Description
ABSTRACT
Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the early twentieth century but has not received adequate attention in developing countries. The establishment of “Safe Injection Global Network (SIGN)” was an milestone towards safe injection practice globally. In developing countries, people perceive injection as a powerful healing tool and do not hesitate to pay more for injections. Unsafe disposal and reuse of contaminated syringe is common. Ensuring safe injection practice is one of the greatest challenges for healthcare system in developing countries. To address the problem, interventions with active involvement of a number of stakeholders is essential. A combination of educational, managerial and regulatory strategies is found to be effective and economically viable. Rational and safe use of injections can save many lives but unsafe practice threatens life. Safe injection practice is crucial in developing countries. Evidence based interventions, with honest commitment and participation from the service provider, recipient and community with aid of policy makers are required to ensure safe injection practice.
INTRODUCTION
The WHO(2004) research shows that over 12 billion of injections administered are unsafe injection. Health care workers are exposed to the risk of blood-borne diseases such as HIV, Hepatitis B and C in their daily encounter with infected patients and materials through unsafe injections. Injection is an important health care procedure used worldwide for administration of drugs. Billions of injections are used worldwide for curative care and for immunization. In developing countries, approximately 16 thousand million injections are administered – a rate of 3.4 (range 1.7-11.3) injections per person per year. Majority of the injections are unnecessary and are not used safely. Reuse of injection equipment in the absence of sterilization is common
TABLE OF CONTENTS
TITLE PAGE I
ATTESTATION II
CERTIFICATION III
DEDICATION IV
ACKNOWLEDGEMENT V
ABSTRACT
INTRODUCTION
TABLE OF CONTENTS VII
CHAPTER ONE: INTRODUCTION
1.1 Background Information 1
1.2 Statement of the Problem 2
1.3 Justification of the study 3
1.4 Objectives of the Study 3
CHAPTER TWO: LITERATURE REVIEW
2.1 Definition of injection, safe injection, unsafe injection 4-7
2.2 Steps of giving safe injection 8
2.3 Safe Choices matter 11-12
2.4 Interventions and challenges for save injection practice 13
2.5 Safe disposal of used injections equipments 14
2.6 Training community health practitioners on injection safety 14-15
2.7Advocacy for injection safety 16 2.8Roles of other health progammes in promoting injection safety 17
CHAPTER THREE: METHODOLOGY
3.0 METHODOLOGY 18
CHAPTER FOUR: DISCUSSION
4.0 DISCUSSION 19 CHAPTER FIVE: CONCLUSIONS
5.0 CONCLUSIONS 20
5.1 RECOMMENDATION 21
REERENCES 22
CHAPTER ONE
1.1 BACKGROUND
Injection safety, or safe injection practices, is a set of measures taken to perform injections in an optimally safe manner for patients, healthcare personnel, and others. The Standard Precautions section of the 2007 Guideline for Isolation Precautions provides evidence- based recommendations for safe injection practices and reflects the minimum standards that healthcare personnel should follow to prevent transmission of infections in healthcare settings.(Brokensha,1999). Despite these recommendations, outbreaks and patient notifications resulting from healthcare personnel failing to adhere to Standard Precautions and basic infection control practices continue to be reported.(Bhattarai,2000). Unsafe injection practices that have resulted in disease transmission have most commonly included:(Brokensha,1999; Bhattarai,2000).
Using the same syringe to administer medication to more than one patient, even if the needle was changed or the injection was administered through an intervening length of intravenous (IV) tubing(Drucker,2001).
Accessing a medication vial or bag with a syringe that has already been used to administer medication to a patient, then reusing contents from that vial or bag for another patient Using medications packaged as single-dose or single-use for more than one patient Failing to use aseptic technique when preparing and administering injections For these reasons, CDC reminds healthcare personnel of thefollowing practices that are critical for patient safety(Reeler,1990):
Never administer medications from the same syringe to more than one patient, even if the needle is
- changed or you are injecting through an intervening length of IV tubing.
