Policy

Needlesticks and OR Safety

Doctors and needlesticks.

The very nature of our work exposes us on a daily basis to occupational injury and the possibility of contracting a blood-borne disease – HIV, HCV and HBV. Too often, however, we respond to that danger with denial.

In December 2007, CIR News reported on a New England Journal of Medicine article that revealed high rates of surgery resident needlesticks. CIR News also interviewed CIR surgical resident members about the article and their own experience with needlesticks. Why are surgery residents getting so many sticks? Why are rates of reporting sticks so low? And how do residents come to grips with the serious occupational exposure they face on a daily basis?

To begin answering these important questions, CIR has formed an OR Safety Task Force.

>> Go to the OR Safety Task Force site

Work Hours Reform

In 1989, CIR helped shape New York State’s regulations that set maximum work hour limits for housestaff. Since then, CIR members have negotiated hours limitations and program security clauses in Miami, Los Angeles and Boston. These important advances have become models for improving residency programs across the country.

CIR continues to work to establish evidence-based work hour scheduling for resident physicians that optimizes the quality of patient care, resident education, and safety.

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Institute of Medicine Releases Resident Work Hours Recommendations

On December 2, 2008, the Institute of Medicine (IOM) released its much anticipated report, "Resident Duty Hours: Enhancing Sleep, Supervision and Safety." Most news reports have focused on the IOM’s specific hours recommendations,

but the 428-page report is also an exhaustive review of the ‘sleep and safety’ literature, as well as a panoramic review of graduate medical education in its entirety.

Some of the other important IOM recommendations focus on workload limits, direct onsite attending supervision, safe transportation options home for post-call residents (paid for by hospitals) and increased oversight of work hours by the federal government (Centers for Medicare and Medicaid Services) and the Joint Commission.

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Institute of Medicine Studies Link between Resident Work Hours & Patient Safety

At the behest of Congress (specifically the House Energy and Commerce Committee) and the Agency for Healthcare Research and Quality (AHRQ), the venerable Institute of Medicine has convened a Committee of experts to “synthesize current evidence on medical resident schedules and healthcare safety” and “develop strategies to enable optimization of work schedules to improve safety in the healthcare work environment.”

CIR President L. Toni Lewis, MD was asked to present at the Committee’s first public hearing in Washington DC on December 3, 2007, and CIR Exec. Vice President Nailah Thompson, DO testified during the second public hearing on March 4, 2008 in Irvine, CA.

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Healthcare Equality: Reducing Disparities in Care

From the polling we've conducted of CIR members, we've learned that you are deeply concerned with disparities in care based on race or socio-economic conditions. We have worked for the past six months with The Healthcare Equality Project, part of SEIU's Change That Works campaign, on making sure that health care reform doesn't just focus on extending coverage to all, but also works to eradicate disparities in care. Here are five things you need to know about healthcare equality

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