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 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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Health Care Disparities

Health care reform is emerging as a key issue in the 2008 presidential campaign, and over two dozen state legislatures and governors are examining proposals to significantly expand health insurance coverage. These health care reform discussions are being triggered by concerns about rapidly escalating health care costs, rising ranks of the uninsured, and the uneven quality of health care. But few of these discussions have focused on the problem of health care disparities, that is, differences in access to and the quality of health care, relative to more advantaged groups, experienced by racial and ethnic minorities, immigrants, those who are not proficient in English, and others.

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