including details of data collection techniques, tasks
participants will be asked to do, the estimated time commitment involved, and how data will be
analysed. (500 words max).
Research design: Mixed method study design will be used to collect both quantitative and qualitative data
related to needle stick injuries in health care setting. The main rationale for selecting mixed method study is to collect
quantitative data related to the rate of injuries in the selected setting before and after the intervention ( Creswell &
Creswell, 2017). The second purpose is to understand and evaluated the changes in attitude and knowledge of staffs
before and after the intervention program. This approach would help to compare the findings and estimated the true
effect of intervention on outcome variables like rate of injury, barriers to needle stick injury preventions and skills in
preventing injuries.
Date collection techniques: After recruitment of samples, data will be collected in two phases. Survey via the use of
questionnaire will be the main tool for data collection. The first phase will focus on conducting surveys with all nurses to
understand their knowledge regarding needle stick injuries. The survey questionnaire will focus on collecting
demographic details of participants and the other vital part of the questionnaire will include questions like the following
question:
 What is needle stick injury?
 How it is caused?
 What you do to prevent injuries?
 Do you report about such incidents to the concerned authority?
 What barriers prevent you from reducing such injuries?
Hence, the first survey question consists of short and open ended question which the participants can complete within 10
minutes. To maintain comfort and convenience of staffs, the survey will be administered face to face or via online mode
so as per individual participant’s preference. This approach will help to complete the survey within the desired
timeframe. The rate of injuries will be recorded at this stage three months before the intervention after contacting
hospital administrative
The second phase of survey will be done after the implementation of the proposed intervention. The second survey will
mainly focus on evaluating staff’s experience of changing practice and skills after the intervention. Second survey will
be done three months after the delivery of the intervention. The following question will be used to evaluate the efficacy
of the intervention:
 Do you feel the new intervention was effective for you?
 Did it reduced the burden of needle stick injury?
 Did you faced any barriers in incorporating training content in actual practice?
 Did you experienced any barriers while implementing safety device in your daily practice
Method of implementation of the interventions:
The intervention will involve giving training sessions on the occupational exposure to infection while handling needle
sticks, types of contamination occurring due to contact with body fluids, vaccination options, reporting methods and
procedures to be followed after the exposure. The training session will be given for one week consisting of one hour
session after each alternative day. The training will be given by means of audio visual aid using graphics and real
practice videos to explain staffs regarding needle stick injuries. After the training, each staffs will be provided with a
safety engineered device which has safety features for preventing percutaneous injury. The selection of such device will
be done by experience health care personnel and technical staffs who have knowledge about the cause of such injuries
and device which is most efficient in preventing such accidents. Device selection will also depend on types of activities
which is performed most often by nurses in the clinical setting. The staffs will be given the selected device for use and
the effectiveness of the intervention will be evaluated after three months.
Data analysis process:
The method chosen for data analysis included coding of data according to outcome variables and comparison of findings
to come to a final conclusion about the effectiveness of staffs. The knowledge level was judged based on rate of injuries
or events caused for each staffs. Thematic approach will be used to analyze data related to barriers and experience of
staffs after the intervention. This will help to identify the intervention is efficacious to be implemented in hospital setting
or not.

