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

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.

Department

Description

Provenance

Citation

Published Version (Please cite this version)

10.1017/ice.2016.12

Publication Info

Myers, Douglas J, Hester J Lipscomb, Carol Epling, Debra Hunt, William Richardson, Lynn Smith-Lovin and John M Dement (2016). Surgical Team Stability and Risk of Sharps-Related Blood and Body Fluid Exposures During Surgical Procedures. Infection control and hospital epidemiology, 37(5). pp. 512–518. 10.1017/ice.2016.12 Retrieved from https://hdl.handle.net/10161/31407.

This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.

Scholars@Duke

Lipscomb

Hester Johnstone Lipscomb

Professor Emeritus in Family Medicine and Community Health

Research Interests
Broad research interests:
Health Disparities
Injury Epidemiology
Occupational Epidemiology
Surveillance
Intervention evaluation - use of conceptual frameworks, latency of effect

More specific current interests:
Occupational injuries and disorders of construction workers.
Injuries associated with pneumatic nail guns
Safety policy 

Musculoskeletal disorders (MSDs) of occupational origin, as well as the effect of MSDs on the ability to work; special interest in back disorders.

Classification of MSDs, episodes of care; problems with use of ICD9 codes for classification of MSDs related to epidemiologic research. Integration of latency into epidemiologic models assessing work related musculoskeletal disorders.

Occupational violence 

Work-related falls.

Vulnerable work populations.

Epling

Carol Ann Epling

Assistant Professor in Family Medicine and Community Health
Richardson

William James Richardson

Professor of Orthopaedic Surgery
  1. Current research includes investigation of biomechanical aspects of cervical injury with head impact. This involves cadaveric work with high-speed photography and load cells to ascertain the mechanism for spinal fractures.

    2. An animal model is being used to evaluate the biomechanics of cervical laminectomy versus laminoplasty compared to the normal spine. A portion of the animals are developing myelopathy secondary to instability after the surgical procedure and this is being evaluated with MRI scanning as well as mechanical and radiographic testing.


    3. Studies are being performed to develop an impedance pedicle probe to aid safe insertion of pedicular instrumentation in the lumbar spine. Ongoing studies are being performed to define the optimal frequency for the probe to yield the most sensitive and specific device. Hopefully this will lead to development of a device for human use. Studies will compare impedance probe to currently used EMG techniques to see if combing them will lead to greater sensitivity and specificity.

    4. Studies are being completed on testing particular pull-out strength and doing a multi-varied analysis looking at size of the pedicle and bone density by two different techniques.

    5. Current work is ongoing to develop an outcomes instrument and database to be used in the outpatient setting for patients with spinal complaints, both cervical and lumbar. The device will be used to evaluate clinical effectiveness for a variety of treatments for spinal conditions and to look at patient satisfaction issues.
Smith-Lovin

Lynn Smith-Lovin

Robert L. Wilson Professor Distinguished of Sociology

I study emotion, identity, and action. I’m interested in the basic question of how identities affect social interaction. I use experimental, observational, survey and simulation methods to describe how identities, actions and emotions are interrelated. The experiments I do usually involve creating social situations where unusual things happen to people, then seeing how they respond behaviorally or emotionally. I observe small task group interactions to see how identities influence conversational behavior. My survey work often focuses on gender and other social positions that influence the groups and networks in which people are imbedded. My simulations studies involve affect control theory, a mathematical model of how identities, actions and emotions affect one another. Now, I’m putting affect control theory together with McPherson’s ecological theory of affiliation to show how social systems, identities, and emotional experience are connected.

Dement

John McCray Dement

Professor Emeritus in Family Medicine and Community Health

Research interest focus on occupational and environmental epidemiology including exposure assessments for epidemiological studies. Exposure assessments involve the development of new and innovative exposure assessment methods and application of these methods to cohort and case-control studies of exposed populations. Research topics include occupational lung diseases and occupational and environmental carcinogens such as asbestos fibers, man-made fibers, and benzene. Epidemiological studies involve the development of quantitative risk estimates for occupational diseases among cohorts of workers exposed to substances such as asbestos. Other ongoing occupational lung disease studies include assessments of exposures and lung diseases among construction workers at Department of Energy nuclear facilities. The objective of this research is to identify possible occupational and personal factors related to the risk of lung diseases such as asbestosis, silicosis, and COPD.

Construction industry health and safety research is another area of research focus. This research includes development of epidemiological surveillance methods for work related diseases and injuries using existing data sources such as medical claims and worker compensation data. Work related musculoskeletal diseases among carpenters are currently being studied in collaboration with the United Brotherhood of Carpenters.

Other ongoing research includes the development and implementation occupational safety and health surveillance systems for health care workers. The objective of this research is to develop, implement, and evaluate a model surveillance program which can be implemented in other health care settings. This project involves both population-based and case-based surveillance strategies. Surveillance and prevention programs for workplace violence experienced by health care workers is a research interest,

Prevention and management of diabetes and cardiovascular diseases among workers participating in multi-employer health funds is a current area of research interest.


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