University of California Los Angeles (UCLA), Department of Anesthesiology and Perioperative Medicine, United States of America.
University of California Los Angeles (UCLA), Department of Anesthesiology and Perioperative Medicine, United States of America.
J Clin Anesth. 2022 Sep;80:110885. doi: 10.1016/j.jclinane.2022.110885. Epub 2022 May 26.
Anesthesiologists are at high risk for needlestick injury. Such injuries pose a serious health threat from exposure to bloodborne pathogens. This retrospective analysis aimed to examine needlestick injury rate among anesthesia providers between 2010 and 2020 at the University of California Los Angeles, Department of Anesthesiology and Perioperative Medicine to determine specialty-specific factors associated with these injuries.
Retrospective analysis.
Academic Anesthesiology Department.
None.
All reported incidents of needlestick injuries to employees are sent to the Injury and Illness Prevention Committee. We included all anesthesia residents, fellows, nurse anesthetists, solo anesthesiologists, and supervising anesthesiologists.
The overall rate of reported needlestick injuries was 5.3%. The rates for anesthesia residents were 2.1%, 13.5%, 7.9%, and 6.7% for post graduate year 1-4 (PGY 1-4) residents. The rates were 14.3%, 4.7%, 2.1%, and 6.9% for fellows, nurse anesthetists, supervising anesthesiologists, and solo anesthesiologists, respectively. We found that PGY2 residents had a higher injury rate than PGY1 residents (p-value<0.001). When grouping PGY2, PGY3, and PGY4 residents together, they had a collective rate of 9.4%. Furthermore, residents had a higher needlestick injury rate than supervising anesthesiologists (p-value <0.001).
PGY2 residents and fellows had the highest rate of needlestick injury. Our study highlights the trend of increasing sharps injuries after PGY1 while supervising anesthesiologists had the lowest rate. Proposed mechanisms for the increased sharps injuries include residents' transition from medicine-based internship to the operating room environment with increased exposure to potentially injurious equipment, overnight call, and increased work-related and cognitive stress. Improving understanding of institution-specific prevention programs, raising awareness during their initial high-intensity training period with one-to-one supervision when habits are formed, and reducing exposure to sharps using a needleless system are some steps toward reducing the incidence of sharps injuries in a field where the risk remains high.
麻醉师发生针刺伤的风险很高。这种伤害会因接触血源性病原体而对健康造成严重威胁。本回顾性分析旨在调查 2010 年至 2020 年期间加利福尼亚大学洛杉矶分校麻醉科和围手术期医学系麻醉提供者的针刺伤发生率，以确定与这些伤害相关的专科特定因素。
回顾性分析。
学术麻醉科。
无。
所有向伤害和疾病预防委员会报告的员工针刺伤事件均被记录。我们包括所有麻醉住院医师、研究员、注册护士麻醉师、单独麻醉师和监督麻醉师。
报告的针刺伤总发生率为 5.3%。住院医师的发生率分别为 PGY1-4 的 2.1%、13.5%、7.9%和 6.7%。研究员、注册护士麻醉师、监督麻醉师和单独麻醉师的发生率分别为 14.3%、4.7%、2.1%和 6.9%。我们发现 PGY2 住院医师的受伤率高于 PGY1 住院医师（p 值<0.001）。当将 PGY2、PGY3 和 PGY4 住院医师分组时，他们的总发生率为 9.4%。此外，住院医师的针刺伤发生率高于监督麻醉师（p 值<0.001）。
PGY2 住院医师和研究员的针刺伤发生率最高。我们的研究强调了 PGY1 之后锐器伤害增加的趋势，而监督麻醉师的发生率最低。锐器伤害增加的机制包括住院医师从以医学为基础的实习过渡到手术室环境，增加了接触潜在伤害性设备、夜间值班以及工作相关和认知压力的机会。了解机构特定的预防计划、在他们形成习惯的初始高强度培训期间提高认识并进行一对一监督、使用无针系统减少锐器的使用，这些都是减少高风险领域锐器伤害发生率的一些步骤。
