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全国范围内外科住院医师针刺伤事件及其报告的评估。

National Evaluation of Needlestick Events and Reporting Among Surgical Residents.

机构信息

Surgical Outcomes and Quality Improvement Center, Department of Surgery and Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL; Northwestern Medicine, Chicago, IL.

Surgical Outcomes and Quality Improvement Center, Department of Surgery and Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL; Northwestern Medicine, Chicago, IL.

出版信息

J Am Coll Surg. 2019 Dec;229(6):609-620. doi: 10.1016/j.jamcollsurg.2019.09.001. Epub 2019 Sep 18.

Abstract

BACKGROUND

Needlestick injuries pose significant health hazards; however, the nationwide frequency of needlesticks and reporting practices among surgical residents are unknown. The objectives of this study were to examine the rate and circumstances of self-reported needlestick events in US surgery residents, assess factors associated with needlestick injuries, evaluate reporting practices, and identify reporting barriers.

STUDY DESIGN

A survey administered after the American Board of Surgery In-Training Examination (January 2017) asked surgical residents how many times they experienced a needlestick during the last 6 months, circumstances of the most recent event, and reporting practices and barriers. Factors associated with needlestick events were examined using multivariable hierarchical regression models.

RESULTS

Among 7,395 resident survey respondents from all 260 US general surgery residency programs (99.3% response rate), 27.7% (n = 2,051) noted experiencing a needlestick event in the last 6 months. Most events occurred in the operating room (77.5%) and involved residents sticking themselves (76.2%), mostly with solid needles (84.7%). Self-reported factors underlying needlestick events included residents' own carelessness (48.8%) and feeling rushed (31.3%). Resident-level factors associated with self-reported needlestick events included senior residents (PGY5 29.9% vs PGY1 22.4%; odds ratio 1.66; 95% CI 1.41 to 1.96), female sex (31.9% vs male 25.2%; odds ratio 1.31; 95% CI 1.18 to 1.46), or frequently working more than 80 hours per week (odds ratio 1.42; 95% CI 1.20 to 1.68). More than one-fourth (28.7%) of residents did not report the needlestick event to employee health.

CONCLUSIONS

In this comprehensive national survey of surgical residents, needlesticks occurred frequently. Many needlestick events were not reported and numerous reporting barriers exist. These findings offer guidance in identifying opportunities to reduce needlesticks and encourage reporting of these potentially preventable injuries among trainees.

摘要

背景

针刺伤会带来严重的健康危害,但美国外科住院医师的针刺伤发生率及其报告情况尚不清楚。本研究旨在调查美国外科住院医师自我报告的针刺伤发生率和情况,评估针刺伤相关因素,评估报告实践,并确定报告障碍。

研究设计

在全美外科住院医师年度培训考试(2017 年 1 月)之后,一项问卷调查了外科住院医师在过去 6 个月中经历针刺伤的次数、最近一次事件的情况以及报告实践和障碍。使用多变量层次回归模型来研究与针刺伤事件相关的因素。

结果

在来自全美 260 个普通外科住院医师培训项目的 7395 名住院医师调查对象中(应答率 99.3%),27.7%(n=2051)报告在过去 6 个月中发生过针刺伤事件。大多数事件发生在手术室(77.5%),涉及住院医师自伤(76.2%),主要使用实心针(84.7%)。针刺伤事件的潜在人为因素包括住院医师自己的粗心大意(48.8%)和感到匆忙(31.3%)。与自我报告的针刺伤事件相关的住院医师水平因素包括资深住院医师(PGY5 29.9%比 PGY1 22.4%;比值比 1.66;95%置信区间 1.41 至 1.96)、女性(31.9%比男性 25.2%;比值比 1.31;95%置信区间 1.18 至 1.46)或经常每周工作超过 80 小时(比值比 1.42;95%置信区间 1.20 至 1.68)。超过四分之一(28.7%)的住院医师未向员工健康部门报告针刺伤事件。

结论

在这项针对外科住院医师的全面全国性调查中,针刺伤经常发生。许多针刺伤事件未被报告,存在许多报告障碍。这些发现为减少针刺伤和鼓励培训生报告这些潜在可预防的伤害提供了指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/987a/6900867/6673a8251f4b/nihms-1060960-f0001.jpg

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