Department of Anesthesiology, University of Miami, Jackson Health System, 1611 NW 12th Ave., DTC 318, Miami, FL 33136, USA.
Int J Qual Health Care. 2022 Mar 28;34(1). doi: 10.1093/intqhc/mzac019.
Anesthesia practitioners are at risk for percutaneous injuries by blood-contaminated needles and sharp objects that may result in the transmission of human immunodeficiency virus and hepatitis viruses. Reporting these injuries is important for the early prevention and management of blood-borne infections.
To investigate the occurrence, reporting, characteristics and outcome of contaminated percutaneous injuries (CPIs) in anesthesia residents, fellows and faculty.
A cross-sectional anonymous survey electronically distributed to all 214 anesthesia practitioners at a large academic multihospital-based anesthesia practice in Florida, USA.
The overall response rate was 51% (110/214) (60% (50/83) for residents, 50% (8/16) for fellows and 45% (52/115) for anesthesia faculty). Fifty-nine percent (65/110) (95% confidence interval (95% CI): 5068) of participants reported having one or more CPIs during their years of anesthesia practice (residents 42% (95% CI: 2955), fellows 50% and faculty 77% (95% CI: 6688)). The number of CPIs per anesthesia practitioner who answered the survey was 0.58 for residents, 0.75 for fellows and 1.5 for faculty. Within the last 5 years, 35% (95% CI: 2644) of participants had one or more CPIs (39% of residents, 50% of fellows and 29% of faculty). CPIs in the last 5 years in faculty older than 45 years of age were 12% (3/25) compared to 44% (12/27) in faculty younger than 45 years of age.Analyzing data from practitioners who had one CPI revealed that 70% (95% CI: 5585) reported the incident at the time of injury (residents 85%, fellows 100% and faculty 58%). Hollow-bore needles constituted 73.5% (95% CI: 5988) of injuries. As per participants' responses, 17% (18/103) of CPIs received postexposure prophylaxis and there were zero seroconversions.
Based on our study results, most anesthesia practitioners will sustain a CPI during their years of practice. Despite some improvements compared to historic figures, the occurrence of CPIs continues to be high and reporting of percutaneous injuries remains suboptimal among anesthesia residents. A fifth of injuries in the perioperative setting is from an infected source and requires postexposure prophylaxis. Although no infections were reported due to CPI exposure in this study, findings underscore the need for more education and interventions to reduce occupational blood exposures in anesthesia practitioners and improve reporting.
麻醉从业者有因被血液污染的针头和锐器刺破而感染经血液传播的人类免疫缺陷病毒和肝炎病毒的风险。报告这些损伤对于早期预防和管理血源性感染非常重要。
调查麻醉住院医师、研究员和教师中污染性经皮损伤（CPIs）的发生、报告、特征和结果。
对美国佛罗里达州一家大型学术多医院麻醉实践中的 214 名麻醉医生进行了横断面匿名电子调查。
总回复率为 51%（110/214）（住院医师为 60%（50/83），研究员为 50%（8/16），麻醉教师为 45%（52/115））。59%（65/110）（95%置信区间（95%CI）：5068）的参与者报告在其麻醉实践期间发生过一次或多次 CPIs（住院医师为 42%（95%CI：2955），研究员为 50%，教师为 77%（95%CI：6688））。回答调查的每位麻醉医生的 CPIs 数量为住院医师 0.58，研究员 0.75，教师 1.5。在过去 5 年中，35%（95%CI：2644）的参与者发生过一次或多次 CPIs（39%的住院医师、50%的研究员和 29%的教师）。在年龄超过 45 岁的教师中，过去 5 年中发生的 CPIs 为 12%（3/25），而年龄小于 45 岁的教师中为 44%（12/27）。在年龄超过 45 岁的从业者中，分析发生过一次 CPI 的从业者的数据显示，70%（95%CI：5585）在受伤时报告了该事件（住院医师为 85%，研究员为 100%，教师为 58%）。空心针构成了 73.5%（95%CI：5988）的损伤。根据参与者的回答，17%（18/103）的 CPIs接受了暴露后预防措施，并且没有发生血清转化。
根据我们的研究结果，大多数麻醉医生在其执业期间都会遭受 CPI。尽管与历史数据相比有所改善，但 CPI 的发生仍然很高，麻醉住院医师的穿刺损伤报告仍然不理想。围手术期 17%的损伤来自感染源，需要进行暴露后预防。尽管本研究未报告因 CPI 暴露而导致的感染，但研究结果强调需要更多的教育和干预措施，以减少麻醉医生的职业性血液暴露并改善报告。
