Jeyaraman Madhan, Jeyaraman Naveen, Iyengar Karthikeyan P, Selvaraj Preethi, Ramasubramanian Swaminathan, Jain Vijay Kumar
Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai, Tamil Nadu 600077 India.
Trauma and Orthopaedic Surgeon, Southport and Ormskirk Hospitals, Mersey and West Lancashire Teaching NHS Trust, Southport, PR8 6PN UK.
Indian J Orthop. 2024 May 16;58(9):1239-1247. doi: 10.1007/s43465-024-01178-4. eCollection 2024 Sep.
Needlestick and sharps injuries (NSSIs) represent an existential occupational hazard risk to orthopaedic surgeons during their career due to the interaction with various devices, instruments and bone fragments. Consequently, NSSIs have the potential to transmit infections such as Hepatitis B (HBV), Hepatitis C (HCV) and Human Immunodeficiency Virus (HIV) leading to serious illness. The purpose of this cross-sectional study was to identify the clinical settings predisposing orthopaedic surgeons to NSSIs and assess their adherence to safety protocols in the Indian context.
An online cross-sectional survey of 618 orthopaedic surgeons in India, stratified by experience into two groups: under five years and with 5 years or more was undertaken. The data were collected via an expert-validated online questionnaire to evaluate demographic distribution, injury characteristics, knowledge of safety protocols, and adherence to these protocols. Descriptive statistics summarized the data, Chi-square tests assessed variable associations, and odds ratios were computed for significant variables. Ethical integrity was maintained via electronic informed consent and for confidentiality assurances.
The study revealed that orthopaedic surgeons with less than 5 years of clinical experience had higher risks for NSSIs as compared to those with 5 or more years of clinical practice. Conversely, the latter group was more susceptible to bone spike injuries and viral positive needlestick incidents. The analysis shows that whilst the more experienced practitioners displayed greater proficiency in the application of universal precautions and NSSI prevention, they were also less likely to report injuries, often due to discomfiture. Risk profiles were consistent across different practice settings and affiliations, regardless of experience level.
This cross-sectional study reveals less experienced orthopaedic surgeons face higher risks of NSSIs, possibly due to inadequate education or awareness. More experienced practitioners encounter distinct risks, likely owing to long-term exposure and traditional practices. There is an immediate need to raise awareness of the potential risks of NSSIs, enhanced education, appropriate training, collaboration with the hospital risk management team and developing a culture of transparent reporting to mitigate these risks. The emphasis should be on reducing the incidence and fostering open reporting of NSSIs to protect clinicians and promote health safety.
针刺伤和锐器伤(NSSIs)是骨科医生职业生涯中实实在在的职业危害风险,因为他们会接触各种器械、仪器和骨碎片。因此,针刺伤和锐器伤有可能传播乙型肝炎(HBV)、丙型肝炎(HCV)和人类免疫缺陷病毒(HIV)等感染,导致严重疾病。这项横断面研究的目的是确定在印度背景下,使骨科医生易发生针刺伤和锐器伤的临床环境,并评估他们对安全规程的遵守情况。
对印度618名骨科医生进行了一项在线横断面调查,根据经验将他们分为两组:从业年限不足5年组和5年及以上组。通过一份经过专家验证的在线问卷收集数据,以评估人口统计学分布、损伤特征、安全规程知识以及对这些规程的遵守情况。描述性统计对数据进行了总结,卡方检验评估了变量之间的关联,并计算了显著变量的比值比。通过电子知情同意书和保密保证来维护伦理完整性。
研究表明,临床经验不足5年的骨科医生发生针刺伤和锐器伤的风险高于临床实践5年及以上的医生。相反,后一组更容易受到骨钉刺伤和病毒阳性针刺事件的影响。分析表明,虽然经验更丰富的从业者在应用普遍预防措施和预防针刺伤和锐器伤方面表现出更高的熟练程度,但他们报告受伤的可能性也较小,这通常是由于感到尴尬。无论经验水平如何,不同执业环境和所属机构的风险特征都是一致的。
这项横断面研究表明,经验不足的骨科医生面临针刺伤和锐器伤的风险更高,这可能是由于教育不足或意识不够。经验更丰富的从业者面临不同的风险,可能是由于长期接触和传统做法。迫切需要提高对针刺伤和锐器伤潜在风险的认识,加强教育,进行适当培训,与医院风险管理团队合作,并营造一种透明报告的文化氛围,以降低这些风险。重点应放在降低针刺伤和锐器伤的发生率,并促进对其进行公开报告,以保护临床医生并促进健康安全。