K. Kapp1, M. Mendez1, A. Bors1, R. Corn1, F. Sharif1, F. Alemi1 1University Of Missouri Kansas City,Department Of Surgery,Kansas City, MO, USA
Introduction: The Centers for Disease Control estimate there are over 300,000 needlestick injuries in the US each year (with 23% occurring in the operating room) resulting in productivity loss of $82.2 million. The Accreditation Council for Graduate Medical Education data demonstrated 99% of residents had at least one needlestick by their final year of training with over half going unreported and 16% involving patients with HIV, Hepatitis B, Hepatitis C, or history of IV drug use. Morbidity from needlesticks has devastating effects on surgeons both personally and financially. The purpose of this study is to evaluate barriers to residents disclosing injuries to their healthcare system so that efficient means of reporting can be proposed to improve processes since early reporting leads to post-exposure prophylaxis and treatment decreasing sero-conversion and chronic infection.
Methods: An anonymous survey was distributed in person among residents of surgical specialties during didactic sessions. Survey items canvassed included post-graduate training year, number of past needlesticks, facility location of occurrence, activity during occurrence, number of needlesticks reported, who they reported to, barriers to reporting including knowledge of how to report, time of day, fear of repercussions, previous poor experience, severity of injury, fear of or lack of confidentiality, bother to the patient, perceived low risk of disease transmission, estimated time away from clinical activity for reporting, overall personal experience in reporting, and whether they would report a future injury based on prior experience. Data was analyzed with comparisons made between specialties.
Results:Surveys yielded responses from 76 residents in 6 surgical subspecialties. Most needlestick injuries occurred in the Operating Room or Emergency Department. 70% of residents had a needlestick with 14% of injuries never being reported. Forty-five percent of residents reported needlesticks less than 75% of the time. Top reasons residents didn't report include: Process is too time consuming, Lack of time, and Patient appeared low risk. The majority estimated time away from clinical activity was 30-120 minutes.
Conclusion:Needlestick injuries are underreported by surgical residents nationally and in our institution with the main barrier to reporting being time constraints. Despite measures to improve safety and decrease the occurrence, the CDC reports needlestick injuries in the OR have increased by 6.5%. Delayed reporting causes significant morbidity resulting in personal and financial harm to surgical residents. Streamlining the process particularly the paper work by giving resident Occupational Health education during orientation and providing surgeons with reporting packets at the beginning of each academic year with basic resident and facility information prefilled to save time may increase needlestick injury reporting by surgical residents.