Defense Date


Document Type


Degree Name

Master of Public Health


Epidemiology & Community Health

First Advisor

Gonzalo Bearman

Second Advisor

Kate Lapane


Background: The American College of Surgeons guidelines suggest the use of intact gloves, double gloving, hands-free zone technique to pass sharp instruments, and blunt tip suture needles to protect patients, as well as the surgical team. This study estimates the extent to which these guidelines are followed in a large academic health system. Methods: Over a two-month period in the spring of 2010, 320 general surgical attendings, subspecialty surgical attendings, and surgical resident physicians practicing at a large academic health system, were approached during or after surgical conferences to participate in a cross-sectional study. Nearly 1/3rd completed an anonymous and voluntary self-administered survey. The survey included questions regarding knowledge of each technique, beliefs about effectiveness of each technique, and adherence to the guidelines. Responses were compared by surgeon rank. Results: Awareness of ACS recommendation guidelines was high among surgical attendings (68%) and residents (60%). While 60% of residents adhered to these recommendations, only 43% of attendings adhered. Both attendings (65%) and residents (64%) had similar negative perception toward double gloving in terms of tactile sensation and hand free zone hindrance during procedural operations during cases. Forty percent of residents and attendings agreed on unhindered concentration to hand free zone technique. Blunt tip suture needle use had low awareness and usage regardless of surgeon rank (~40%). Conclusion: Increased promotion of the ACS guidelines is warranted. Continuing medical education for surgical attendings may promote more widespread adoption of techniques to promote safety.


© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

August 2010

Included in

Epidemiology Commons