Frequency of medical students’ needlesticks often underreported

In a recent survey, 59% of U.S. surgical residents questioned said they had sustained a needlestick as a medical student, many noting they were stuck more than once — a mean total of two needlesticks per respondent.

Concerns over the increased risk of transmitting potentially dangerous or life-threatening bloodborne diseases through needlesticks led Martin A. Makary, MD, MPH, an associate professor of surgery at the Johns Hopkins University School of Medicine, and colleagues to conduct a study into the frequency and reporting of needlesticks among medical students.

They surveyed 741 surgery residents at 17 medical centers and received usable responses from 699 of them. Their findings appear in the December issue of Academic Medicine.

In a press release from the Johns Hopkins Medical Institutions, Makary said he blames the surgeon training programs, in part, for these problems.

“Medical schools are not doing enough to protect their students and hospitals are not doing enough to make medical school safe,” he stated.

Reducing the number of needlesticks, which put both providers and patients at risk, may mean having medical students use more simulation technology and perform less training that involves human beings, at least until they are more skilled, Makary stated in the release.

Survey results related to the reporting of needlesticks among respondents showed a 92% likelihood the needle injury would be reported when the patient was at high risk of an infectious disease like HIV or hepatitis. However, investigators found a 47% likelihood such an event would be reported when the needlestick involved a low-risk patient.

“Authors of the study believe that needlesticks go unreported due to cumbersome reporting procedures, fears about poor clinical evaluations by their superiors, and embarrassment. The most common reason given in the study for why the medical students did not report needle injuries was the amount of time involved in making a report,” according to the release.

At a time when directives on safety and avoiding medical errors are being emphasized, “Hospitals are not creating a culture of speaking up,” Makary stated in the release.

The study was supported by the Mr. and Mrs. Chad Richison Foundation and the Lotus Global Health Foundation.

Sharma GK. Acad Med. 2009; 84(12):1815-1821.