Download INJECTION SAFETY AND MANAGEMENT OF HOSPITAL WASTE

1Dr.I.A.Joshua
2Dr
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 SEMINAR
 To 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 SAFETY
OUTLINE OF PRESENTATION
1. INTRODUCTION
2. CONCEPT OF SAFE INJECTION
3. ISSUES IN MISUSE AND OVERUSE OF IINJECTION
4. MAGNITUDE OF THE PROBLEM OF UNSAFE INJ
5. PUBLIC HEALTH IMPORTANCE
6. WAY FORWARD
7. MANAGEMENT OF NEEDLE STICK INJURY
8. CONCLUSION
INTRODUCTION
 Injected 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 recipient
 The safety of the health workers
 The safety of the community
ISSUES IN MISUSE & OVERUSE OF INJECTION
 Injection 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 PROBLEM
 In 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 IMPORTANCE
Unsafe injections or unsafe practices in relation to
immunization are not only Responsible for cases of Hepatitis B,C,HIV/AIDS, etc
 And other serious potentially lethal side effects
suffered by vaccine recipients
 May pose an occupational hazard to health providers
 Environmental 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 injury
 Encourage bleeding from the wound- do not suck or
rub
 Wash area thoroughly with soup and water
 Cover with a water –proof dressing
 If known, note the name of the patient
 Report to occupational health unit
 Notify line manager and document the accident
 If 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!
REFERENCES
 SIGN (Safe Injection Global Network)
www.safeinjection.or (accessed April 2013)
 WHO (2005). Managing an injection safety policy,
WHO/V& B/0.1.30
 CDC 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