HIV Prevention Knowledge Base
Biomedical Interventions: Injection Safety
Safer Insulin Needle Use and Disposal
This article describes the results of a pilot program for safe disposal of insulin syringes and needles. The program gave diabetics in Guyana a month’s supply of insulin syringes and one of four types of syringe disposal containers. It also initiated a disposal box return program at health facilities, trained pharmacists and diabetes clinic nurses in counseling skills, and trained waste handlers in safe disposal of the containers brought by patients back to clinics. The program dramatically reduced needle reuse, and patients returned syringes to clinics for disposal. Empty tablet containers and containers that clients had found themselves were the most popular choice because they incurred no cost.
World Health Organization Guidelines on Drawing Blood: Best Practices in Phlebotomy
These guidelines aim to promote best practices in phlebotomy to protect both health care workers and patients and improve the quality of blood samples. They provide practical guidance on phlebotomy, with chapters dedicated to different aspects—blood sampling systems, blood donation, arterial and capillary sampling, and drawing blood from children and infants. Implementation, monitoring, and evaluation are covered in detail. There are also line drawings to illustrate safe phlebotomy techniques, a table comparing blood drawing devices, checklists for infection prevention and control best practice, a description of content required when training phlebotomists, and a useful glossary.
U.S. Outbreak Investigations Highlight the Need for Safe Injection Practices and Basic Infection Control
This report highlights recent outbreaks of viral hepatitis at outpatient clinics, dialysis centers, and long-term care facilities in the United States to show that improper use of syringes, needles, and medication continues to happen even in developed countries. It refutes commonly held myths about injection safety (e.g., that changing the needle is sufficient to avoid contamination and that devices need only to be cleaned when there are visible contaminants). Boxes summarize injection safety information, recommendations for safe practices, and frequently asked questions. The authors conclude by calling on health care providers everywhere to review their injection safety procedures.
About the Workbook for Designing, Implementing and Evaluating a Sharps Injury Prevention Program
This workbook is divided into sections on the organizational steps and operational processes in implementing a sharps injury prevention program. The target audience includes health care administrators and program managers, helping them to assess their facility’s injection safety program, to document planning and prevention activities, and to evaluate injection safety interventions. There is a detailed description of a sharps injury prevention program with tools such as forms and report templates for every step of the process. Once implemented, the program can help health care facilities gain accreditation and meet regulatory requirements. The workbook also provides guidance for calculating the cost of sharps injury and their prevention.
Situation Analysis of Infection Prevention and Control in Bishkek and Osh, Kyrgyzstan
This report, in response to an HIV epidemic among children caused by poor infection control and contaminated blood, found that although there is strong awareness of infection control among hospital staff, there is a chronic shortage of resources to train and protect them. Gap analysis details shortcomings in many areas from hand hygiene, injections, and blood drawing to waste management, supply management, and worker supervision. There are detailed recommendations to strengthen the health care system, improve training, build capacity, and make infection prevention and control commodities more available. The report also provides several tools for the assessment of health facilities, policies, and training.
The Improvement Collaborative: An Approach to Rapidly Improve Health Care and Scale Up Quality Services
This report spells out the case for quality improvement in health care and the role of a structured improvement method known as an improvement collaborative, whereby different teams use the same indicators and work collaboratively to implement best practices and improve quality of care. The essential elements of this approach are shared objectives, adequate support for teams testing changes, a clear definition of changes to be made, regular performance measurement, shared learning, and a strategy to disseminate best practices. It outlines the key phases for implementing improvement collaborative—preparation, implementation, and dissemination, with detailed bullet points for each stage. This approach was adapted for quality improvement by the injection safety project in Zambia.
Preparation of National Health-Care Waste Management Plans in Sub-Saharan Countries
Drawing on experience gained during numerous technical assistance projects in the region, this manual provides tools for the assessment and planning of health care waste management that are specifically applicable to countries in sub-Saharan Africa. It offers guidance in four sections, starting with the fundamentals of health care waste management. Guidance sections for national assessment, as well as for the development and implementation of a national health care waste management plan, follow. Jointly developed by the World Health Organization and the Secretariat of the Basel Convention, the manual harmonizes both the waste management and public health dimensions of safe disposal of medical waste.
Training Health Care Workers in the Management of Sharps Waste: Guide For Training of Waste Handlers
This manual is aimed at raising awareness of the risks of improper handling and disposal of sharps, to define the roles of staff involved in sharps waste management, and to provide staff with the information they need for proper disposal. Topics covered include health care worker safety, waste segregation, use of safety boxes, sharps disposal, and destruction of used supplies. Each chapter opens with a set of PowerPoint slides. More detailed information is presented in an accessible question-and-answer format with plenty of illustrations. There are also guidance notes for the trainer.
Safety of Injections: World Health Organization-U.N. Children’s Fund-U.N. Population Fund Joint Statement on the Use of Auto-Disable Syringes in Immunization Services
This joint statement reiterates the policy of the three U.N. organizations to supply vaccines bundled together with auto-disable syringes and safety disposal boxes for used syringes and needles. Partners in the financing of immunization programs are requested to finance only auto-disable syringes and incorporate safe waste management into their immunization projects. The statement reaffirms the U.N. Children’s Fund policy of only allowing its funded projects to procure auto-disable and not standard disposable syringes. The human and financial costs of unsafe injections are covered, as well as the extent of vaccination in many countries and its increasing use in disease control and prevention.
Managing an Injection Safety Policy: A Framework to Benchmark, Assess, Plan, Implement and Evaluate a National Strategy for the Safe and Appropriate Use of Injections
This manual provides a framework for a national injection safety policy incorporating benchmarking, assessment, planning, implementation, and evaluation. It is targeted at national-level public health managers as well as their national and international partners. The document sets targets for indicators of injection practices and details the objectives, indicators, and cost elements of an injection safety action plan. Appendices include data on the burden of disease caused by unsafe injections, best practice guidelines, a template agenda for a national injection safety planning workshop, and cost-effectiveness data. A list of 10 key resources rounds out the guide.