Safe Injection Practices
Provincial Disease Surveillance and Response Unit
Directorate General Health Services Sindh
Department of Health, Government of Sindh
Learning Objectives
At the end of the session participants will be able to :
1. Discuss the burden of unsafe injection practices and its associated risk
and complications
2. Identify the impact of unsafe injection practices
3. Demonstrate the steps of safe injection administration
4. How to avoid needle stick injury
Background of Ratodero HIV outbreak
• In 2019, HIV outbreak was reported in Ratodero city of Larkana,
due to lack of IPC practices
Age Wise distribution of HIV cases @ Ratodero,Larkana
60%
54% Total 1024 HIV Positive 824
50%
(80%) Children
40%
Percentage
30%
24%
20% 16%
10%
2%
0%
0-5 Year 6-14 Year 15-45 Year >45 Year
Age Group
Impact of Poor IPC Practices
Risk of transmission of HBV, HCV & HIV
Socioeconomic burden
Mental trauma/stress
Social stigma
Increase morbidity (E.G: injection site
abscesses leading to amputation)
Increase mortality due to HCAI/HAI
How can an injection be safe?
If any of the steps to make an injection safe are properly follow
In particular, if:
• Injection should be given in an environment that is clean and hygienic
• Needle or the syringe should not be used for more than one patient
• Package should be sterile or new and sealed
• Vial should not be used multiple times
• Skin should be properly disinfected
• Needle is disposed off safely
• Avoid unnecessary injection administration if there any oral option
e.g. antibiotics, which can cause resistance.
• the injection technique is proper , otherwise it can cause nerve injury
leading to paralysis of the area
Needle Stick Injury
• It is an accidental puncture wound
caused by a needle or other sharp object
that has been used in medical
procedures.
• These injuries often occur when
healthcare workers handle needles or
other sharp medical instruments,
exposing them to potential bloodborne
pathogens, such as:
• Hepatitis B virus (HBV)
• Hepatitis C virus (HCV)
• Human Immunodeficiency Virus (HIV)
How To Prevent Needle Stick Injury
Recap Needle, Use Overfill sharp
One Hand Scoop boxes
Leave needles in
bottles
Bend, Cut or
Manipulate
Pass sharps
Leave broken
from hand to
Throw sharps in vials at the
hand
regular garbage counter
What To Do Then?
• Use one hand scoop technique
• Use sharp boxes for injection &
sharp disposal
• Use of incinerator for proper
discard
Step 01
Clean Work Station
• A clean work space or
workstation is necessary
to avoid contamination
and allow safe injection
preparations.
Nursing
stations in
Pakistan
Step 01: Clean Workstation
• A clean workspace or workstation is
necessary to avoid contamination and
allow safe injection preparations.
Step 2: Hand Hygiene
• Best way to prevent the spread of
germs in the HCFs and community
• Use appropriate product and
technique
• An alcohol-based hand rub product is
preferable, if hands are not visibly
soiled
• Rub hands for 20–30 seconds!
• Soap, running water and single use
towel, when visibly dirty or contaminated
with proteinaceous material
• Wash hands for 40–60 seconds!
Steps of Handwash
Hand Hygiene Technique With Alcohol Hand Hygiene Technique With Soap and Water
Hand Hygiene Technique
When Need to Handwash?
Recommendations
Use Don’t
• Use aseptic technique to avoid • Do not reuse syringes for administration
contamination of sterile injection of medications to multiple patients, even if
equipment the needle or cannula on the syringe is
changed
• Use fluid infusion and administration • Do not administer medications from
sets (i.e., intravenous bags, tubing single-dose vials or ampules to multiple
and connectors) for one patient only patients or combine leftover contents for
and dispose appropriately after use later use
• Use single-dose vials for parenteral • Do not keep multidose vials in the
medications whenever possible immediate patient treatment area and
store in accordance with the
• Use new syringe each time in case manufacturer’s recommendations; discard
of multi-dose vial. if sterility is compromised or questionable.
Thank You So Much