6. RECRUITMENT OF PARTICIPANTS
Participant Details
Describe your proposed recruitment strategy to source target participants. Provide the number
and age range, giving a justification of your proposed sample size. (100 words)
The target population group for this project will be nurses working in acute hospitals and those with large patient flow.
Purposive sampling technique will be applied to select nurses from two hospital settings. This is because the focus will
be to select only those nurses who are most involved in handling needle and sharp equipments in hospital. Focussing on
the characteristics of the population will help to select a population that can give answer to the research question (Etikan,
Musa & Alkassim, 2016). The process of recruitment will be completed by taking permission from authorities of the
hospital and sending details about the project to all nursing staffs working in each hospital. After dissemination of the
project details to all nursing staffs, only those will be included in the project who gives their consent to take part in the
process. Hence, the process of distributing project information and desired sample size needed for the project will serve
the purpose of purposive sampling.
Other criterion for sample selection is to recruit nurses between age of 18-50 years. The main rationale behind this is to
analyze the impact of work experience on needle stick injury rate. The proposed sample size for this study is expected to
be 50. This sample size has been taken because qualitative data also needs to be collected regarding experience of staffs
after the intervention. This may help to complete data collection process without any inconvenience.
Target participants
Who are the target participants? (Tick as many as applicable)
Students or staff of this University
 Adults (over the age of 18 years and competent to give consent)
Children/legal minors (under the age of 18 years, with parental consent)*
Elderly individuals
Individuals from non–English-speaking backgrounds
Pensioners or welfare recipients
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Sample Application for
HREC Approval
(NURBN3022)
Intellectually or mentally impaired individuals unable/with compromised capacity to provide
consent
Physically disabled individuals
Patients or clients
Prisoners, parolees, or wards of the state
Individuals highly dependent on medical care with a compromised capacity to give consent
Aboriginal and/or Torres Strait Island communities
Women who are pregnant and the human foetus
People who may be involved in illegal activities
*Parental consent may not be required in some instances - refer National Statement, 4.2.8 & 4.2.9
7. RISK MANAGEMENT
This section raises the issue of your duty of care toward research participants. To what risks are
participants subjected? What will you do should an emergency occur, or should a participant
become upset or distressed? What is your risk management strategy?
Refer National Statement: Section 2.1 Risk and Benefit
Research Activities
Which of the following activities will the research involve? (Tick as many as apply)
 Use of a questionnaire (attach copy)
Interviews (attach interview questions)
 Observation of participants without their knowledge
Participant observation Audio- or video-
taping of interviewees or events
Access to personal and/or confidential data (including student, patient or client data) without
participants’ specific consent
 Administration of any stimuli, tasks, investigations or procedures which may be
experienced by participants as physically or mentally painful, stressful or unpleasant
during or after the research process
Performance of any acts which may diminish the self-esteem of participants or cause them to
experience embarrassment, regret or depression
Use of non-treatment of placebo control conditions
Collection of body tissues or fluid samples
4

Sample Application for
HREC Approval
(NURBN3022)
Identify as far as possible all potential risks to participants (e.g., physical, psychological, social,
legal, economic) associated with the proposed research. Explain what risk management
procedures will be put in place, along with contact details of an appropriately qualified organisation
for participant reference in case of distress, eg: Lifeline (200 words)
Although the intervention proposed has minimum risk to physical health of research participants, however the process of
providing training may increase psychological risk for the nurses. This is because nurses will have to take time out of their
shift time to take part in the training program for one week. This might increase their stress level and mental fatigue.
However, in recognition of psychological distress and poor motivation of staffs in participating in the training program, it
has been planned to keep the duration of training program to only one hour and deliver the training after alternative days.
This would help to avoid extra time spent in work and also enable nurse take rest the other day. Furthermore, if the any
nurse feels distressed after taking part in the session, a procedure will be put in place to make arrangement for those nurses
to meet the Life Line Crisis Support group. It is an organization in Australia that provides all support for people experience
anxiety or stress due to mental health issues, pressure from work, accident, loss of loved ones and other life stressors.
Hence, nurses will get the opportunity to talk with the staffs and learn way to handle pressure at work.
Apart from psychological risk, there is ethical concern because the participant’s information related to safety procedures
and challenges will be recorded. However, it is planned to reduce ethical risk by giving information regarding not using
private and confidential data like patient name and personal details during the data analysis process.
8. CONSENT
Obtaining and Documenting Consent
How will informed consent be obtained/recorded?
 Signed consent form
Recorded verbal consent
Implied by return of survey
Other (Please specify):
9. INFORMATION PROTECTION (DATA STORAGE & SECURITY)
Confidentiality
Tick which method will be used to guarantee confidentiality/anonymity?

Non-identifiable (anonymous) data, which have never been labelled with individual
 identifiers or from which identifiers have been permanently removed, and by means of
which no specific individual can be identified.
Re-identifiable data, from which identifiers have been removed and replaced by a code,
but it remains possible to re-identify a specific individual by, for example, using the code or
linking different data sets .
Individually identifiable data, where the identity of a specific individual can reasonably be
ascertained. Examples of identifiers include the individual’s name, image, and date of birth
or address.
Security and Storage
Does the Principal Researcher accept responsibility for the security of the data Yes
collected?
Who will have access to data?
Access by named researchers only Access by other(s) than named researcher(s)

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Sample Application for
HREC Approval
(NURBN3022)
Which of the following methods will be used to ensure data security?
Data will be kept in locked filing cabinets
Data and identifiers will be kept in separate, locked filing cabinets
 Access to computer files will be available by password only
Other (please describe)
10. RESEARCH TOOLS
Please check that the following documents are included in your application by writing in the box
below (300 words)
Are the following research tools are included in this Yes No N/A
application?
Questionnaire

