Needlestick injuries among resident physicians.

Abstract

OBJECTIVE: To assess the frequency and causes of needlestick injuries in medical and surgical housestaff. DESIGN: A retrospective survey. SETTING: Urban university teaching hospital. PARTICIPANTS: 386 housestaff; 221 responded. INTERVENTION: Survey questionnaire. MAIN RESULTS: 1) Frequency of needlestick: Of 221 respondents, 57 (26%) reported never having had a needlestick, while 164 (74%) reported at least one needlestick injury with a suture or hollow-bore needle. The average frequencies were 0.63 per resident-year among 149 non-surgical residents and 3.8 per resident-year among 72 surgical residents. Among residents in internal medicine, 12 of 78 needlestick injuries (15%) sustained were from patients documented to be HIV-positive. 2) Causes of needlestick: The causes of injury were assessed in detail in a sample of the 157 most recent needlestick injuries. Suturing was the cause in 35 of 61 (57%) surgical residents, while recapping needles was the cause in 36 of 96 (38%) non-surgical residents. Inexperience was not the cause of injury; in 94% of cases the residents felt comfortable performing the procedure, and in 74% of cases the residents had performed the procedure more than 50 times before. 3) Reporting of injury: Only 30 (19%) of 157 injuries were reported to the personnel health service, thus compromising documentation for potential workmen's compensation. CONCLUSIONS: Needlestick injuries are common among medical and surgical housestaff. Efforts should be made to prevent needlestick injuries and to report those that occur.