Nursing Practice: Systematic Review Analysis of Sharps Injuries Impact

This report provides a critical appraisal of a systematic review investigating the impact of sharps injuries on student nurses. The review, conducted by Hambridge, Nichols, and Endacott (2016), aims to understand the risk factors associated with sharp instrument use and their impact on nursing students' personal and professional lives. The appraisal assesses the literature review and search process, the quality of the review, the precision of the results, and the discussion analysis. The systematic review included 40 articles and identified psychological and physical impacts such as fear, anxiety, and depression. The report highlights the need for further research and support for nursing students to address the challenges posed by sharps injuries. The student assignment is available on Desklib, a platform that offers a variety of study tools and resources for students.

Running head: SYSTEMATIC REVIEW ANALYSIS
SYSTEMATIC REVIEW ANALYSIS
Name of the student
Name of the university
Author note

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Introduction
While working in healthcare facilities, healthcare workers, and nursing professionals are
exposed to several sharp objects such as surgical instruments, scalpels, glasses, lancets, hollow
bore needles, catheter stylets, and different blood bore needles (Suliman et al., 2018). As per the
Choi et al. (2018), while working in healthcare facilities, every 1 in 10 healthcare workers
undergoes such sharp instrument injury each year, due to which they suffer from several
complications. The primary complications of sharp injuries among nursing professionals include
blood-borne infection, contagious infections, viral and bacterial infections and so on (Pradhan,
2017). As per Hada et al. (2018), globally, more than 66,000 hepatitis B viral infections, 16,000
hepatitis C virus and 1000 HIV infections were caused by the sharp object infections among the
nursing and other healthcare professionals in the year 2000. Besides sharp injuries, other effects
such as higher cost of post-exposure related treatment and medication, related disabilities, the
gap in their service or learning due to infection and economic impact could affect the mental and
economic aspect of patient’s health (Besey & Zengin, 2019).
Despite prevalent and common in the healthcare facilities throughout the world, very
limited research process has been conducted so that the evidence regarding the sharp instrument
related injury among nursing professionals could be developed (Arli & Bakan, 2018). The
primary aim of this evidence-based article is to review a systematic research article and critically
evaluate the population studied, intervention given and the outcomes that have been considered
in the research article. Further through a detailed assessment of the paper, the relevance of the
literature review, quality of the review process, the precision of the results and discussion
analysis would be provided in this paper. The research article which has been selected for the

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review process in this paper is by Hambridge, Nichols and Endacott (2016), that discusses the
impact of sharp instrument related injuries on the student nursing professionals.
Review problem/focus/ question
The primary aim of the selected research article is to explain the risk factors associated
to the use of sharp instruments and maintain their safety in the healthcare facility so that due to
such injuries their personal and professionals life could not hamper (Hambridge, Nichols &
Endacott, 2016). Further, due to the scarcity of research articles about the topic selected for this
assessment, a systematic review process was conducted for the research process (Arli & Bakan,
2018). The research question selected for this process was to understand the impact and extent of
sharp injuries on the nursing professionals who have recently joined the nursing profession.
Hence, the primary focus of the studied population the systematic review process was the pre-
registration student nursing professionals so that the impact of the process could be determined
(Brett et al., 2014). The intervention which was used to churn the research papers included and to
collect the useful data for the assessment would be methodological quality assessment form the
40 research articles selected for this review process. Further prior to inclusion of these research
articles in the research process, the researchers included critical appraisal tool (CASP tool) for
systematic review so that the effectiveness of the included articles could be included in the
research process (Clark et al., 2014). Besides to extract the data from the research articles
included for the study, MAStARI DATA extraction instrument had been selected for the review
process by the researchers.

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Literature review and search process
The systematic review conducted in this research paper was focused on identifying the
impact of occupational sharp objects and the effect of it on the student nursing professionals. The
systematic review process was conducted in this research process in six stages such as searching
the research articles, conducting appropriate screening of the research articles, conducting
critical appraisal using the CASP tools, extracting data from the research process, and finally
aggregating the data to conduct proper data collection (Hambridge, Nichols & Endacott, 2016).
Several databases were searched to collect research articles compatible to the research
process, such as CINAHL, BMJ journal collection, Cochrane library, Medline, Pub Med, UK
Pub Med central, Psyc Net and Pysc Info and EBSCO and Science Direct were selected for the
research process. Further, the grey research articles which were selected for the research process
were Google Scholar, British Library Electronic Online Service, NHS journals and national
research register to collect the research articles for the process (Hambridge, Nichols & Endacott,
2016).
The appropriateness of the research process was determined by imposing several
inclusion and exclusion criteria in the systematic review process so that appropriate and accurate
research articles could be collected. The inclusion criteria included for the process was mention
of occupational injuries of nursing professionals using scalpels, sutures, needles, stitch cutters,
and glass scissors (Hambridge, Nichols & Endacott, 2016). Further to determine the relevancy of
the research, a timeline was set from 1980 to 2014 and for the research process, both qualitative
and quantitative research articles were included in the study. Further, to determine the
effectiveness of the research process, the CASP tool was selected as National Institute for Health

