Improving Doctors' Knowledge and Practices on Needle-Stick Injury Prevention and Management: A Two-Cycle Clinical Audit at Al Managil Teaching Hospital.

BACKGROUND: Needle-stick injuries (NSIs) pose a major occupational hazard for doctors, serving as a route for transmission of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). International guidelines emphasize immediate wound care, avoidance of recapping, use of safety-engineered devices, and timely initiation of post-exposure prophylaxis (PEP). However, knowledge and adherence remain suboptimal in many low-resource settings. This audit evaluated doctors' awareness, knowledge, and practices related to NSI prevention and management at Al Managil Teaching Hospital, with the aim of identifying gaps and assessing the impact of targeted interventions. METHODS: A closed-loop clinical audit was conducted in two cycles (May and September 2025) among doctors working in high-risk departments. Fifty participants were included in each cycle. Data were collected through a structured questionnaire covering demographics, sharps-safety knowledge, immediate management of NSIs, training and reporting practices, and awareness of immunization and PEP protocols. Following the first cycle, interventions included structured teaching sessions, posters, and distribution of guideline leaflets. The same questionnaire was re-administered in the second cycle to measure changes in knowledge and awareness. RESULTS: Substantial improvements were observed across all domains of knowledge and practice. Recognition of HBV as the most common NSI-transmitted pathogen increased from 52% to 100%. Awareness of correct first-aid measures (washing with soap and water) rose from 72% to 100%, while understanding that safety-engineered devices are the most effective preventive measure improved from 14% to 100%. Correct knowledge of sharps disposal (replacing at three-quarters full, disposal without recapping) improved from 26% and 12% at baseline to 100% in the re-audit. Training and reporting also demonstrated marked progress: formal training increased from 18% to 100%, regular refresher training from 14% to 100%, and awareness of a reporting system from 25% to 98%. Knowledge of PEP improved from 24.5% to 100% for definition and from 38% to 100% for correct initiation within 72 hours. CONCLUSION: Targeted educational interventions achieved significant improvements in doctors' knowledge and awareness of NSI prevention and management. The audit underscores the importance of recurrent training, safe sharps disposal practices, and supportive reporting systems. Sustained institutional commitment, reinforced by national guidelines and monitoring, is necessary to translate knowledge into lasting improvements in occupational safety.