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

Abstract

Objectives: Health care workers are at risk for sharps-related injuries while working in the clinical arena. The authors sought to quantify and compare the frequency of these injuries for all health care personnel between the urban and community emergency department (ED).Methods: A retrospective review was performed on the institutional human resources database of all self-or supervisor-reported sharps-related injuries that occurred to ED personnel in a single health system from January 2010 through September 2014. The health system was composed of a single urban academic Level I trauma center and seven community EDs, two of which were academic Level III trauma centers. Each sharps-related injury was reviewed for site of injury, job class, and type of instrument causing the injury.Results: There were 171 sharps-related injuries reported during 447,986 urban and 1,350,623 community patient visits. Of the 171 injuries, 44.4% occurred to physicians, 39.2% to nurses, 12.9% to support staff, and 3.5% to physician assistants. Injuries occurred more frequently at the urban academic medical center when compared to the pooled community sites: 20.3 per 100,000 patient visits (n = 91) versus 5.9 per 100,000 patient visits (n = 80), respectively (odds ratio = 3.43, 95% confidence interval = 2.54 to 4.63, p < 0.001). They also occurred more frequently at the urban site when individually compared to each community site.Conclusions: Physicians accounted for the largest proportion of health care workers reporting sharpsrelated injuries. These injuries occurred more frequently in the urban ED than in the community EDs.ACADEMIC EMERGENCY MEDICINE 2015;22:1348-1350 © 2015 by the Society for Academic Emergency Medicine A n occupational exposure to a blood-borne pathogen carries a risk to health care workers for the transmission of communicable diseases. 1 The majority of these exposures have been identified as occurring through sharps-related injuries, in which a sharp object contaminated with blood or bodily fluids produces a percutaneous injury.2 Independent of contracting a communicable disease, health care personnel who suffer sharps-related injuries are at increased risk of suffering both physical and psychological impairment. 3,4 With an estimated 385,000 such injuries occurring to health care workers within the United States annually, there has been a substantial movement to focus on preventative efforts, such as mandating the use of universal precautions, supporting awareness campaigns, introducing safety devices, and educating health care workers on the safe handling and disposal of sharps devices. 5,6 Many states have also implemented legislative action to help identify and reduce future risk of these injuries. 7Despite 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...

Healthcare professionals’ perspectives on working conditions, leadership, and safety climate: a cross-sectional study

“…This result has not been described previously and is surprising, since within their profession physicians have more invasive activities than nurses. Studies also show that physicians, for example, are more affected by needlestick injuries than nurses [74, 75]. Therefore, we cannot explain why nurses in our sample indicated occupational risks more often than physicians.…”

Clinical, economic, and humanistic burden of needlestick injuries in healthcare workers

“…HCWs in urban EDs face higher risk for sharps injuries compared to community EDs with rates of 20.3 versus 5.9 per 100,000 patient visits, respectively ( p <0.001). 27 The environment in EDs is fast-paced and often unpredictable, in addition to often unknown source status, thus increasing the risk of NSIs and their consequences.…”

Emergency physician risk of occupational mortality: A scoping review

“…16 Beyond violence, a study showed that 55%-70% of emergency physicians experienced at least 1 needlestick, and that many (44%) of the 171 sharp injuries in an ED during a 4-year period were suffered by physicians. 17 The risk of infection transmission among healthcare workers was also high during public health outbreaks (eg., the 2009 H1N1 pandemic, the SARS, and Middle East respiratory syndrome outbreak), underscoring the importance of proper PPE. During the first wave of the H1N1 pandemic, Kumar et al reported that 18.5% of ED healthcare workers were seropositive for H1N1.…”

“…In addition, about 78% of emergency physicians experienced at least 1 violent act over a 1‐year period, with 21% of those incidents being physical assault 16 . Beyond violence, a study showed that 55%–70% of emergency physicians experienced at least 1 needlestick, and that many (44%) of the 171 sharp injuries in an ED during a 4‐year period were suffered by physicians 17 . The risk of infection transmission among healthcare workers was also high during public health outbreaks (eg., the 2009 H1N1 pandemic, the SARS, and Middle East respiratory syndrome outbreak), underscoring the importance of proper PPE.…”