Chapter 5 SHARPS AND INJECTION SAFETY_Final_Draft.pptx

IPC-For Safety Injection Technique in Health Facility

1. CHAPTER 5 SHARPS AND INJECTION SAFETY

2. Objectives Chapter objective Identify the risks and impacts of unsafe injections and demonstrate how to safely handle and dispose of sharps. Enabling Objectives By the end of this chapter, participants will be able to: Classify the common reasons for providing unnecessary and unsafe injection Identify the risk and impact associated with unsafe injection Demonstrate how to handle sharps safely

3. Outline 5.1. Overview 5.2. Risks and magnitude of unsafe injections 5.3. Best Practices in Injection Safety 5.4. Principles of safe injection practices 5.5. Practical guidelines on handling parenteral medications 5.6. Safe administration of injections and handling of sharps 5.7. Summary

4. 5.1. Overview Definition: Safe Injection : i s an injection that does not harm the recipient, does not expose the HCW to any avoidable risks, provided by skilled person, using appropriate injection equipment and does not result in waste that is dangerous for the community .

5. 5.1. Overview…Magnitude of unsafe injections Globally 16 billion injections are administered each year Concurrently, it is also estimated that at least 50 % of all injections are unsafe. A study conducted in Ethiopia showed (2004 and 2005) showed; 74% of injections were unsafe, 72% of health facilities practiced unsafe disposal The prevalence rate of needle stick injury was 30 to 35%. 45% of the community members preferred injections to other preparations.

6. Activity 5.1 : Individual Reflections Refer to activity 5.1. on your training participant manual, Page __ Time allowed: 5 minutes

7. 5.2. Risks of Unsafe Injections 1. Risk to patients Transmission of blood-borne infections (HBV, HCV, HIV/AIDS…etc). Injection abscesses Paralysis Drug/allergic reactions shock 2. Risk to Health Care Workers Occupational exposure to sharps injuries. Estimation; 39% of HCV, 37% of HBV, and 4.4% of HIV infection The indirect medical costs The psycho-social impact is also immense

8. 5.3. Best Practices in Injection Safety Activity 5.2: Group discussion Refer to activity 5.1. on your training participant manual, Page _ Time allowed: 10 minutes

9. 5.3. Best Practices in Injection Safety Many injectable medications have an oral equivalent that are equally strong, effective, and much safer. Unnecessary injections should be reduced through: A. Avoid unnecessary injections. Injections should only be used in: Life threatening conditions Mal-absorption syndromes or Inability to swallow

10. Best practice… Prescribers and Service providers should also: Encourage patients to accept oral medications when possible. Injections should be given only when necessary. Explain the risks associated with injections Inform patients of the potential side effects of medications that are being prescribed Explore why patients prefer injections

11. Best practice… Educating the patients Encourage patients to accept oral medications Explain the risks associated with injections, when possible, to limit the use only when necessary. Administer Injections Safely : Ensure the right ways to give safe injection Refer to Table 5.2. on your reference manual ( page__ )

12. 5.4. Principles Of Safe Injection Practice Use Sterile Injection Equipment Prevent Contamination of Injection Equipment and Medication Prevent Injuries to the Provider P revent Access to Used Needles and Syringes Note: Refer to pages __to __ from the participant’s manual

13. Principles of safe injection… Apply standards for Administering Injections Keep the injection preparation area free of clutter Use injection: sterile, single-use needles and syringes Wash hands with soap and water; dry Check for expiry date, breach, leaks, particles, or contamination. Wipe the top of the vial with 70% alcohol using a swab or cotton-wool ball. Allow it to dry. Ensure aseptic technique while giving the injection, Dispose the used syringes and needles immediately into the sharp’s container

14. Best Practices for Administering Injection Select safe medicines Use of sterile equipment Avoid contamination (Adhere to principles of Aseptic Technique) Re-constitute drugs or vaccines safely Disposal of injection wastes and sharps properly Disseminate public health education and information.

