Submited on: 25 Sep 2015 07:42:05 AM GMT
Published on: 26 Sep 2015 12:20:44 PM GMT
Great Potential, But Further Analysis of Data Would Be Very Beneficial
Posted by Mr. Eric Lindahl on 03 Nov 2017 03:43:10 AM GMT Reviewed by Interested Peers

  • What are the main claims of the paper and how important are they?

    The main claim of this paper is there is the high level of needle stick injuries (NSIs) among various groups of healthcare workers in a teaching hospital in West Bengal, India. These statistics were gathered from a survey taken by the health care workers.  This data is important because it shows NSIs are still a very real problem, even at a tertiary care academic teaching hospital.  Even more surprising are the rates of healthcare workers who are unaware of the basic procedures available after a needle stick that can prevent further injury.  For example, only 43% of healthcare workers were aware of the availability of post exposure prophylaxis services (PEP), which could prevent contraction of a serious infection.

  • Are these claims novel? If not, please specify papers that weaken the claims to the originality of this one.

    I don't believe these claims are novel.  Based on information in the paper, it seems that awareness of treatment and prevention options involving NSIs in India as a whole are lacking.  The paper states the statistics gathered from this academic hospital were better that those found in some other studies in India.  In addition, NSIs appear to be quite prevalent based on included information collected by the WHO, and even those statistics are likely vastly underreported.  This is not to say the results are not insightful.  It shows that there is a high risk of infection, even in high level hospitals, and there is much more work to be done in terms of educating HCWs. 

  • Are the claims properly placed in the context of the previous literature?

    I think the article does a good job of framing this study in the context of previously published literature. Some relevant background is provided, and related studies are included as well. The paper could use some more background info on the comparison of this data to other teaching hospitals, both in India and throughout the world.  This information would be helpful to get a better idea of the baseline level of NSIs in comparable settings. 

  • Do the results support the claims? If not, what other evidence is required?

    The results of the surveys demonstrated the high level of NSI incidence at the study location.  While this study did not include a hypothesis to be proven or disproven, the article was framed in a way that made it appear that NSIs were a prevalent, worldwide problem.  The data collected at this hospital surely provides evidence for that claim. Again, the inclusion of relevant data from various other geographies would be helpful in providing context for the data presented here. 

  • If a protocol is provided, for example for a randomized controlled trial, are there any important deviations from it? If so, have the authors explained adequately why the deviations occurred?

    There is not much info provided on the protocol of this study, which I think is a glaring weakness.  There is no indication given as to which HCWs were targeted to receive the survey, or why this hospital was chosen.  I am assuming every HCW at this institution was sent a survey, and those that responded were included in the dataset.  It is unclear if there was a disparity in the number of members in each group, or if the rates of response varied. Also, including characteristics of each group could be helpful as well, such as: gender, education level, years of experience, training received, etc.  Additionally, the data could be skewed based on the varying degrees of exposure to needles between the different groups of HCWs.  These statistics are not provided either. 

  • Is the methodology valid? Does the paper offer enough details of its methodology that its experiments or its analyses could be reproduced?

    There is more to be desired in the detail of the methodology section.  It would be helpful to know the length of the survey, type of questions included, response types (1-10, T/F, open ended) etc.  Because of this, it would likely be hard to replicate this study.  

  • Would any other experiments or additional information improve the paper? How much better would the paper be if this extra work was done, and how difficult would such work be to do, or to provide?

    This study is more or less a presentation of raw data collected from a survey.  The authors state they used SPSS to complete data analysis, but there is really no analysis that I see; it seems the results are just presented as percentages of yes/no answers.  It would be helpful to dig a little deeper into the data, or improve the surveys to include more detailed information.  This information could include things such as: education background, number of training hours, type of training undertaken, frequency of working with needles, time of day the NSIs occurred, average number of hours worked weekly, etc.  This could provide for real insight into how the incidence of these events could be reduced.  This would take some work on the front and back end of the data collection process, but the conclusions and impact of this paper could be greatly increased by these improvements in study design. 

  • Is this paper outstanding in its discipline? (For example, would you like to see this work presented in a seminar at your hospital or university? Do you feel these results need to be incorporated in your next general lecture on the subject?) If yes, what makes it outstanding? If not, why not?

    This paper is not outstanding.  If it included more detailed collection of data, along with some data analysis leading to actionable conclusions on how to improve the rate of NSIs, I think it would be much more useful. Additionally, taking into account a larger dataset, ie from all tertiary hospitals in a certain geographic area, then this study may carry more weight.  Ideally, this study would be able to provide evidence of the causes of these needle sticks, and trends behind their occurrence, rather than simply stating that NSIs are a problem (which appears to be well known). 

  • Other Comments:

    There is much more this paper could have done to be an asset to lowering NSI rates.  Collecting more thorough data and analyzing it in a meaningful way could have given deeper insight into the causes and possible solutions to this widespread problem.  Instead it is just presenting raw data on the rates of NSIs at one hospital in India. 

  • Competing interests:
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  • Experience and credentials in the specific area of science:

    2nd year Doctor of Pharmacy student in the USA

  • How to cite:  Lindahl E .Great Potential, But Further Analysis of Data Would Be Very Beneficial[Review of the article 'The prevalence of needle stick injury among healthcare personnel in a tertiary care hospital in Kolkata ' by kumar b].WebmedCentral 2017;8(11):WMCRW003391
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