Needlestick in anesthesia practitioners
Abstract:
Background: Anesthesia practitioners are at risk for percutaneous injuries by blood-contaminated needles and sharp objects that may result in transmission of HIV and hepatitis viruses. Reporting these injuries is important for early prevention and management of blood-borne infections. We investigated the occurrence, reporting, characteristics, and outcome of contaminated percutaneous injuries (CPI) in anesthesia residents, fellows, and faculty.
Methods: A cross-sectional anonymous survey electronically distributed to all 214 anesthesia practitioners at a large academic multihospital-based anesthesia practice in Florida, USA.
Results: The overall response rate was 51% (110/214) (60% (50/83) for residents, 50% (8/16) for fellows, 45% (52/115) for anesthesia faculty). 59% (65/110) (95%CI: 50,68) of participants reported having one or more CPI during their years of anesthesia practice (residents 42% (95%CI: 29,55), fellows 50%, faculty 77% (95%CI: 66,88). Numbers of CPI per anesthesia practitioner who answered survey was 0.58 for residents, 0.75 for fellows, and 1.5 for faculty.Within the last 5 years, 35% (95%CI: 26,44) of participants had one or more CPI (39% of residents, 50% of fellows, 29% of faculty. CPI in the last 5 years in faculty older than 45 years of age was 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: 55,85) reported the incident at the time of injury (residents 85%, fellows 100%, faculty 58%). Hollow-bore needles constituted 73.5% (95%CI: 59,88) of injuries. As per participants responses, 17% (18/103) of CPIs received post-exposure prophylaxis and there were zero seroconversions.
Conclusion: Based on our study results, most anesthesia practitioners will sustain a CPI during their years of practice. Despite some improvement compared to historic figures, occurrence of CPI continues to be high and reporting of percutaneous injuries remains suboptimal among anesthesia residents. A fifth of injuries in the perioperative setting are from an infected source and require 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.
Reference:
Zbeidy R, Livingstone J, Shatz V, Raveh Y, Gad R, Nicolau-Raducu R, Souki FG. Occurrence and Outcome of Blood-Contaminated Percutaneous Injuries among Anesthesia practitioners: A Cross-sectional Study. Int J Qual Health Care. 2022 Mar 18:mzac019. doi: 10.1093/intqhc/mzac019. Epub ahead of print. PMID: 35303082.