Most Surgical Residents Fail To Report Needle-Stick Injuries
Almost all surgical residents accidentally stick themselves withneedles or other sharp medical instruments but most fail to report theinjury, increasing their risk of contracting HIV, hepatitis or otherbloodborne diseases from infected patients, according to a studypublished Thursday in the New England Journal of Medicine, the New York Times reports.
For the study, researchers at Georgetown University and Johns Hopkins Universityquestioned 699 physicians who in 2003 were residents at 17 medicalcenters nationwide. They found that 99% of participants had experiencedat least one needle-stick injury by the final year of residency, withan average of eight such injuries per resident. The study found that51% of residents did not report the injuries to an employee healthservice, which is required at some hospitals. Of the residents whoreported their injuries, 53% were stuck while working with a patient athigh risk for common, potentially fatal bloodborne diseases, the Times reports (Altman, New York Times, 6/28).
The National Institute for Occupational Safety and Healthestimates that one in 300 health care workers who are stuck with aneedle while working with an HIV-positive person will contract thevirus. In addition, NIOSH estimates that two in 100 health care workerswho are stuck while treating people with hepatitis C will develop theinfection. The researchers noted that although the risk of disease islow, it would be virtually nonexistent if health care workers reportedthe injuries and sought treatment immediately, the Baltimore Sun reports.
According to the Sun,surgical residents are prone to needle sticks because they areinexperienced. In addition, residents often work with high-riskpatients and conduct procedures in which needle sticks are common.About 800,000 needle sticks occur annually. CDC between 1985 and 1999 documented 55 cases of health care workers contracting HIV, the Sun reports (Emery, Baltimore Sun, 6/28).
According to the Times,being rushed at work was the No. 1 reason residents did not reportneedle-stick injuries. The study found that residents believedreporting their injuries would take too much time, could jeopardizecareer opportunities and might cause them to lose face among peers, theTimes reports. In addition, some residents believed thattimely medical treatment would not prevent them from contracting HIV oranother illness.
The study's findings are "further evidence"that protection measures recommended by CDC to prevent such injuriesand provide treatment should be strengthened, the Times reports.Researchers urged surgeons to provide residents with specificinstruction on safe techniques and what to do if an injury occurs.Other preventive measures include wearing two sets of surgical gloves;using electric scalpels, clips and glue rather than sharp instruments;improving techniques for passing instruments between health careworkers; using postoperative check lists; and increasing the use ofnurse practitioners and physician assistants to reduce workloads. Inaddition, infection control experts are urging physicians to use thesame precautions in treating all patients and not only those at highrisk of HIV and other infections, according to the Times. Reaction
Martin Makary, a surgeon at Johns Hopkins who led the survey, said thatsurgeons have made "little progress in the last 20 years" in preventingneedle-stick injuries and that hospitals "are not doing what theyshould" to prevent such injuries (New York Times, 6/28). Makaryadded that attending physicians should insist that injuries be reportedto the hospital, adding that if treatment is sought immediately, HIV is"almost 100% preventable" (Baltimore Sun, 6/28).
Reprinted with permission from kaisernetwork.org. You can view theentire Kaiser DailyHIV/AIDS Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . TheKaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service ofThe Henry J. Kaiser Family Foundation.