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Surgical Team Stability and Risk of Sharps-Related Blood and Body Fluid Exposures During Surgical Procedures

Published online by Cambridge University Press:  09 February 2016

Douglas J. Myers ,
Hester J. Lipscomb ,
Carol Epling ,
Debra Hunt ,
William Richardson ,
Lynn Smith-Lovin  and
John M. Dement
Douglas J. Myers*
Affiliation:
Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina Department of Occupational and Environmental Health Sciences, West Virginia University, Morgantown, West Virginia
Hester J. Lipscomb
Affiliation:
Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina
Carol Epling
Affiliation:
Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina
Debra Hunt
Affiliation:
Division of Biological Safety, Duke University Medical Center, Durham, North Carolina
William Richardson
Affiliation:
Department of Orthopedic Surgery, Duke University Medical Center, Durham, North Carolina
Lynn Smith-Lovin
Affiliation:
Department of Sociology, Duke University, Durham, North Carolina
John M. Dement
Affiliation:
Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina
*
Address correspondence to Douglas Myers, ScD, Occupational and Environmental Health Sciences Department, West Virginia University, 1 Medical Center Dr, PO Box 6190, Morgantown, WV 26506 (djmyers@hsc.wvu.edu).
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Abstract

OBJECTIVE

To explore whether surgical teams with greater stability among their members (ie, members have worked together more in the past) experience lower rates of sharps-related percutaneous blood and body fluid exposures (BBFE) during surgical procedures.

DESIGN

A 10-year retrospective cohort study.

SETTING

A single large academic teaching hospital.

PARTICIPANTS

Surgical teams participating in surgical procedures (n=333,073) performed during 2001–2010 and 2,113 reported percutaneous BBFE were analyzed.

METHODS

A social network measure (referred to as the team stability index) was used to quantify the extent to which surgical team members worked together in the previous 6 months. Poisson regression was used to examine the effect of team stability on the risk of BBFE while controlling for procedure characteristics and accounting for procedure duration. Separate regression models were generated for percutaneous BBFE involving suture needles and those involving other surgical devices.

RESULTS

The team stability index was associated with the risk of percutaneous BBFE (adjusted rate ratio, 0.93 [95% CI, 0.88–0.97]). However, the association was stronger for percutaneous BBFE involving devices other than suture needles (adjusted rate ratio, 0.92 [95% CI, 0.85–0.99]) than for exposures involving suture needles (0.96 [0.88–1.04]).

CONCLUSIONS

Greater team stability may reduce the risk of percutaneous BBFE during surgical procedures, particularly for exposures involving devices other than suture needles. Additional research should be conducted on the basis of primary data gathered specifically to measure qualities of relationships among surgical team personnel.

Infect Control Hosp Epidemiol 2016;37:512–518

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 5 , May 2016 , pp. 512 - 518
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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