1Dr.I.A.Joshua2Dr JG Makama

3Dr A Oyemecho

1Department of Community/2Department of Surgery

Kaduna State University, Kaduna, Nigeria

3Department of Epidemiology and Community Health, Benue State

University, Makurdi, Nigeria

OBJECTIVES OF THE SEMINARTo improve the knowledge of the University

community including students, hospital staff and general public on injection safety and management of hospital waste.

To prevent/ decrease the occurrence of needle stick injuries among staff and others.

To sensitize the management on the need for periodic injection safety assessment.

To improve knowledge on proper process of hospital waste management.

INJECTION SAFETYOUTLINE OF PRESENTATION 1. INTRODUCTION2. CONCEPT OF SAFE INJECTION 3. ISSUES IN MISUSE AND OVERUSE OF

IINJECTION4. MAGNITUDE OF THE PROBLEM OF UNSAFE

INJ5. PUBLIC HEALTH IMPORTANCE6. WAY FORWARD7. MANAGEMENT OF NEEDLE STICK INJURY8. CONCLUSION

INTRODUCTIONInjected medicines are commonly used in

healthcare settings for the prevention, diagnosis, and treatment of various illnesses

Unsafe injection practices put patients, healthcare providers and the community at risk of infectious and non-infectious adverse events and have been associated with a wide variety of procedures and settings. This harm is preventable.

Safe injection practices are part of general precautions and standard practices in health care delivery aimed at maintaining basic levels of patient safety and provider protection

As defined by the World Health Organization (WHO), a safe injection does not harm the recipient, does not expose the provider to any avoidable risks and does not result in waste that is dangerous for the community(WHO, 2005).

Syringes with a reuse prevention features offer the highest level of injection safety to recipients

WHO (2005) urges that by 2005 all injectable medications are supplied with matching quantities of single use injection devices, appropriate diluents and safety boxes through essential medicine programmes and other health programme supply mechanism

CONCEPT OF SAFE INJECTION

A safe injection does not harm the recipient, does not expose the health workers to any avoidable risk and does not result in waste that is dangerous for the community

The safe collection and disposal of used sharps (needles, syringes with fixed needles) is an integral part of the life cycle of injection device

The collection of sharps waste in safety containers (safety boxes) at the point of use and their safe and environmentally responsible disposal protect health care workers and the general public from needle stick injuries

A first step toward evaluating the frequency of unsafe injection practices in countries is an injection safety assessment

Three major considerations are especially relevant in the assessment of potential unsafe injections-

The safety of the recipientThe safety of the health workersThe safety of the community

ISSUES IN MISUSE & OVERUSE OF INJECTIONInjection is one of the most common

health care procedures

Each year at least 16 billion injections are administered in developing & transitional countries (WHO,2005).

The vast majority, about 95% are given in curative care, immunization accounts for about 3% of all injections, the remainder for other indications including use of injections for transfusion of blood/blood products & contraceptives

Majority of therapeutic injections in developing and transitional countries are unnecessary.

In some situation, as many as 9 out of 10 patients presenting to PHC providers receive an injection, over 70% of which are unnecessary or could be given in an oral formulation.

REASONS FOR INJECTION MISUSE & OVERUSE

1.Patients tend to prefer injections because they believe these to be stronger and faster.

2.They also believe that doctors regards injections to be best treatment.

3. In turn, Drs over prescribed injections because they believe that this best satisfies patients.

4.In addition, prescription of injection sometimes allows the charging of higher fee for service.

Better communication between patients & providers can clarify these types of misunderstandings & help to reduce injection overuse!

MAGNITUDE OF THE PROBLEMIn general, the assessments undertaken have

shown that reuse of reconstituted syringe is common. So there is need for advocacy for policy change which will lead to the implementation of safe injection practices

Epidemiological studies indicate that a person who experiences one needle-stick injury from a needle used on an infected source patient has risks of 30%, 1.8%, and 0.3% respectively to become infected with HBV, HCV and HIV

Dumping Hospital waste in open areas is a practice that can have major adverse effects on the population. The «recycling» practices that have been reported, particularly, the reuse of syringes is certainly the most serious problem in a number of countries.

The WHO estimates that over 23 million infections of hepatitis B, C and HIV occur yearly due to unsafe injection practices (reuse of syringes and needles in the absence of sterilization)(WHO, 2005).

PUBLIC HEALTH IMPORTANCEUnsafe injections or unsafe practices in relation to

immunization are not only-Responsible for cases of Hepatitis B,C,HIV/AIDS,

etcAnd other serious potentially lethal side effects

suffered by vaccine recipientsMay pose an occupational hazard to health

providersEnvironmental hazards to the community (soil , air

& water)Unsafe injection practices can seriously impede

the progress made by immunization programmes leading to substantial negative effects on global immunization coverage

WAY FORWARD

Safe & appropriate injections can be achieved by adopting a 3 part strategy-

1. Changing behaviour of health workers and patients

2. Ensuring availability of equipment and supplies

3. Managing waste safely and appropriately

 

  

MANAAGEMENT OF NEEDLE STICK INJURY

In the event of a sharp or needle stick injuryEncourage bleeding from the wound- do not

suck or rubWash area thoroughly with soup and waterCover with a water –proof dressingIf known, note the name of the patientReport to occupational health unitNotify line manager and document the accidentIf patient is thought to be HIV +, post-exposure

prophylaxis (PEP) may be required. This should be given as soon as possible after injury.

STAFF SHOULD BE FAMILIAR WITH LOCAL PEP GUIDELINES!

CONCLUSION

The safe use of injections, collection, transportation and disposal of used sharps (needles, syringes with fixed needles) is an integral part of the life cycle of injection device.

All have a responsible so ensure that is done properly!

THANK YOU!

REFERENCESSIGN (Safe Injection Global Network)

www.safeinjection.or (accessed April 2013)WHO (2005). Managing an injection safety

policy, WHO/V& B/0.1.30CDC 24/7 : Saving lifes and protecting people.WHO fact sheet No 231: Injection safety

(revised October 2006).A paper presented by Dr .I.A.Joshua at a

conference @ Byumba Health Institute, Rwanda, 2005.

Bailliere’s Nurses Dictionary, edited by Barbara F.Weller, 23 edition, p 556, appendix 15