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Home/Large Joints and Extremities/80% of Residents Have a Sharps Injury: Only 42% Report it!
Large Joints and Extremities

80% of Residents Have a Sharps Injury: Only 42% Report it!

June 6, 2022 2 min read Premium comments

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80% of Residents Have a Sharps Injury: Only 42% Report it!
Needle Safety Demo / Source: Wikimedia Commons and Intropin
Secondary#sharpsrelatedinjuries

When researchers from multiple institutions anonymously surveyed 518 orthopedic residents, they found that 80.5% had experienced a sharps injury. Their study, “Workplace Hazards in Orthopaedic Surgery Training: A Nationwide Resident Survey Involving Sharps-related Injuries,” appears in the May 1, 2022 edition of the Journal of the American Academy of Orthopaedic Surgeons.

Co-author Adam Gordon, M.D., a research fellow at Maimonides Medical Center in Brooklyn, New York, explained how important this subject is for study: “Surgical specialties are at increased risk for occupational hazards including sharps-related injuries. Surgical trainees have been shown to be 3 times more likely to incur these injuries than non-surgical trainees, with orthopaedic surgery residents being 12 times more likely than the safest specialty, emergency medicine.”

“An education research collaborative consisting of over 90 orthopaedic residency programs in the United States, the Collaborative Orthopaedic Educational Research Group, distributed a survey to better understand these injuries. The objectives of this study were to report the frequency of sharps injuries during training and evaluate which characteristics influence the number of injuries and reporting behaviors.”

Sixty-two percent of the respondents said that they had received adequate occupation safety training specifically related to orthopaedic surgery. Needle sticks (38.8%) were responsible for the greatest percentage of injuries, followed by Kirschner wires (33.6%), scalpel (22.5%), and bone (17.3%).

“The majority of resident orthopaedic surgeons (80%) recalled some form of safety training during orientation,” Dr. Gordon told OTW. “Despite this, 80% of trainees experienced a sharps injury with 20% of them having 5 or more.”

“Despite this common occurrence, only 42% of residents always reported their injuries. The reported reasons why not all sharps-related injuries were reported were, in decreasing frequency:

  • Didn’t feel a risk (63.1%),
  • Felt it was a hassle (58.9%),
  • Felt embarrassed (14.5%),
  • Some other reason (8.7%),
  • Forgot (5.8%),
  • Didn’t know what to do (3.3%).

Inadequate training specific to orthopaedic surgery and each subsequent year of postgraduate training were associated with having the most sharps injuries.”

“The findings of our study should be utilized by orthopaedic surgery departments to heighten awareness of this occupational hazard. There is a role for multiple organizations to prioritize the safety of training resident surgeons. These include organizations such as the Occupational Safety and Health Administration, residency organizations such as The Accreditation Council for Graduate Medical Education, orthopaedic surgery organizations including the American Academy of Orthopaedic Surgeons, and finally hospital administrators. A collaborative effort to minimize needlestick and sharps injuries and standardize reporting practices should be an area of continual focus for these organizations.”

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Discussion

14
DS
Dr. Sarah MitchellOrthopedic Surgeon · Mayo Clinic

This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?

8
JT
James Thornton, MDSpine Fellow · HSS

Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.

5
RP
R. PatelSports Medicine · Stanford

We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.

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