Safe injection practices for Doctors and nurses
Post on 14-Feb-2017
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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
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
Dr Ketan Ranpariya
Dr Ketan Ranpariya
Unsafe Injections cause many outbreaks
Dr Ketan Ranpariya
Unsafe Injections cause many outbreaks
Dr Ketan Ranpariya
Dr Ketan Ranpariya
Dr Ketan Ranpariya
True or False ?
Dr Ketan Ranpariya
Dr Ketan Ranpariya
Dr Ketan Ranpariya
True or False ?
Dr Ketan Ranpariya
Dr Ketan Ranpariya
Dr Ketan Ranpariya
True or False ?
Dr Ketan Ranpariya
Dr Ketan Ranpariya
Dr Ketan Ranpariya
True or False ?
Dr Ketan Ranpariya
Dr Ketan Ranpariya
Dr Ketan Ranpariya
These were
Dr Ketan Ranpariya
Dr Ketan Ranpariya
Who are at risk of Unsafe Injection Practice ?
Dr Ketan Ranpariya
Who are at risk of Unsafe Injection Practice ?
1. Recipient 2. Health Care Worker3. Community
Dr Ketan Ranpariya
Practices that can harm recipients
Dr Ketan Ranpariya
Practices that can harm recipients
• Giving an injection when there are safer alternatives
Dr Ketan Ranpariya
Practices that can harm recipients
• Reusing a syringe or needle
Dr Ketan Ranpariya
Practices that can harm recipients
• Attempting to sterilize and reuse disposable syringes
Dr Ketan Ranpariya
Practices that can harm recipients
• Improper Sterilization technique for glass syringes.
Dr Ketan Ranpariya
Practices that can harm recipients
• Use only disinfectants on contaminated syringes and needles to prepare them for reuse.
Dr Ketan Ranpariya
Practices that can harm recipients
• Touching the needle
Dr Ketan Ranpariya
Practices that can harm recipients
• Loading syringes with multiple doses and injecting multiple persons
Dr Ketan Ranpariya
Practices that can harm recipients
• Applying pressure to bleeding sites with used material or a finger
Dr Ketan Ranpariya
Practices that can harm recipients
• Vaccinating infants in the buttocks
Dr Ketan Ranpariya
Practices that can harm recipients
• Leaving a needle in the vial to withdraw additional doses
Dr Ketan Ranpariya
Practices that can harm healthcare workers
Dr Ketan Ranpariya
Practices that can harm healthcare workers
• Recapping contaminated or used needles
Dr Ketan Ranpariya
Practices that can harm healthcare workers
• Placing needles on a surface or carrying them any distance prior to disposal
Dr Ketan Ranpariya
Practices that can harm healthcare workers
• Sharpening blunt or blocked needles for reuse
Dr Ketan Ranpariya
Practices that can harm healthcare workers
• Reaching into a mass of used syringes or needles (for cleaning or sorting waste)
Dr Ketan Ranpariya
Practices that can harm the community
Dr Ketan Ranpariya
Practices that can harm the community
• Leaving used syringes in areas where children can play with them
Dr Ketan Ranpariya
Practices that can harm the community
• Giving or selling used syringes to vendors who will resell them
Dr Ketan Ranpariya
Practices that can harm the community
• Leaving used syringes in areas accessible to the public
Dr Ketan Ranpariya
Dr Ketan Ranpariya
Dr Ketan Ranpariya
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
Wrong Habits of Injection Givers ( 54 % )
Dr Ketan Ranpariya
Wrong Habits of Injection Givers
• Giving an injection when there are safer alternatives
Dr Ketan Ranpariya
Wrong Habits of Injection Givers ( 54% )
• Giving injection by just changing needle
Dr Ketan Ranpariya
Is it safe to Re Use Syringe with NEW needle ???
Dr Ketan Ranpariya
Wrong Habits of Injection Givers ( 54% )
• Injection without proper hand washing
Dr Ketan Ranpariya
Wrong Habits of Injection Givers ( 54% )
• Permanent needle on multi dose vials
Dr Ketan Ranpariya
Wrong Habits of Injection Givers ( 54% )
• Improper cleaning of injection site
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Wrong Habits of Injection Givers ( 54% )
• Cleaning needle with spirit
Dr Ketan Ranpariya
Wrong Habits of Injection Givers ( 54% )
• Checking needle sharpness with cotton
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Wrong Habits of Injection Givers ( 54% )
• Touching needle with finger while injecting
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Wrong Habits of Injection Givers ( 54% )
• Pushing medicine fast
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Wrong Habits of Injection Givers ( 54% )
• Using spirit cotton on after injection
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Wrong Habits of Injection Givers ( 54% )
• Improper disposal of injection waste
Dr Ketan Ranpariya
Questionable Sterility ( 24% )
Dr Ketan Ranpariya
Questionable Sterility ( 24% )
• sterilize and reuse disposable syringes
Dr Ketan Ranpariya
Questionable Sterility ( 24% )
• Improper Sterilization technique for glass syringes
Dr Ketan Ranpariya
Questionable Sterility ( 24% )
• Sub standard sterilization of disposable syringes
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Questionable Sterility ( 24% )
• Keeping used syringes for next injection even for same patient
Dr Ketan Ranpariya
Reuse of syringes ( 22% )
Dr Ketan Ranpariya
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
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
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
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
Intentional Reuse
Reasons for the injection giver to purposefully reuse injection equipment
– Altruism - limited number of syringes; many patients in need
Dr Ketan Ranpariya
Intentional Reuse
Reasons for the injection giver to purposefully reuse injection equipment
– Economic reasons – reuse for financial gain
Dr Ketan Ranpariya
Dr Ketan Ranpariya
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
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
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
Re Use Prevention (RUP) Syringes
RUP syringes meet ISO 7886-4 requirements for passive reuse prevention.
Dr Ketan Ranpariya
Re Use Prevention (RUP) Syringes
The reuse prevention mechanism does not require any additional steps beyond delivery of a dose
Dr Ketan Ranpariya
Re Use Prevention (RUP) Syringes
Dr Ketan Ranpariya
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
Benefits of using RUP Syringes
RUP syringes ensure proper disposal of syringes since it is getting locked after injection & breakable plunger
Dr Ketan Ranpariya
Benefits of using RUP Syringes
It prevents both intentional & downstream reuse
Dr Ketan Ranpariya
Bio Medical Waste Management Rules
Dr Ketan Ranpariya
Dr Ketan Ranpariya
Sharp containers
Dr Ketan Ranpariya
Dr Ketan Ranpariya
ESNC an Innovative Game Changer
Dr Ketan Ranpariya
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
FAB- BD Emerald™ Needle Collector
• Slide door- Closed containment of Needles – Prevent exposure of sharps– Infection prevention - Ease of operation
Dr Ketan Ranpariya
FAB- BD Emerald™ Needle Collector
• Made of Polypropylene – • Non Chlorinated Plastic
– No PVC– Incinerable if BMWM rules allows
Dr Ketan Ranpariya
Share Your Knowledge
Dr Ketan Ranpariya
Thank You !!!
Dr Ketan Ranpariya
To Participate in “Safe Injection Practice” Campaign 10 K
You can contact us on : 0 70 48 70 41 41 : www.facebook.com/HIVCLINICSURAT
: doctorforhiv@gmail.com : www.hivaidssurat.com
Dr Ketan Ranpariya
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