Knowledge, Compliance Behaviors, and Associated Factors Regarding Needlestick Injuries Among Nursing Students in Palestine: A Cross-Sectional Study

Abstract

Background: Needlestick injuries (NSIs) pose a critical occupational hazard for nursing students during clinical education. Knowledge of safety protocols and adherence to standard precautions are essential for preventing bloodborne pathogen exposure. This study aimed to evaluate knowledge levels regarding NSIs, safe procedural practices, and associated demographic and training factors among undergraduate nursing students in Palestine. Methods: A quantitative cross-sectional design was conducted among 365 undergraduate nursing students across four major universities in the southern West Bank. Data were gathered using a validated self-administered questionnaire measuring demographic characteristics, clinical training history, safety practices, and an 8-item NSI knowledge scale. Knowledge scores were categorized using Bloom's cutoff points (Poor ≤59%, Moderate 60–79%, High ≥80%). Independent sample t-tests, one-way ANOVA, and Pearson correlation coefficients were used to analyze factors associated with knowledge scores. Results: The mean age of participants was 20.82 ± 1.04 years; 80.5% were female, and 51.8% were in their fourth year of study. High adherence was reported for always wearing gloves (79.7%) and always avoiding needle recapping (73.4%). The mean knowledge percentage score was 79.18% ± 18.87%, with 55.6% categorized as High, 32.9% as Moderate, and 11.5% as Poor knowledge. Students demonstrated high knowledge regarding NSI definitions (92.1%) and proper sharps disposal (92.9%), but gaps were identified regarding sharps container maximum capacity (58.6%) and immediate handwashing with soap and water post-exposure (66.8%). Female students scored significantly higher in knowledge than male students (81.34% vs. 70.25%, p < 0.001). Furthermore, students who always wore gloves (80.46% vs. 74.16%, p = 0.010) and those who always avoided recapping needles (80.55% vs. 75.39%, p = 0.021) exhibited significantly higher knowledge scores. Laboratory training (p = 0.103), academic year (p = 0.638), and age (p = 0.338) were not significantly associated with knowledge levels. Conclusion: Palestinian nursing students demonstrate a generally high level of knowledge regarding NSIs, which positively correlates with essential safety behaviors. However, targeted educational interventions are necessary to address specific post-exposure protocol knowledge deficits and to enhance safety education among male nursing students.