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and Care Excellence have recommended this tool for the critical appraisal of the research process
(Clark et al., 2014). As per Carlborg, Kindström and Kowalkowski (2014), the study design
which is included for the systematic review process such as randomized control trial, case-
control study, cross-sectional study, quasi-experimental study, and others belong to the level I, II
and III of the level of evidence. Further, the qualitative research articles which were included in
the study such as surveys, questionnaires, and ethnography were also level I and II of evidence,
hence the articles were appropriate as per the research process (Pollock et al., 2014).
While determining the appropriateness of chosen study design, the article of Hambridge,
Nichols and Endacott (2016) should be mentioned in which researchers determined the
effectiveness of the systematic review process. The research mentioned that systematic review is
the critical process in which multiple articles, their selected study, chosen research process, and
data analysis were included and hence, application of these helps to develop a pool of data
collected from all the research articles (Carlborg, Kindström & Kowalkowski, 2014). This data
pooling in systematic review proves in called a Meta-analysis process which is effective in
determining effective and scientifically efficient research process. Further, it was also mentioned
in the research of Pollock et al. (2014), that systematic review helps to remove all the bias
included in the research process of the entire included research article and hence, the research
findings which are found after completion of the review process holds accuracy and efficacy.
Quality of the review
Evidence-based research is an effective process using which healthcare professionals
around the world collects research processes so that through effective research and efficient
interventions, accurate strategies for healthcare professionals could be identified. Therefore,

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through the application of the systematic review in the research process, researchers determine
the accuracy and efficiency of research with high rigor and effectiveness (Suliman et al., 2018).
To determine the rigor or high quality of the systematic review, the researchers included
articles which have published between 1980 and 2014. The primary research behind the selection
of this time frame was the discovery of HIV AIDS that happened after 1981 and AIDS is one of
the primary issues which occur due to the occupational injury among nursing professionals
throughout the world (Hambridge, Nichols & Endacott, 2016). Hence, by selecting an accurate
timeframe, researchers determine the reliability of the research process. Further, to determine the
accurate selection of articles from the databases chosen for the process, several inclusion and
exclusion criteria were selected depending on which from the pool of 376 research articles
collected from more than 20 databases, only 40 accurate and efficient to answer the research
question were selected (Hambridge, Nichols & Endacott, 2016). Moreover, to assess the quality
of the research process, the research articles screened through CASP tool so that all the 10 steps
of screening of qualitative and qualitative research processes the effectiveness and rigor of the
research process could be identified (Hambridge, Nichols & Endacott, 2016).
The data synthesis process was dependent on all the research articles included for the
study and then through the application of the MAStARI data extraction process, all the
qualitative data were extracted from the selected article. This was an effective process as through
the implementation of this data extraction process all the bias of the study articles were removed
from the process. Further, for the data collection process of quantitative research articles
included in this systematic review research process, Joanna Briggs Institute’s- QARI data
collection tool was used as it is effective in collecting data for systematic analysis process (Munn
et al., 2014).

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The result of all the studies was included as a whole for this systematic analysis and
while discussing the 40 selected research processes, all the similarities in research design, search
data collection and analysis method were included in the study (Hambridge, Nichols & Endacott,
2016). Further, besides similarity, contradictory research processes and findings were also
included in the study so that a critical discussion of the research papers included in the study
could be conducted. Further, as per Shamseer et al. (2015), to provide logical flow and rigour to
the research analysis, that is expected from a literature review or meta-analysis research process,
all the variations in subject selection, research methodology, and data collection process were
included in the study so that through the commentary of their results or findings, the ability of
the research in addressing the primary question of the systematic review process could be
assessed (Hambridge, Nichols & Endacott, 2016).
Results
The result of this research articles included in the systematic review was processed in two
five sections. There were 40 research articles within which 34 articles had surveys, 4 quasi-
experimental studies, 1 case study analysis, and 1 qualitative data were included in the study.
Within the four themes of traumatic incidence, the reaction of the incidence, need for support
and intervening factors (Hambridge, Nichols & Endacott, 2016). Hence, majority of the research
indicated to the fact that nursing professionals lacked the awareness about sharp objectives and
the resultant injuries, more two nursing professionals were not able to report to the occupational
injuries to the healthcare facility because the healthcare facility lacked the healthcare and
counseling support which is required to overcome the trauma related to the process (Hambridge,
Nichols & Endacott, 2016). Besides, after collecting data from the survey related research
articles, student nursing professionals were affected with frustration, incompetence, low-self

