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Continued non-compliance with the American College of Surgeons recommendations to decrease infectious exposure in the
Christina M Welc1, Ali Nassiry, Kara Elam
1Department of Internal Medicine, Division of Infectious Diseases, Virginia Commonwealth University, Richmond, Virginia 23298-0019, USA.
Background:
The American College of Surgeons (ACS) Statement on Sharps Safety recommends the use of double gloving (DG), hands-free zone (HFZ), and blunt-tip suture needles (BTSN) in the operating room to decrease needlestick injuries. Despite this endorsement, compliance is low. This survey determined the perceptions, attitudes, and barriers to compliance with these guidelines.
Methods:
A survey using a voluntary convenience sample of surgical staff members in which queries related to understanding of the ACS recommendations were posed. A total of 107 of the 324 surveys were completed and returned, for a response rate of 33%. Most respondents were residents (64%) or attending surgeons (29%).
Results:
Respondents were most familiar with recommendations for DG (58% of residents and 68% of attendings) and HFZ (61% for both groups) but less so for BTSN (48% of residents and 52% of attendings). More than 50% of the staff believed that DG decreased the risk of needlesticks, yet fewer than half used DG more than 75% of the time. Half believed that HFZ protected from sticks, yet fewer than 10% used it at least 75% of the time. Fewer than 50% believed that BTSN minimizes the risk of injury, with fewer than 10% of respondents using them at least 75% of the time. Reasons for non-compliance included decreased tactile sensation with DG, lack of training with HFZ, and lack of availability of BTSN.
Conclusions:
To improve compliance with the ACS recommendations, institutions must improve awareness of the guidelines and the benefits associated with compliance and remove barriers to their incorporation into standard practice.
Insights
Surgical staff know about sharps safety guidelines but don't always follow them. Improving awareness and removing barriers are key to increasing compliance and preventing needlestick injuries.
Area of Science:
- Surgical Safety Practices
- Occupational Health in Healthcare
- Injury Prevention in Medicine
Background:
- The American College of Surgeons (ACS) recommends double gloving (DG), hands-free zone (HFZ), and blunt-tip suture needles (BTSN) to reduce surgical needlestick injuries.
- Compliance with these ACS sharps safety guidelines is reportedly low in operating rooms.
- A survey was conducted to understand surgical staff perceptions, attitudes, and barriers regarding these safety recommendations.
Purpose of the Study:
- To assess the awareness, attitudes, and perceived barriers among surgical staff concerning ACS sharps safety guidelines.
- To identify factors contributing to low compliance with recommended safety practices.
- To inform strategies for improving the adoption of sharps safety measures in surgical settings.
Main Methods:
- A voluntary convenience survey was administered to surgical staff, collecting data on understanding of ACS recommendations.
- 107 out of 324 distributed surveys were completed, yielding a 33% response rate.
- Respondents primarily included surgical residents (64%) and attending surgeons (29%).
Main Results:
- Familiarity was highest with double gloving (DG) and hands-free zone (HFZ) but lower for blunt-tip suture needles (BTSN).
- Despite believing in the efficacy of DG and HFZ, fewer than half of respondents used DG regularly, and less than 10% consistently used HFZ.
- Perceived barriers included reduced tactile sensation with DG, insufficient HFZ training, and limited availability of BTSN.
Conclusions:
- Improving compliance requires enhancing institutional awareness of ACS guidelines and their benefits.
- Addressing and removing practical barriers to implementing DG, HFZ, and BTSN is crucial.
- Standardizing the incorporation of these sharps safety measures into daily surgical practice is essential for reducing needlestick injuries.
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