Needlestick Injuries in Interventional Radiology Are Common and Underreported

Abstract

Purpose To determine the prevalence of and risk factors for needlesticks in interventional radiology physicians, as well as the attitudes, behaviors, and conditions that promote or interfere with reporting of these injuries. Materials and Methods A total of 3889 interventional radiologists from academic and private practice in the United States were surveyed by emailing all interventional radiologist members of the Society of Interventional Radiology, including attending-level physicians and trainees (April-August 2016). The institutional review board waived the need for consent. Questions inquired about the nature, frequency, and type of needlestick and sharps injuries and whether and to whom these incidents were reported. Stepwise regression was used to determine variables predicting whether injuries were reported. Results In total, 908 (23%) interventional radiologists completed at least a portion of the survey. Eight hundred fourteen (91%) of 895 respondents reported a prior needlestick injury, 583 (35%) of 895 reported at least one injury while treating an HIV-positive patient, and 626 (71%) of 884 reported prior training regarding needlestick injury. There was, on average, one needlestick for every 5 years of practice. Most needlestick or sharps injuries were self inflicted (711 [87%] of 817) and involved a hollow-bore device (464 [56%] of 824). Only 566 (66%) of 850 injuries were reported. The most common reasons for not reporting included perceived lack of utility of reporting (79 [28%] of 282), perceived low risk for injury (56 [20%] of 282), noncontaminated needle (53 [19%] of 282), too-lengthy reporting process (37 [13%] of 282), and associated stigma (23 [8%] of 282). Only 156 (25%) of 624 respondents informed their significant other. Stepwise regression assessing variables affecting the likelihood of reporting showed that male sex (P = .009), low-risk patient (P < .0001), self injury (P = .010), trainee status (P < .0001), and the total number of prior injuries (P = .019) were independent predictors of not reporting. Conclusion Needlestick injuries are ubiquitous among interventional radiologists and are often not reported. RSNA, 2017 Online supplemental material is available for this article.

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“…The nonreporting rates of 32% (NSIs) and 36% (MCEs) from our study are slightly lower than the mean BBFE nonreporting rate of 41% (range, 29% to 98%) found in our literature review, 3,6‐9,12‐21,26‐31 which may reflect our study’s low response rate, variation in response rates by role, recall bias, or participation bias (if staff members with exposures were more or less inclined to participate). The results of our study and others suggest that reported BBFE data underestimate true incidence.…”

“…Reports of never having received NSI‐prevention education from 27% of participants is puzzling because all hospital clinical personnel are required to complete annual online education modules for NSI prevention at the hospital where the data were collected. The reasons that respondents gave for not reporting an NSI that we also found in the literature included a lack of knowledge of reporting procedures 8,14,17,18,21,27‐29,30 and requirements, 3,13,15,17 stigma or shame, 8,12‐15,17,21,26‐30 and a belief that their own antibody status 8 or that personal protective equipment 9 prevented them from acquiring a bloodborne pathogen. …”

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“…Staff working in procedure areas are at risk for needlestick injuries and exposure to contagious body fluids. Needlestick injuries are common among interventional radiologists, 91% of whom reported having at least one needlestick injury and 31% of whom reported having a needlestick injury involving a human immunodeficiency virus-positive patient (54). As most needle injuries result from recapping needles, preventative measures need to include raising awareness regarding and minimizing this practice.…”

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“…In addition, good quality studies use a blind method for filling their questionnaires to minimize the rate of denial because of stigma. In a recent study in the US in which data were collected data by email, 91% of interventional radiologists had sustained NSIs, and only 66% of the injuries were reported (Deipolyi, Prabhakar, Naidu, & Oklu, ).…”

“…The common reasons for NSI occurrence for nurses seem to be rushing, fatigue, lack of skill, stuck by others, and carelessness/accidents (Hasak, Novak, Patterson, & Mackinnon, ). Common reasons for not reporting NSIs may be a belief in low utility of reporting, long reporting processes, belief that the needle was not contaminated, and associated stigma (Deipolyi et al, ). The rate of these injuries is higher in healthcare workers in training and medical sciences students, compared to other groups of healthcare workers (Prüss‐Üstün, Rapiti, & Hutin, ).…”