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esteemed, insecurity, anger and fear of infection of several viral infections. However, in the
selected research article, no statistical analysis of the research findings was collected and hence
lacked the confidence intervals, hence no such Odd ratio or the NNT for the statistical analysis of
the research findings were included in the study (Hambridge, Nichols & Endacott, 2016).
Discussion/result analysis
In this discussion process, the entire 40 articles collected from the previously mentioned
science databases and then research findings were collected so that the effect of occupational
sharps injuries and associated side effects on the nursing professionals could be assessed
(Hambridge, Nichols & Endacott, 2016). The findings of the systematic review indicated that the
majority of student nursing professionals’ suffered from a feeling of fear after facing such
injuries in their clinical placement or clinical practice sessions, in South Africa. Further another
study mentioned that after suffering such injury, student nursing professionals developed
anxiety, stress, and depression because it affected their work experience and affected their
occupational healthcare related experience. More than 15.2% of the nursing professionals were
affected with emotional distress, frustration, panic and extreme numbness due to lack of empathy
or concern from senior nursing professionals in the healthcare facility (Hambridge, Nichols &
Endacott, 2016).
In the research article by Naghavi et al (2013) included in the research process mentioned
that all the nursing professionals who took part in the survey for the research process indicated
that as per their thinking, occupational injuries were directly proportionate to their feeling of
distress and anxiety. As due to the persistent occupation injuries they faced in the healthcare
facility, they developed post-traumatic stress due to which they felt stigmatized of working in the

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surgery department in the near future. Majority of the research findings of this research of
Hambridge, Nichols and Endacott (2016), mentioned that fear of blood borne pathogenic disease
was their primary concern due to which they were hesitating to work with such objects which
could lead to occupational injury. As one of the studies included in the research process
mentioned that 93% of the total nursing staff included in the study were concerned about the
occurrence of HIV as they lacked proper counseling or communication facilities where they can
communicate such complex situations (Hambridge, Nichols & Endacott, 2016). Hence,
psychological impact emerged as the primary effect on student nursing professionals due to the
occupational injury among student nursing professionals who were involved in their clinical trial
or practice.
The second concern which emerged from the systematic review process of 40 research
articles were the negative effect on the self-esteem of the nursing professionals that could affect
their future career as a nursing professional in the healthcare facilities around the world. It is
mentioned in the care process majority of the nursing professionals were stigmatized of
conducting the similar action in are facilities due to which they suffered from occupational injury
and hence, it affected their confidence of conducting critical or surgical interventions
(Hambridge, Nichols & Endacott, 2016). It is a negative impact as the majority of the nursing
professionals would start resigning from the facilities and the scarcity of the nursing
professionals would affect the quality of the care process. Hence, this was also included in the
systematic review research articles and hence the personal aspect of nursing professionals was
the second aspect which was affected due to occupational injury (Hambridge, Nichols &
Endacott, 2016). Further, in some of the research articles, long term psychiatric effects and
severe episodes of depression were also noticed as the healthcare facilities where such incidences

9SYSTEMATIC REVIEW ANALYSIS
occurred, they did not have any counseling or communication facilities where the nursing
professionals could share their occupational hazard related conditions. Hence, the research article
mentioned that besides the student nursing professionals, 12% of the student physicians or
doctors also suffered from the occupational injury within which 97% were stigmatized because
of the consequences it could lead to in their health, occupation, and lifestyle. Therefore from the
detailed analysis of the systematic review paper by Hambridge, Nichols and Endacott (2016),
indicated to the future reccomnedations that due to occupational injuries with sharp instruments
while conducting healthcare interventions, nursing professionals and their emotional, mental and
physical health are affected. Hence, it is important for the healthcare facilities to consider this
situation and provide them with communication of counseling therapy so that they could
overcome their stigma and focus on serving the community and country involved (Hambridge,
Nichols & Endacott, 2016).
Conclusion
An occupational injury is a big concern for the healthcare professionals around the world
as its severity, its consequences, and deleterious effects could lead to severe physical, mental and
emotional health conditions among healthcare professionals. Despite the prevalence of such
injuries in general healthcare process around the world lack of research processes affect the
achievement of a proper intervention using which it could be lowered. This paper, therefore,
conducted a systematic review of the paper by Hambridge, Nichols and Endacott (2016), in
which the primary aim of the researcher was to identify the severe complication of occupational
injuries among the student nursing professionals. In this process, the research design, the data
collection method, data analysis and the results of the research article was collected and the rigor
and reliability of the concluded i=research articles were assessed. Finally through the application

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of systematic review indicated to the fact that the majority of the complication of these
occupational injuries among nursing professionals was related to their mental strength, their
working ability, and their psychological aspect. Therefore, the systematic review was successful
in finding the answer to the research question, it aimed for.

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