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Karen Daley, PhD, MPH, RN, FAAN, remembers the stick as if it happened in slow-motion, the details still clear to her 12 years later. She had helped a co-worker draw blood from a patient in the emergency department. She turned to reach behind her for the sharps container. Mounted high on the wall, it was overfilled, but she couldn't see it well because it was above eye level.
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During last year's H1N1 influenza pandemic, health care workers inadvertently transmitted flu to their co-workers, in some cases triggering a hospital-based outbreak. That and other information about H1N1 transmission helped shape new guidelines from the Centers for Disease Control and Prevention that rely on vaccination, respiratory hygiene, and monitoring of ill employees by employee health professionals.
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Medical residents aren't the only hospital employees suffering from fatigue.
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With widespread adoption of safer sharps in hospitals, needlesticks declined by more than half for some of the most hazardous devices. Safety has become the norm in phlebotomy. Needle devices are placed in sharps containers instead of being left on bed linens or carts, where someone else may be stuck.
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Training and education of health care workers is an important aspect of preventing transmission of flu. The Centers for Disease Control and Prevention offers this specific recommendation:
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The problem of fatigued medical residents has gotten the attention of the U.S. Occupational Safety and Health Administration.
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Current ACGME standard (2003)
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Ever since 1796, when Edward Jenner introduced the world's first vaccine against smallpox, the role of vaccination has arguably become one of the most important advances in medicine.
