Stick and Tell A Survey of Emergency Medicine Residents and Needlestick Exposures

Abstract

An estimated 400,000–800,000 sharps-related injuries occur among healthcare workers (HCWs) annually in the United States. The risk of needlestick exposure may be particularly high among emergency medicine (EM) residents, who are learning new procedures in a relatively uncontrolled environment. Despite the potentially serious consequences of percutaneous injuries (PCIs), practitioners in training often down-play the occurrence of PCIs and do not report exposures.Current literature implies that underreporting of needlestick injuries is multifactorial. By not seeking care after needlesticks occur and thereby delaying treatment, residents incur more risk from exposures. We sought to elucidate the underlying issues that might contribute to this lack of reporting needlestick injuries. Using an anonymous survey, we collected information regarding factors that contributed to sustaining a PCI as well as perceived barriers that prevented residents from reporting these exposures. This information is desirable for both residency programs and employee health departments to reduce the occurrence of unreported exposures.The survey contained 19 questions, and all subjects were EM residents from the 8 Accreditation Council for Graduate Medical Education–accredited programs in the state of Illinois during the period January–February 2011. The voluntary survey was distributed via e-mail and through a paper version distributed at a regional EM residency conference.

The Urban Emergency Department: A Potential Increased Occupational Hazard for Sharps‐related Injuries

“…9,10 This has historically been attributed to physicians feeling too busy to undergo the reporting process or inappropriately minimizing the hazards associated with exposures. 9,10 However, if this is unchanged and physicians continue to underreport, then the true incident of sharps-related injuries would be much higher than that observed in this study.…”

“…Despite this, we do suspect this observation of more physicians reporting sharps-related injuries may in part represent a change in health care workers' reporting, where physicians in particular have previously been recognized as less likely to report such exposures. 9,10 This has historically been attributed to physicians feeling too busy to undergo the reporting process or inappropriately minimizing the hazards associated with exposures. 9,10 However, if this is unchanged and physicians continue to underreport, then the true incident of sharps-related injuries would be much higher than that observed in this study.…”

“…[8][9][10] While prior studies have focused on identifying injuries that occur within the general hospital or operating room, most have failed to quantify and compare the rates of injury between different types of emergency department (ED) settings. We hypothesized that the frequency of needle…”

“…7 Despite significant effort for reduction, sharps-related injuries continue to pose a significant risk to hospital personnel in all health care settings. [8][9][10] While prior studies have focused on identifying injuries that occur within the general hospital or operating room, most have failed to quantify and compare the rates of injury between different types of emergency department (ED) settings. We hypothesized that the frequency of needle insertions and procedures that occur in the urban ED setting, coupled with the often chaotic and unpredictable nature of this environment, would create a high-risk area for sharps-related injuries to occur.…”