- Do not enter a medication vial, bag, or bottle with a used syringe or needle.
- Never use medications packaged as single-dose or single-use for more than one patient. This includes ampoules, bags, and bottles of intravenous solutions.
- Always use aseptic technique when preparing and administering injections.
- 2 STATEMENT OF THE PROBLEM
According to the WHO(2004), the most recent study indicates that each year, unsafe injections cause an estimated 1.3 million early deaths, a loss of 26 million years of life, and an annual burden of USD 535 million in direct medical costs. Unsafe injection practices are a powerful engine to transmit blood-borne pathogens, including hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Because infection with these viruses initially presents no symptoms, it is a silent epidemic. However, the consequences of this are increasingly recognized.
Hepatitis B virus: HBV is highly infectious and causes the highest number of infections: in developing and transitional countries 21.7 million people become infected each year, representing 33% of new HBV infections worldwide WHO(2004).
Hepatitis C virus: Unsafe injections are the most common cause of HCV infection in developing and transitional countries, causing two million new infections each year and accounting for 42% of cases. WHO(2004).
Reuse of syringes and needles in the absence of sterilization exposes millions of people to infections. Assessments carried out in numerous countries have revealed that syringes and needles are often just rinsed in a pot of tepid water between injections. WHO(2004).
Many injections around the world are unnecessary and often unsafe. Unsafe injections put lives at risk and every year cause 1.67 million hepatitis B infections, up to 315 120 hepatitis C infections and up to
33 877 human immunodeficiency virus (HIV) infections.(WHO,2015)1,2 The World Health Organization (WHO,2015) Guidelines recommend rational use of injections, safe injection practices and the exclusive use of safety-engineered syringes for all types of injections by 2020. Safety- engineered syringes exist for both immunization and therapeutic use and have mechanisms preventing re-use of the device [re-use prevention(RUP) syringe] and/or protecting health care providers from needle-stick injuries [sharp injury protection (SIP) feature]. Prescribers and health care providers have a key role to play in making the right choices that support safe injections and reduce unnecessary injections.
1.3 JUSTIFICATION OF THE STUDY
The study was conducted to highlight and show the clearly the important of safe injection practice and also show the implications and risks of practicing unsafe injection procedures to other community health practitioners that did not adhere safe injection practice.
1.4 OBJECTIVES OF THE STUDY
The objectives of this study are to:
- Review the status of safe injection practice
- Highlight importance of safe injection practice and
- Mention interventions and highlight the challenges towards safe injection practice in Nigeria.
- To examine the injection safety measures put in place by the community health practitioners.
CHAPTER TWO
LITRETURE REVIEW
2.1 CONCEPT OF INJECTION, SAFE INJECTION AND UNSAFE INJECTION
Injection: This is the process of introducing of any medical liquid or chemical into the body system using syringe and needle. Injection can be in of different types or routes of administrations namely(WHO2004):
- Intramuscular injection (I.M) this is usually given deep into the muscles there by inserting the needle at an angle of 90° into the muscle.
- Intravenous injection (I.V) this is usually given through the vein of blood vessel thereby inserting the needle into the vein. It is the most fastest in action and most effective route.
- Intrathecal injection (I.T) here the needle usually was inserted into the space between the ribs into the heart directly this type of injection is only given in tertiary level of healthcare setting.
- Intdermal (I.D) this is usually immunizable injection which is given immediately below the epidermis layer of the skin usually inserting the needle at an angle of 0°.
- Subcuteneous injection (S.C) is also immunizable injection that is usually given into the muscle but inserting the needle at an angle of 45°.
- Safe injection; The World Health Organization (WHO2004) defines a safe injection to be one that does not harm the recipient, does not harm the health care worker, and does not harm the community.
Safety of recipient
The risk of harming recipient can be avoided by administering useful injection (right medication) with a new sterile single use device, and observing proper technique by qualified and well trained health workers. To ensure safety to the recipient there should be sufficient supply of quality single use devices throughout the year(WHO2004)…
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