safe injection practices for doctors and nurses
TRANSCRIPT
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Safe Injection PracticeFor Doctors and Nurses
Dr Ketan Ranpariya (MBBS, PGDHM,PGDHIVM,HIVM)HIV / AIDS CONSULTANAT
Mobile: 0 75 75 88 70 70
Dr Ketan Ranpariya
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Disclaimer• This information is for Awareness of Health Care
Personnel as part of “Safe Injection Practice” Campaign 10 K.
• I do not have anything for financial disclosure. It’s release for Public Health Interest
• Have a Safe and Healthy Injection Practice and keep yourself and patient safe.
• Let’s Join Hand and Work Together to achieve Harmless Injection Practice
Dr Ketan Ranpariya
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Dr Ketan Ranpariya
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Dr Ketan Ranpariya
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Unsafe Injections cause many outbreaks
Dr Ketan Ranpariya
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Unsafe Injections cause many outbreaks
Dr Ketan Ranpariya
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Dr Ketan Ranpariya
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Dr Ketan Ranpariya
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True or False ?
Dr Ketan Ranpariya
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Dr Ketan Ranpariya
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Dr Ketan Ranpariya
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True or False ?
Dr Ketan Ranpariya
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Dr Ketan Ranpariya
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Dr Ketan Ranpariya
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True or False ?
Dr Ketan Ranpariya
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Dr Ketan Ranpariya
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Dr Ketan Ranpariya
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True or False ?
Dr Ketan Ranpariya
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Dr Ketan Ranpariya
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Dr Ketan Ranpariya
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These were
Dr Ketan Ranpariya
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Dr Ketan Ranpariya
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Who are at risk of Unsafe Injection Practice ?
Dr Ketan Ranpariya
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Who are at risk of Unsafe Injection Practice ?
1. Recipient 2. Health Care Worker3. Community
Dr Ketan Ranpariya
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Practices that can harm recipients
Dr Ketan Ranpariya
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Practices that can harm recipients
• Giving an injection when there are safer alternatives
Dr Ketan Ranpariya
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Practices that can harm recipients
• Reusing a syringe or needle
Dr Ketan Ranpariya
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Practices that can harm recipients
• Attempting to sterilize and reuse disposable syringes
Dr Ketan Ranpariya
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Practices that can harm recipients
• Improper Sterilization technique for glass syringes.
Dr Ketan Ranpariya
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Practices that can harm recipients
• Use only disinfectants on contaminated syringes and needles to prepare them for reuse.
Dr Ketan Ranpariya
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Practices that can harm recipients
• Touching the needle
Dr Ketan Ranpariya
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Practices that can harm recipients
• Loading syringes with multiple doses and injecting multiple persons
Dr Ketan Ranpariya
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Practices that can harm recipients
• Applying pressure to bleeding sites with used material or a finger
Dr Ketan Ranpariya
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Practices that can harm recipients
• Vaccinating infants in the buttocks
Dr Ketan Ranpariya
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Practices that can harm recipients
• Leaving a needle in the vial to withdraw additional doses
Dr Ketan Ranpariya
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Practices that can harm healthcare workers
Dr Ketan Ranpariya
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Practices that can harm healthcare workers
• Recapping contaminated or used needles
Dr Ketan Ranpariya
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Practices that can harm healthcare workers
• Placing needles on a surface or carrying them any distance prior to disposal
Dr Ketan Ranpariya
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Practices that can harm healthcare workers
• Sharpening blunt or blocked needles for reuse
Dr Ketan Ranpariya
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Practices that can harm healthcare workers
• Reaching into a mass of used syringes or needles (for cleaning or sorting waste)
Dr Ketan Ranpariya
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Practices that can harm the community
Dr Ketan Ranpariya
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Practices that can harm the community
• Leaving used syringes in areas where children can play with them
Dr Ketan Ranpariya
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Practices that can harm the community
• Giving or selling used syringes to vendors who will resell them
Dr Ketan Ranpariya
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Practices that can harm the community
• Leaving used syringes in areas accessible to the public
Dr Ketan Ranpariya
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Dr Ketan Ranpariya
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Dr Ketan Ranpariya
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Characteristics of Unsafe Injections (63 % of all Injections are Unsafe) – All India
Total
Total Unsafe
Wrong Habits of Injection
Givers54 %
Questionable Sterility 24 %
Reuse 22 %
Dr Ketan Ranpariya
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Wrong Habits of Injection Givers ( 54 % )
Dr Ketan Ranpariya
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Wrong Habits of Injection Givers
• Giving an injection when there are safer alternatives
Dr Ketan Ranpariya
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Wrong Habits of Injection Givers ( 54% )
• Giving injection by just changing needle
Dr Ketan Ranpariya
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Is it safe to Re Use Syringe with NEW needle ???
