A survey of nearly 700 surgical residents in 17 U.S. medical centers finds that more than half failed to report needle-stick injuries involving patients whose blood could be a source of HIV, hepatitis and other infections.

Authors of the report appearing in the June 28 issue of The New England Journal of Medicine say most residents in the survey falsely believe that reporting and getting timely medical attention wont prevent infection. Residents also say reporting takes too much time and interrupts their work.

The fact that we have so many residents who fail to understand the importance of timely reporting of needle-stick exposures in order to protect themselves from serious medical consequences clearly illustrates the breadth of this problem and the need for hospitals to develop systems to address it, says contributing author Mark S. Sulkowski, M.D., of the Division of Infectious Diseases at Johns Hopkins.

Lead author Martin Makary, M.D., M.P.H., a surgeon at The Johns Hopkins Hospital, says that while residents must take more responsibility, its 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 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 be
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Contact: Eric Vohr
evohr1@jhmi.edu
410-955-8665
Johns Hopkins Medical Institutions
27-Jun-2007