[High-risk needlestick injuries and virus transmission : A prospective observational study]

Reducing Sharps Injuries in the Operating Rooms of an Academic Tertiary Care Center

BACKGROUND

Data on the prevalence and distribution of operating room (OR) sterile field sharps injuries sustained by attending surgeons, residents, scrub nurses, and surgical technologists are limited. The goal of this study is to understand current practices, injuries, and reporting behavior at an academic center, implement interventions, and assess their effect on sharps safety and reporting.

METHODS

An electronic survey with questions pertaining to sharps handling practices, injuries, and reporting was e-mailed to 864 staff between July and September 2014. Adjusted analyses for risk of injury were performed. A follow-up survey was sent in January 2018, following the implementation of a shorter injury reporting form and a neutral zone.

RESULTS

The overall response rate was 49.3%, with 363 completed surveys. Of respondents, 44.9% reported injuries occurring in the preceding three years. Physicians comprised 65.1% of injured staff and sustained 68.8% of the total injuries. Compared to attending surgeons, residents had a similar likelihood of injury (odds ratio 0.9, 95% confidence interval [CI] 0.37-2.2), whereas scrub nurses (odds ratio 0.3, 95% CI 0.17-0.54) and technologists (odds ratio 0.3, 95% CI 0.14-0.76) had a lower likelihood. Half of those injured reported to Occupational Health Services. Of those who did not report, 46.4% stated that time was a limiting factor. Following the interventions, the incidence of injuries among survey respondents remained unchanged. However, 54.0% of respondents stated that it was easier to report injuries.

CONCLUSION

Attending surgeons and residents sustain the majority of OR sterile field sharps injuries and are the least likely to report them. Shorter reports made it easier to report the injuries.

Basic knowledge among GP trainees regarding HIV pre- and post-exposition-prophylaxis

Introduction

Preventing human immunodeficiency virus (HIV) infection is central to containing the HIV pandemic. For pre- and post-exposure prophylaxis (PrEP and PEP), drugs approved in Germany are available. Basic information on this should be obtained from physicians in further training to become specialists in General Practice (GP) since they may have to deal with this topic of high relevance for the health of patients at risk and also the physicians' health after a possible exposure in the professional context.

Methodology

A multiple-choice questionnaire was handed out to doctors in further training in General Practice on seminar days of the Competence Centre for General Practice Saxony-Anhalt for an immediate answer.

Results

Of the 109 doctors, 73 completed the questionnaire. A general high relevance of the topic HIV was stated by 95%. In contrast, 71% said it was relevant for family doctor activities. The knowledge questions on the prevalence were answered correctly for all questions with less than 40%; 21% stated that they knew the indication prerequisite for a PEP; 49% answered the question about the period of the highest efficacy of PEP correctly. PrEP as a drug option for prophylaxis is known to a part of the respondents, 79% would prescribe PrEP, 69% were in favour of a health insurance benefit.

Discussion

The results show that the necessary basic knowledge about HIV is partly available. Basic knowledge on structured action in the fields of HIV testing, PEP and PrEP should be taught in a manner appropriate to the relevance of the topic in the context of the German general practice setting. Even a basic knowledge about PEP may help to ensure that the general practice teams receive proper measures after a possible exposition.