Regional Disparities and Related Factors in Knowledge, Attitude, and Practice Toward Needlestick Injuries Among Clinical Nurses: A Propensity Score-Matched Comparative Study of Chongqing Versus National-Level Data.

Background: Needlestick injuries (NSIs) are a major occupational hazard for healthcare workers, particularly clinical nurses. Regional disparities in NSI incidence and related knowledge, attitude, and practice (KAP) remain underexplored in China.

Methods: A cross-sectional online survey collected 16,070 valid responses from 34 provincial-level regions in China between November 2022 and February 2023. Propensity score matching (PSM) was applied to control for demographic differences, followed by univariate and multivariate analyses to compare KAP levels and influencing factors of NSIs.

Result: After PSM, nurses in Chongqing demonstrated higher frequencies of NSI prevention training, broader adoption of needleless connectors, and more comprehensive institutional management measures (all P<0.001) compared to national counterparts. KAP scores in Chongqing were significantly superior across all domains (P<0.001), and the self-reported NSI incidence was lower (P=0.005). Multivariable analyses identified frequent training (≥3 times/year), awareness of needleless systems, and integration of NSI prevention into hospital quality control systems as independent predictors of higher KAP scores and lower NSI risk.

Conclusions: Clinical nurses in Chongqing exhibited superior KAP profiles and reduced NSI incidence compared to national averages. Systematic training and institutional integration of NSI prevention emerged as critical strategies to enhance occupational safety. These findings underscore the need for standardized policy enforcement and equitable resource distribution across regions.