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Host should also protect students on electives from HIV

BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7384.338/a (Published 08 February 2003) Cite this as: BMJ 2003;326:338

Protecting all medical students from blood borne infection

Dear Editor,

Tai, Neilson and Boffard proposed that hosts for medical students on
electives should develop protocols for handling sharps to help protect
students from exposure to HIV1. We feel that protecting medical students
from exposure to HIV and other blood borne diseases is not a problem just
for institutions hosting medical student electives but that it should be
tackled by all medical schools for all medical students. Any patient has
the potential to carry a blood borne disease and students should be taught
to take adequate precautions for all patients.

We recently conducted a small study observing year 4 medical students
inserting intravenous cannula on ward patients. The results for infection
control and handling of sharps are worrying (Table 1). Anecdotally some
students didn’t wear gloves as they felt the patient wasn’t in an “at risk
category”.

  Table 1.  Observations of medical students in infection control and 
sharps handling for insertion of intravenous cannulae.

Yes	        No 
Take sharps bin to bedside*	18  (53%) 	15  (44%)
Decontaminate hands	         8  (23%)	26  (77%)
Wear gloves	                24  (71%)	10  (29%)
Dispose of sharp in sharps bin*	15  (44%)	18  (53%)
* NB: in one case a supervising junior doctor took the sharps bin to the 
bedside and disposed of the sharps.

A study by Goodfellow and Claydon of recent medical graduates in
England showed that many were inexperienced in invasive practical
procedures2. How we teach and assess students in invasive practical
procedures needs to be addressed and strengthened. Guidelines/protocols
for practical procedures need to be developed that are transparent and
reflect best practice. These guidelines need to be disseminated to
students and their tutors. However, one of the main perceived problems is
that students are not observing good practice by doctors involved in
invasive procedures on the wards. Unless poor role modelling is addressed
guidelines and protocols will have little impact.

Dr SC Rennie, BST SHO, Ninewells Hospital, Dundee.
scrennie@doctors.org.uk

Mrs L Malek, SCOT project officer, University of Dundee.

Ms JR Rudland, Lecturer in Medical Education, University of Dundee,

1. Tai NRM, Nielson S, and Boffard K. Host should also protect
students on electives from HIV. BMJ 2003; 326: 338 - 338.

2. Goodfellow PB, Claydon P. Students sitting medical finals – ready
to be house officers? J Roy Soc Med 2001; 94: 516-520.

Competing interests:  
None declared

Competing interests: Table 1. Observations of medical students in infection control and sharps handling for insertion of intravenous cannulae.Yes No Take sharps bin to bedside* 18 (53%) 15 (44%)Decontaminate hands 8 (23%) 26 (77%)Wear gloves 24 (71%) 10 (29%)Dispose of sharp in sharps bin* 15 (44%) 18 (53%)* NB: in one case a supervising junior doctor took the sharps bin to the bedside and disposed of the sharps.

10 February 2003
Sarah C Rennie
BST SHO Plastic surgery
Linda Malek, Joy R. Rudland
Ninewells Hospital and Medical School, Dundee, DD1 9SY