Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-05T04:57:15.610Z Has data issue: false hasContentIssue false
  • English
  • Français

Needlestick and sharps injuries in orthopedic surgery residents and fellows

Published online by Cambridge University Press:  26 September 2019

Joseph E. Snavely Open the ORCID record for Joseph E. Snavely [Opens in a new window] ,
Benjamin C. Service ,
Daniel Miller ,
Joshua R. Langford  and
Kenneth J. Koval
Joseph E. Snavely*
Affiliation:
Department of Orthopaedic Surgery, Orlando Health, Orlando, Florida
Benjamin C. Service
Affiliation:
Department of Orthopaedic Surgery, Orlando Health, Orlando, Florida
Daniel Miller
Affiliation:
Department of Orthopaedic Surgery, Orlando Health, Orlando, Florida
Joshua R. Langford
Affiliation:
Department of Orthopaedic Surgery, Orlando Health, Orlando, Florida
Kenneth J. Koval
Affiliation:
Department of Orthopaedic Surgery, Orlando Health, Orlando, Florida
*
Author for correspondence: Joseph E. Snavely, Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Needlestick and sharps injury (NSSI) is a common occupational hazard of orthopedic surgery training. The purpose of this study was to examine the incidence and surrounding circumstances of intraoperative NSSI in orthopedic surgery residents and fellows and to examine postexposure reporting.

Design:

A 35-question cross-sectional survey.

Setting:

The study was conducted by orthopedic surgery residents and faculty at a nonprofit regional hospital.

Participants:

The questionnaire was distributed to US allopathic orthopedic surgery residency and fellowship programs; 300 orthopedic surgery trainees participated in the survey.

Results:

Of 223 trainees who had completed at least 1 year of residency, 172 (77.1%) sustained an NSSI during residency, and 57 of 63 trainees (90.5%) who had completed at least 4 years sustained an NSSI during residency. The most common causes of NSSI were solid needles, followed by solid pins or wires. The surgical activity most associated with NSSI was wound closure, followed by fracture fixation. The type of surgery most frequently associated with NSSI was orthopedic trauma, followed by hip and knee arthroplasty. Of 177 trainees who had sustained a prior NSSI, 99 (55.9%) failed to report all events to their institution’s occupational health department.

Conclusions:

