Graduation Year


Document Type




Degree Granting Department

Global Health

Major Professor

Boo Kwa, Ph.D.

Co-Major Professor

Donna Haiduven, Ph.D.

Committee Member

Aurora Sanchez-Anguiano, Ph.D.

Committee Member

Ricardo Izurieta, Dr.P.H.


focus groups, intervention, PRECEDE-PROCEED Model


Nurses as health care workers are at risk of biological agents such as bacteria, viruses and others. At health care settings exposure to bloodborne pathogens can cause infections through needlestick injuries. The objectives of this research were to determine factors surrounding recapping needles in hospital nurses and to implement an educational strategy to reduce the recapping practices.

It was a descriptive and exploratory approach where the PRECEDE component of the PRECEDE/PROCEDE Model was used as the framework to systematize and analyze the information obtained from the focus group sessions.

A total of 120 nurses participated from four different departments. The study was conducted in three phases: diagnosis, implementation and evaluation of the educational strategy. The results obtained from the focus group sessions revealed that predisposing, reinforcing, enabling and environment factors were related to the practice of recapping and needlestick injuries. Most of this information represented the essential basis for the implementation of the educational strategy. During the diagnostic phase, the percentage of needles without recapping was 24% contrasting with 40% found after the educational strategy. The percentage difference (16%) was statistically significant (p < 0.001). The odds ratios calculation in the departments studied showed that the educational strategy was a protective factor to avoid the recapping of used needles.

An important conclusion is that the educational strategy, which focused on the practice and habit of what should be done (e.g., NOT recapping used needles), contributed to the decrease in recapping practice. However, nurses perceived did it not provide a safe working environment.

The implications are focused on: nurses and hospital management have to engage in an active role to promote a safety work environment where nurses and other health care workers can be protected. The incorporation of educational strategies, continuous and updated training, as well as the evaluation and monitoring process can play a determinant role in the control of hazard exposures. It is imperative that a safe and healthy workplace for the personnel be provided; not less important is the acquisition of equipment and devices for sharp handling and disposal, to complement the prevention of accidents related to needlestick injuries.