15. 5.5. Practical guidance on handling parenteral medication When giving medication: ALWAYS follow the one needle, one syringe, and one injection rule. DO NOT use a single-loaded syringe to administer medication to several patients even if you change the needle every time between patients. DO NOT use the same mixing syringe and needle to reconstitute several vials. DO NOT combine leftover medications for later use. DO NOT use single-use vials for multiple patients, if possible

16. Practical guidance … When using single-use vials: “single-dose", "single-use”, or “preservative-free” should be used only for a single patient. If used for multiple patients, can be repackaged one time into multiple single-use syringes Store for only 24 hours. Follow the principle of one syringe, one needle, one time. Discard the single-use vial after use or If sterility or content is compromised, if not properly stored after opening

17. Practical guidance… When using multi-dose vials: Follow the principle of one syringe, one needle, one time. avoid double-dipping label the multi-dose vial DO NOT store multi-dose vials in patient care areas Discard a multi-dose vial if sterility is compromised, not properly stored after opening, undated, has a visible hole in the rubber septum

18. Practical guidance… Practical guidance on setting up for preparing injections Keep the injection preparation area free of clutter so all surfaces can be easily cleaned Disinfect injection preparation surface 0.5% sodium hypochlorite solution, 70% alcohol

19. Practical guidance… Procedure for vials with a rubber septum Wipe the access rubber septum with 70% alcohol Use a new, single-use, disposable, sterile syringe and needle for each insertion into a vial. Never leave a needle in a multi-dose vial Once the loaded syringe and needle have been withdrawn from a multi-dose vial, administer the injection as soon as possible.

20. Practical guidance… Reconstitution Always use sterile injection equipment to withdraw the reconstitution solution from an ampoule or a vial Remove the needle and syringe and discard them immediately Mix the contents of the vial thoroughly until all visible particles have dissolved If a dose cannot be administered immediately, cover the needle with the cap using a one-handed scoop technique: Should not be used >24 hrs.

21. After reconstitution, label container with: Date and time of preparation Type and volume of diluent Final concentration Expiry date and time after reconstitution Name and signature of the person reconstituting the drug For multi-dose medications that DO NOT require reconstitution Date and time of first piercing of the vial Expiry date and time after reconstitution Name and signature of the person first piercing the vial Practical guidance…Labeling

22. 5.6. Safe administration of injections and handling of sharps Important points DO NOT allow the needle to touch any contaminated surface. DO NOT reuse a syringe, even if the needle has been changed. DO NOT touch the rubber septum after disinfection with the 70% alcohol (isopropyl alcohol or ethanol). DO NOT re-enter a multi-dose vial with the same needle used for mixing or reconstituting medications.

23. Important points…Safe administration of injections DO NOT re-enter a vial with a needle or syringe used on a patient if that vial will be used again (whether it is for the same patient or for another patient). DO NOT use bags or bottles of intravenous solution as a common source of supply for injections (e.g., normal saline flushes) for multiple patients Avoid recapping needles, but if a needle must be recapped, use a single-handed scoop technique

24. Safe handling of sharps Activity 5.4: Individual reflections Refer to activity 5.3. on your training participant manual, Page __ Time allowed: 10 minutes

25. Safe handling of sharps… Safety box Do’s Put safety box at arm‘s reach. Do mark the fill line at the three-quarters full level. Always put on a heavy-duty glove when handling sharps containers. Safety box Don'ts Shake a container Use boxes that are open, overflowing, or punctured. Place containers in high traffic areas Don‘t place containers on the floor

26. Other Sharps Safety Dos and Don’ts…Safe handling of sharps Sharp safety Do’s Wear gloves when using needles Discard sharps immediately after use Discard sharps in safety box Use receivers to pass sharps to others Sharp safety Do not’s Walk around with needles and other sharps Do not remove bend, break needle Do not routinely recap needles after use Do not point sharps at yourself or others

27. 5.7. Summary Injections present risks to patients, HCWs, and the community and should be limited where alternative administration routes are available. Safe injection practices are one of the components of Standard Precautions. It is the responsibility of each HCW to ensure safe injection practice