Dr Ketan Ranpariya
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Wrong Habits of Injection Givers ( 54% )
• Injection without proper hand washing
Dr Ketan Ranpariya
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Wrong Habits of Injection Givers ( 54% )
• Permanent needle on multi dose vials
Dr Ketan Ranpariya
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Wrong Habits of Injection Givers ( 54% )
• Improper cleaning of injection site
Dr Ketan Ranpariya
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Wrong Habits of Injection Givers ( 54% )
• Cleaning needle with spirit
Dr Ketan Ranpariya
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Wrong Habits of Injection Givers ( 54% )
• Checking needle sharpness with cotton
Dr Ketan Ranpariya
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Wrong Habits of Injection Givers ( 54% )
• Touching needle with finger while injecting
Dr Ketan Ranpariya
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Wrong Habits of Injection Givers ( 54% )
• Pushing medicine fast
Dr Ketan Ranpariya
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Wrong Habits of Injection Givers ( 54% )
• Using spirit cotton on after injection
Dr Ketan Ranpariya
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Wrong Habits of Injection Givers ( 54% )
• Improper disposal of injection waste
Dr Ketan Ranpariya
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Questionable Sterility ( 24% )
Dr Ketan Ranpariya
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Questionable Sterility ( 24% )
• sterilize and reuse disposable syringes
Dr Ketan Ranpariya
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Questionable Sterility ( 24% )
• Improper Sterilization technique for glass syringes
Dr Ketan Ranpariya
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Questionable Sterility ( 24% )
• Sub standard sterilization of disposable syringes
Dr Ketan Ranpariya
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Questionable Sterility ( 24% )
• Keeping used syringes for next injection even for same patient
Dr Ketan Ranpariya
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Reuse of syringes ( 22% )
Dr Ketan Ranpariya
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Reuse of syringes ( 22% )• Two types of reuse
– Downstream reuse – Where, after discarding of the syringe by the injection giver, someone else takes the syringe for reuse
– Intentional reuse – Where the injection giver intentionally brings about the reuse of the syringe
Dr Ketan Ranpariya
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Downstream ReuseAlthough injection giver does not intentionally
reuse syringe, somewhere along the way the syringe/needle gets picked for reuse
Medical waste is disposed off improperly due to lack of sealable sharps containers and lack of incineration
Dr Ketan Ranpariya
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Downstream Reuse
Can be resold or simply reused: Can’t tell if a syringe is new
• Evidence of “industry” of reprocessing and reselling; particularly in India, Pakistan; also reported in parts of Africa
5-year-old girl smiles as she displays her 'catch' to her mother - dozens of used disposable syringes with the
needles intact! Dr Ketan Ranpariya
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Intentional Reuse
Reasons for the injection giver to purposefully reuse injection equipment
– Lack of knowledge/education • Misunderstanding of limits to “cleaning”
syringes• Lack of awareness that using same syringe
with different needle across patient can spread disease
• Ignorant that using same syringe multiple times on single patient over a long period of time can cause infections as affects sterility
Dr Ketan Ranpariya
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Intentional Reuse
Reasons for the injection giver to purposefully reuse injection equipment
– Altruism - limited number of syringes; many patients in need
Dr Ketan Ranpariya
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Intentional Reuse
Reasons for the injection giver to purposefully reuse injection equipment
– Economic reasons – reuse for financial gain
Dr Ketan Ranpariya
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Dr Ketan Ranpariya
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Reuse prevention devices Auto Disable syringes have been
mandated by WHO/UNICEF/UNFPA and GoI in Immunization services
WHO recommends Reuse Prevention feature enabled syringes as they offer the highest level of safety to the recipients.
Dr Ketan Ranpariya
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Re Use Prevention (RUP) Syringes
4 locking petals in the plunger rod lock in place in the barrel when a full dose is delivered.
Dr Ketan Ranpariya
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Re Use Prevention (RUP) Syringes
If the user attempts to pull the plunger rod out of the lock, the plunger rod will break.
Dr Ketan Ranpariya
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Re Use Prevention (RUP) Syringes
RUP syringes meet ISO 7886-4 requirements for passive reuse prevention.
Dr Ketan Ranpariya
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Re Use Prevention (RUP) Syringes
The reuse prevention mechanism does not require any additional steps beyond delivery of a dose
Dr Ketan Ranpariya
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Re Use Prevention (RUP) Syringes
Dr Ketan Ranpariya
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Benefits of using RUP Syringes
Since RUP syringes get locked after injection, this syringe will not be available for repacking, thereby ensuring fresh syringe each time when we open a pack.
Dr Ketan Ranpariya
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Benefits of using RUP Syringes
RUP syringes ensure proper disposal of syringes since it is getting locked after injection & breakable plunger
Dr Ketan Ranpariya
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Benefits of using RUP Syringes
It prevents both intentional & downstream reuse
Dr Ketan Ranpariya
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Bio Medical Waste Management Rules
Dr Ketan Ranpariya
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Dr Ketan Ranpariya
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Sharp containers
Dr Ketan Ranpariya
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Dr Ketan Ranpariya
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ESNC an Innovative Game Changer
Dr Ketan Ranpariya
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FAB- BD Emerald™ Needle Collector
• Small size – Portable (Easy to Carry)-– Bedside needle containment– Prevent recapping of needle– Prevent NSI (Employee welfare)
Dr Ketan Ranpariya
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FAB- BD Emerald™ Needle Collector
• Slide door- Closed containment of Needles – Prevent exposure of sharps– Infection prevention - Ease of operation
Dr Ketan Ranpariya
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FAB- BD Emerald™ Needle Collector
• Made of Polypropylene – • Non Chlorinated Plastic
– No PVC– Incinerable if BMWM rules allows
Dr Ketan Ranpariya
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Share Your Knowledge
Dr Ketan Ranpariya
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Thank You !!!
Dr Ketan Ranpariya
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To Participate in “Safe Injection Practice” Campaign 10 K
You can contact us on : 0 70 48 70 41 41 : www.facebook.com/HIVCLINICSURAT
: [email protected] : www.hivaidssurat.com
Dr Ketan Ranpariya