In the course of their training, many medical students accidentally stick themselves with needles, yet too often fail to report the incidents, according to new research published in the December issue of the journal Academic Medicine. In a survey of 699 medical residents at 17 different hospitals and medical centers, nearly two thirds reported inadvertently sticking themselves at some point during medical school, and many said they’d actually endured more than one accidental jab. Yet of the 415 study participants who reported needle injuries, roughly half admitted that they had never informed hospital authorities.
In the survey, conducted by researchers at Johns Hopkins University School of Medicine, medical residents explained that a combination of complicated reporting processes, fear of negative reviews from instructors and simply embarrassment often prevented them from reporting accidents with needles. The danger, of course, of remaining tight-lipped on the subject is that the students then aren’t appropriately screened for any resulting infections or administered preventive treatments, and steps aren’t taken to ensure that patients’ weren’t accidentally exposed to any of their health care provider’s blood. The researchers did find that when the accidental injury occurred while treating a patient at high risk for HIV or hepatitis C, medical students were far more likely to report the incident. Nearly all (97%) of medical students reported needlesticks if they took place while caring for high-risk patients, compared with fewer than half (47%) if they were among lower-risk patients.
Nationwide researchers estimate that as many as 800,000 needlestick and similar injuries are reported each year, but that those figures represent only a fraction of the actual incidents. The study’s authors suggest that a medical teaching culture that puts trainees into stressful hands-on learning situations—where they may even be first learning their stitching techniques on actual patients—ends up putting both care providers and patients at risk. The majority of accidental jabs take place when medical students are feeling rushed in the operating room, the researchers say.
The authors stress the importance of creating medical training environments that emphasize safety, and establishing protocols to mandate that needlestick injuries are reported on a more regular basis. After all, they argue, if medical students are reluctant to report their own injuries and worries about their own safety, they may also be reluctant to report their patients’ safety concerns.