Lead author Martin Makary, M.D., M.P.H., a surgeon at The Johns Hopkins Hospital, says that while residents must take more responsibility, it’s also up to hospitals to take “immediate steps to improve safety and care for health care workers to reduce the spread of HIV and hepatitis infection.” Makary says 57 percent of surgical residents reported a feeling of being “rushed” as the primary cause of the injury. He adds that 42 percent said they did not report the injury because it took “too much time” and 28 percent said there was “no utility in reporting.”
Makary suggests that injuries could be greatly reduced by hospitals’ increasing the use of nurse practitioners and physicians assistants to reduce surgical workloads and adopting sharpless surgical techniques such as electric scalpels, clips and glues. “Twenty percent of all general surgery operations could be done without using any sharp instruments,” he says. Furthermore, Makary says, residents would more likely report exposures if hospitals used timely reporting mechanisms (e.g., internal hotlines and response teams), routine prompts (e.g., postoperative checklists that monitor exposures), and peer-to-peer education to create a local culture that encourages speaking up.
“We know also that many residents resist reporting because the training culture suggests that needle sticks ‘go with the territory’ and reporting them may lower peer esteem,” Makary notes. The survey revealed that 99 percent of surgeons-in-training suffered an average of eight needle-stick injuries in their first five years. Of these surgeons, only 49 percent reported injuries to an employee health service. Of those who reported, 53 percent had experienced an injury involving a patient with a history of intravenous drug use and/or infected with HIV, hepatitis B (HBV) or hepatitis C (HCV).
MEDICA.de; Source: Johns Hopkins Medical Institutions