The incidence of NSSI during residency training is high, with >90% of trainees in their fifth year or later of training having received an injury during their training, with a mean of >4 separate events. Most trainees with an NSSI did not report all of their events, which implies that changes are needed in the incident reporting process universally.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 40 , Issue 11 , November 2019 , pp. 1253 - 1257
Copyright
© 2019 by The Society for Healthcare Epidemiology of America. All rights reserved. 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Panlilio, AL, Orelien, JG, Srivastava, PU, et al. Estimate of the annual number of percutaneous injuries among hospital-based healthcare workers in the United States, 1997–1998. Infect Control Hosp Epidemiol 2004;25:556–562.CrossRefGoogle Scholar
Au, E, Gossage, JA, Bailey, SR. The reporting of needlestick injuries sustained in theatre by surgeons: are we under-reporting? J Hosp Infect 2008;70:66–70.CrossRefGoogle ScholarPubMed
Thomas, WJ, Murray, JR. The incidence and reporting rates of needle-stick injury amongst UK surgeons. Ann R Coll Surg Engl 2009;91:12–17.CrossRefGoogle ScholarPubMed
Kerr, HL, Stewart, N, Pace, A, Elsayed, S. Sharps injury reporting amongst surgeons. Ann R Coll Surg Engl 2009;91:430–432.CrossRefGoogle ScholarPubMed
Lakbala, P, Sobhani, G, Lakbala, M, Inaloo, KD, Mahmoodi, H. Sharps injuries in the operating room. Environ Health Prev Med 2014;19:348–353.CrossRefGoogle Scholar
Voide, C, Darling, KE, Kenfak-Foguena, A, Erard, V, Cavassini, M, Lazor-Blanchet, C. Underreporting of needlestick and sharps injuries among healthcare workers in a Swiss University Hospital. Swiss Med Wkly 2012;142:w13523.Google Scholar
Brasel, KJ, Mol, C, Kolker, A, Weigelt, JA. Needlesticks and surgical residents: who is most at risk? J Surg Educ 2007;64:395–398.CrossRefGoogle ScholarPubMed
Folin, AC, Nordström, GM. Accidental blood contact during orthopedic surgical procedures. Infect Control Hosp Epidemiol 1997;18:244–246.CrossRefGoogle ScholarPubMed
Bernard, JA, Dattilo, JR, Laporte, DM. The incidence and reporting of sharps exposure among medical students, orthopedic residents, and faculty at one institution. J Surg Educ 2013;70:660–668.CrossRefGoogle ScholarPubMed
Wallis, GC, Kim, WY, Chaudhary, BR, Henderson, JJ. Perceptions of orthopaedic surgeons regarding hepatitis C viral transmission: a questionnaire survey. Ann R Coll Surg Engl 2007;89:276–280.CrossRefGoogle ScholarPubMed
Vanhille, DL, Maiberger, PG, Peng, A, Reiter, ER. Sharps exposures among otolaryngology-head and neck surgery residents. Laryngoscope 2012;122:578–582.CrossRefGoogle ScholarPubMed
Tso, D, Langer, M, Blair, GK, Butterworth, S. Sharps-handling practices among junior surgical residents: a video analysis. Can J Surg 2012;55:S178–S183.Google ScholarPubMed
Tokars, JI, Bell, DM, Culver, DH, et al. Percutaneous injuries during surgical procedures. JAMA 1992;267:2899–2904.CrossRefGoogle ScholarPubMed
DeGirolamo, KM, Courtemanche, DJ, Hill, WD, Kennedy, A, Skarsgard, ED. Use of safety scalpels and other safety practices to reduce sharps injury in the operating room: what is the evidence? Can J Surg 2013;56:263–269.CrossRefGoogle ScholarPubMed
Ersozlu, S, Sahin, O, Ozgur, AF, Akkaya, T, Tuncay, C. Glove punctures in major and minor orthopaedic surgery with double gloving. Acta Orthop Belg 2007;73:760–764.Google ScholarPubMed
Mischke, C, Verbeek, JH, Saarto, A, Lavoie, MC, Pahwa, M, Ijaz, S. Gloves, extra gloves or special types of gloves for preventing percutaneous exposure injuries in healthcare personnel. Cochrane Database Syst Rev 2014;3:CD009573.CrossRefGoogle Scholar
Haines, T, Stringer, B, Herring, J, Thoma, A, Harris, KA. Surgeons’ and residents’ double-gloving practices at 2 teaching hospitals in Ontario. Can J Surg 2011;54:95–100.CrossRefGoogle ScholarPubMed
Lipson, ME, Deardon, R, Switzer, NJ, de Gara, C, Ball, CG, Grondin, SC. Practice and attitudes regarding double gloving among staff surgeons and surgical trainees. Can J Surg 2018;61:244–250.CrossRefGoogle ScholarPubMed
Hardison, SA, Pyon, G, Le, A, Wan, W, Coelho, DH. The effects of double gloving on microsurgical skills. Otolaryngol Head Neck Surg 2017;157:419–423.CrossRefGoogle ScholarPubMed
Sharma, GK, Gilson, MM, Nathan, H, Makary, MA. Needlestick injuries among medical students: incidence and implications. Acad Med 2009;84:1815–1821.CrossRefGoogle ScholarPubMed
Salzer, HJ, Hoenigl, M, Kessler, HH, et al. Lack of risk-awareness and reporting behavior towards HIV infection through needlestick injury among European medical students. Int J Hyg Environ Health 2011;214:407–410.CrossRefGoogle ScholarPubMed
Choudhury, RP, Cleator, SJ. An examination of needlestick injury rates, hepatitis B vaccination uptake and instruction on ‘sharps’ technique among medical students. J Hosp Infect 1992;22:143–148.CrossRefGoogle ScholarPubMed
Kennedy, R, Kelly, S, Gonsalves, S, Mc Cann, PA. Barriers to the reporting and management of needlestick injuries among surgeons. Ir J Med Sci 2009;178:297–299.CrossRefGoogle ScholarPubMed
Makary, MA, Al-Attar, A, Holzmueller, CG, et al. Needlestick injuries among surgeons in training. N Engl J Med 2007;356:2693–2699.CrossRefGoogle ScholarPubMed
Diprose, P, Deakin, CD, Smedley, J. Ignorance of post-exposure prophylaxis guidelines following HIV needlestick injury may increase the risk of seroconversion. Br J Anaesth 2000;84:767–770.CrossRefGoogle ScholarPubMed
Supplementary material: File

Snavely et al. supplementary material

Snavely et al. supplementary material

Download Snavely et al. supplementary material(File)
File 97.2 KB