Needlestick injuries in med school common -- and often unreported
■ Faculty and hospitals are urged to better educate students and streamline the injury-reporting process.
By Christine S. Moyer — Posted Dec. 11, 2009
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Medical students commonly stick themselves with needles and do not report it, placing them at increased risk for contracting bloodborne pathogens, according to a study in the December Academic Medicine (link).
Researchers surveyed 699 residents at 17 U.S. general surgery residency programs about needlestick injuries they received in medical school.
Fifty-nine percent said they sustained at least one needlestick injury during medical school. Of those, 21% said their most recent injury occurred at school but nearly half did not report the incident.
"I don't put the responsibility on students, because when I talk to them, I find that they choose not to report injuries because [they are discouraged] by the cumbersome internal reporting procedures," said Martin A. Makary, MD, MPH, a study author, associate professor of surgery at Johns Hopkins University School of Medicine and associate professor of health policy and management at Johns Hopkins Bloomberg School of Public Health in Baltimore. "I think hospitals need to create a culture where people are encouraged to report."
Most alarming, Dr. Makary said, was the rate of surgery residents -- 33% -- who said while they were med students they had sustained a needlestick injury that involved a patient with a history of intravenous drug use, HIV, hepatitis B or hepatitis C.
He suggested hospitals provide backup to students who have to leave a patient to report a needlestick injury, allow students sufficient time to file a report and create a streamlined reporting process.
To reduce needlestick injuries, Dr. Makary urged medical schools to create a system of testing and certification of basic techniques for handling needles, to be completed before students' clinical rotations begin.
Dr. Makary also recommended that faculty use surgical simulators to teach medical students new skills, and he suggested that students use blunt-tip needles and wear two layers of gloves when handling sharp instruments in the operating room.
"As a general principle, it seems wrong for us to put our least-trained people in the most high-risk situations."