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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.
A 10-year retrospective cohort study.
A single large academic teaching hospital.
Surgical teams participating in surgical procedures (n=333,073) performed during 2001–2010 and 2,113 reported percutaneous BBFE were analyzed.
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.
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]).
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.
To use a unique multicomponent administrative data set assembled at a large academic teaching hospital to examine the risk of percutaneous blood and body fluid (BBF) exposures occurring in operating rooms.
A 10-year retrospective cohort design.
A single large academic teaching hospital.
All surgical procedures (n=333,073) performed in 2001–2010 as well as 2,113 reported BBF exposures were analyzed.
Crude exposure rates were calculated; Poisson regression was used to analyze risk factors and account for procedure duration. BBF exposures involving suture needles were examined separately from those involving other device types to examine possible differences in risk factors.
The overall rate of reported BBF exposures was 6.3 per 1,000 surgical procedures (2.9 per 1,000 surgical hours). BBF exposure rates increased with estimated patient blood loss (17.7 exposures per 1,000 procedures with 501–1,000 cc blood loss and 26.4 exposures per 1,000 procedures with >1,000 cc blood loss), number of personnel working in the surgical field during the procedure (34.4 exposures per 1,000 procedures having ≥15 personnel ever in the field), and procedure duration (14.3 exposures per 1,000 procedures lasting 4 to <6 hours, 27.1 exposures per 1,000 procedures lasting ≥6 hours). Regression results showed associations were generally stronger for suture needle–related exposures.
Results largely support other studies found in the literature. However, additional research should investigate differences in risk factors for BBF exposures associated with suture needles and those associated with all other device types.
Infect. Control Hosp. Epidemiol. 2015;37(1):80–87
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