National Survey of Sharps Injuries Incidence Amongst Healthcare Workers in the United States

Abstract

Reporting sharps injuries is crucial for healthcare worker occupational safety. However, these incidents are often underreported, thus posing potentially dangerous working environments. Previous small and limited studies have quantified this underreporting in specific groups of healthcare workers. This study aims to expand on these studies by further quantifying sharps injury incidences through a national study, thus better understanding healthcare reporting behaviors and the reasons for underreporting. Patients and Methods: This is a national, multi-center, cross-sectional study conducted via an online anonymous survey distributed through email among United States attending physicians, fellows, residents, medical students, and nurses of all specialties (ie, surgery, medicine, pediatrics). Data analysis used descriptive statistics and regressive modeling with significance defined as p<0.05. Results: Of over 3000 surveys emailed, 460 (15.3%) healthcare workers responded. The most vulnerable cohort to report sharps injuries were medical students (0.87 injuries per year ±0.69, n=92) and Postgraduate Year (PGY) 1 (0.67±0.81, n=71), PGY2 (0.86 ±-0.82, n=48), and PGY3 (0.92±0.8, n=45) resident physicians. Healthcare workers in surgical fields reported significantly higher likelihoods (odds ratio=4.61, p<0.001, 95% confidence interval 2.83-7.26) of sharps injuries. Medical students reported sharps injuries the least (40%) and nurses reported sharps injuries the most frequently (71%). The three most common reasons for not reporting sharps injuries included (1) healthcare workers perceiving low infection risk based on patient medical history, (2) fear of peer perception, and (3) belief of lack of reporting utility or that reporting is inconsequential. Conclusion: Medical students and physicians early in training, especially those in surgical fields, are more vulnerable to sharps injuries, but are less likely to report, while nurses are the most likely to report. Dedicated sharps training, education to reduce stigma around injury, and implementing a simplified reporting process may help encourage reporting as well as consistency in reporting, leading to improved workplace safety.

Sharps Safety

“…In the perioperative setting, the prevalence of needlestick and sharps injuries among medical students and surgical residents who are beginning their clinical experiences has been significant. [5][6][7] In 2020, researchers surveyed 138 surgical residents at one US hospital and found that 68 (49%) had experienced at least one needlestick or sharps injury; the reporting rates for the injuries ranged from 64% for orthopedic surgery residents to 100% for urology and oral-maxillofacial surgery residents. 5 When responding to a question on why they did not report needlestick and sharps injuries, the most common reasons were associated with the amount of nonpatient-care time required for paperwork completion and injury evaluation and treatment.…”

“…5 Medical students and residents are more vulnerable to sharps injuries and are less likely than nurses to report such injuries. 6 Dedicated sharps injuryprevention education sessions that address the need for expedited reporting and treatment and streamlined reporting processes for needlestick and sharps injuries may encourage consistent reporting and lead to improved workplace safety. 5 Some researchers suggest that educational interventions regarding sharps safety can reduce the incidence of sharps injury and increase reporting of injuries; [7][8][9] however, results of a Cochrane systematic review with meta-analysis show that these improvements tend to be small and short-lived.…”

“…In the perioperative setting, the prevalence of needlestick and sharps injuries among medical students and surgical residents who are beginning their clinical experiences has been significant 5‐7 . In 2020, researchers surveyed 138 surgical residents at one US hospital and found that 68 (49%) had experienced at least one needlestick or sharps injury; the reporting rates for the injuries ranged from 64% for orthopedic surgery residents to 100% for urology and oral‐maxillofacial surgery residents 5 .…”

“…Six (67%) of the nine anesthesiology residents participating in the study considered fatigue to be a contributing factor for needlestick and sharps injuries 5 . Medical students and residents are more vulnerable to sharps injuries and are less likely than nurses to report such injuries 6 . Dedicated sharps injury–prevention education sessions that address the need for expedited reporting and treatment and streamlined reporting processes for needlestick and sharps injuries may encourage consistent reporting and lead to improved workplace safety 5 .…”