Draft
Interview Questions Draft
Other
As survey is the main method of investigation for this study, survey questionnaire
and table for demographic details of each participants group has been attached
with this project. The survey questionnaire is different for those implemented
before and those implemented after the intervention. The survey questionnaire
before the implementation of the intervention are as follows:
1. Five questions will on demographic details of research participants
2. The assessment of information related to exposure to needle sticks,
mucocutaneous contamination with bloods and fluids, vaccination status
and measures taken after the intervention will be collected by the below
mentioned five questions.
 What is needle stick injury?
 How it is caused?
 What you do to prevent injuries?
 Do you report about such incidents to the concerned authority?
 What barriers prevent you from reducing such injuries?
The demographic details for the participants will be included in the following
table:
Staff no. Age Work
experience Qualificatio
n Expertise
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Sample Application for
HREC Approval
(NURBN3022)
11. DECLARATIONS
Researcher Declarations:
The information contained herein is, to the best of my knowledge and belief, accurate. I have read
the University’s current human ethics guidelines, and accept responsibility for the conduct of the
procedures set out in the attached application in accordance with the guidelines. I and my co-
researchers have the appropriate qualifications, experience and facilities to conduct the research
set out in the attached application and to deal with any emergencies and contingencies related to
the research that may arise.
Principal Researcher
DR JOANNE PORTER
(Print name in block letters)
Date: …..../…...../….....
Other Researcher Other Researcher
……………………………………………… …………………………………………………
(Print name in block letters) (Print name in block letters)
Date: …..../…...../…..... Date: …..../…...../….....

References:
Bhardwaj, A., Sivapathasundaram, N., Yusof, M. F., Minghat, A. H., Swe, K. M. M., & Sinha, N. K. (2014). The
Prevalence of Accidental needle Stick Injury and their reporting among healthcare Workers in orthopaedic Wards
in General hospital Melaka, Malaysia. Malaysian orthopaedic journal, 8(2), 6.
CDC. (2012). How to prevent needle stick and sharp injuries. Retrieved from:
https://www.cdc.gov/niosh/docs/2012-123/pdfs/2012-123.pdf
Cooke, C. E., & Stephens, J. M. (2017). Clinical, economic, and humanistic burden of needlestick injuries in healthcare
workers. Medical Devices (Auckland, NZ), 10, 225.
Creswell, J. W., & Creswell, J. D. (2017). Research design: Qualitative, quantitative, and mixed methods approaches.
Sage publications.
Etikan, I., Musa, S. A., & Alkassim, R. S. (2016). Comparison of convenience sampling and purposive sampling. American
Journal of Theoretical and Applied Statistics, 5(1), 1-4.
Griswold, S., Bonaroti, A., Rieder, C. J., Erbayri, J., Parsons, J., Nocera, R., & Hamilton, R. (2013). Investigation of a
safety-engineered device to prevent needlestick injury: why has not StatLock stuck?. BMJ open, 3(4), e002327.
Jahangiri, M., Rostamabadi, A., Hoboubi, N., Tadayon, N. and Soleimani, A., 2016. Needle stick injuries and their related
safety measures among nurses in a university hospital, Shiraz, Iran. Safety and health at work, 7(1), pp.72-77.
Kapoor, V., Gambhir, R.S., Singh, S., Gill, S. and Singh, A., 2013. Knowledge, awareness and practice regarding needle
stick injuries in dental profession in India: A systematic review. Nigerian medical journal: journal of the Nigeria
Medical Association, 54(6), p.365.
Nagandla, K., Kumar, K., Bhardwaj, A., Yhmin, C., Lun, L. W., Shi, W. W., & Razak, N. I. B. A. (2015). Prevalence of
needle stick injuries and their underreporting among healthcare workers in the department of obstetrics and
gynaecology. International Archives of Medicine, 8.
Schuurmans, J., Lutgens, S. P., Groen, L., & Schneeberger, P. M. (2018). Do safety engineered devices reduce needle-stick
injuries?. Journal of Hospital Infection.
Sossai, D., Di Guardo, M., Foscoli, R., Pezzi, R., Polimeni, A., Ruzza, L., ... & Dellacà, P. (2016). Efficacy of safety
catheter devices in the prevention of occupational needlestick injuries: applied research in the Liguria Region
(Italy). Journal of preventive medicine and hygiene, 57(2), E110.
Voide, C., Darling, K. E., Kenfak-Foguena, A., Erard, V., Cavassini, M., & Lazor-Blanchet, C. (2012). Underreporting of
needlestick and sharps injuries among healthcare workers in a Swiss University Hospital. Swiss Med Wkly, 142(0).
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