Medical Students Fear Reporting Needle Puncture

December 3, 2009

Medical students are among an underreported group of health care workers with a needle puncture during routine examination of patients. According to a Johns Hopkins University research survey of almost 700 medical school graduates training to be surgeons at 17 medical centers throughout the country, a staggering 59 percent suffered a needle puncture at some point while attending medical school.

This inadvertent needle puncture places not only the health care worker at risk of being infected with Hepatitis C or HIV, but also patients. The health care worker may have already contracted a disease and may infect the patient with a needle puncture to their skin from the same needle that already mad a puncture in the worker.

An estimated 800,000 accidental needle punctures and other injuries are reported by health care workers each year, but this doesn't include the unreported cases of medical students who have needle a puncture while they are training. The scary fact is that medical students are at an even higher risk of an accidental needle puncture because of the lack of experience and skill.

According to Martin A. Makary, MD, Associate Professor of surgery and health policy at Johns Hopkins, a culture has evolved at hospitals and medical schools for students that discourages them from reporting an accidental needle puncture and concurrently places them at high risk of an accidental puncture. This makes it easy to pick up diseases such as Hepatitis C and HIV for thousands of medical students.

Students are often reluctant to report an accidental needle puncture because of the excessive amount of time and paperwork required to make a report, and because they don't want their performance grade to be affected. However, medical students are often assigned mundane tasks such as administering needle puncture, intravenous lines, performing biopsies, and sewing incisions while they are still developing skills at handling a needle puncture.

“Not only are we putting them at the front lines, but when they do sustain a needle stick we have a culture that does not encourage them to speak up and get the care they need,” said Dr. Makary.

“They're being evaluated for a grade which determines what job they get when they finish. It's easy to say that if you get a needle stick injury, take care of it. It's a different thing when you've got this system which puts undue pressure on them not to report.”

When students fail to properly report a needle puncture, they are preventing themselves from receiving early treatments that could help prevent the development of HIV or Hepatitis. Dr. Makary suggests that hospitals simplify the process of reporting a needle puncture and receiving treatment. Currently, workers who suffer from a needle puncture are required to submit extensive paperwork and obtain their supervisor's signature before they can receive treatment. Often, students are working a busy shift and it is difficult for them to find the time to file the puncture report.

Dr. Makary did cite an important advancement in hospitals and how they handle an accidental puncture to employees. John Hopkins is one of those hospitals that have begun using “sharpless surgery” practices which eradicate the use of sharp objects that may puncture the skin. Instead, surgeons utilize lasers to cut, glue for closing, marginally invasive ports for laparoscopic procedures and dull-tip needles to decrease the risk of an accidental puncture. Dr. Makary hopes to see more people using the new puncture prevention techniques and devices to ensure needle safety and to prevent an accidental puncture.

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