HIV Prevention Knowledge Base
Biomedical Interventions: Injection Safety
World Health Organization Best Practices for Injections and Related Procedures Toolkit
This toolkit was designed to meet the training and daily practice needs of all health care workers, specifically those who give injections, draw blood, or manage medical waste, as well as administrators and infection control policymakers. It covers all types of needle injections, phlebotomy, and lancet procedures. The format, with many summary tables, step-by-step practice guides, checklists, and copious illustrations, makes the standard precautions information accessible and easy to follow. In addition to information on injection safety, there is a chapter on occupational risks and management of blood-borne pathogens, including guidance on the post-exposure management of HIV and hepatitis B and C. The content can be easily reproduced as posters, flash cards, and spreadsheets for use in training and education.
The Joint WHO-ILO-UNAIDS Policy Guidelines on Improving Health Workers' Access to HIV & TB Prevention, Treatment, Care and Support Services: A Guidance Note
The 14 interrelated guidelines described in this guidance note are presented as a package and comprise national policies covering rights, legislation, and social protection; workplace policies, programs, and training; and policies covering budget, monitoring, and evaluation. They are aimed at policymakers in labor, health, and national HIV policy, and at health care workers in both the public and private sectors and their professional associations and unions. The workplace guidelines include education of health care workers on infection control and HIV prevention. Primary prevention of exposure to blood-borne pathogens is one of the main priorities of the guidelines.
Do No Harm: Injection Safety in the Context of Infection Prevention and Control, Participants’ Manual
This training participants’ manual was developed for use in Tanzania and provides users with a detailed reference source for injection safety theory and practice. It was developed for training of health care workers to improve injection safety through behavior change, supply management, and safe handling of health care waste. There are chapters on communication about injection safety and preventing infection as well as the practicalities of safe injection. Although some of the information is specific to Tanzania, most of the contents of the manual have wider applicability. Training evaluation tools and a detailed glossary are included in the manual.
Evaluation of Global Alliance for Vaccines and Immunization’s Injection Safety Support
This report commissioned by the Global Alliance for Vaccines and Immunization (GAVI) examines its injection safety support program, which gave commodity and cash aid to 58 national immunization programs over a three-year period. The report found that once GAVI support for injection safety ended, all countries receiving commodities were able to replace and sustain the supply of auto-disable syringes and safety boxes, and those receiving cash also continued to use these safe injection tools. The GAVI project also had a broader positive impact on injection safety due to raised awareness of injection safety, but increased demand did not result in reduced prices for auto-disable syringes.
Do No Harm: Injection Safety in the Context of Infection Prevention and Control, Training Tools and Job Aids
Written as a companion document to Do No Harm: Injection Safety in the Context of Infection Prevention and Control: Training of Trainers Facilitation Guide, this book brings together materials that have already been used in World Health Organization programs in Africa. It comprises injection safety training activities, lesson plans, teaching materials, and job aids. There are practical exercises for training activities aimed at changing behavior, such as practicing injection safety, encouraging patients to accept oral medication, and overcoming fear of reporting needle-stick injuries. There is an extensive collection of handouts for use on the job or in training sessions, as well as job aids such as checklists and posters.
Revised Injection Assessment Tool (Tool C – Revised)
Tool C is used for the assessment of injection safety, phlebotomy, lancet procedures, intravenous injections, and infusions. This tool is standardized, simple enough to be used by trained field workers, and flexible enough to be implemented in a range of different facilities including outpatient departments, immunization programs, laboratories, and blood transfusion services. Tool C provides procedural guidelines for sampling, data collection, data entry, and analysis and reporting. There are tables that can be used to record indicators of risk to patients, providers, and the community. The tool also includes a proposed schedule for facility assessments and a data collection instrument.
Do No Harm (Kenya): Injection Safety in the Context of Infection Prevention and Control, Training of Trainers Facilitation Guide
Written as a companion document to Do No Harm: Injection Safety in the Context of Infection Prevention and Control: Training Tools and Job Aids, this guide can be used by managers, policymakers, and health care workers responsible for injection safety to plan in-service training for operational level staff. There is a chapter on facilitation, which outlines the basic skills of effective adult training, as well as lesson planning and selection of teaching methods and materials. There are sample schedules for training modules on infection prevention, safe injection practices, and management of both supplies and waste. Case studies are used where appropriate to encourage group work and problem solving.
Sharps Injuries: Assessing the Burden of Disease from Sharps Injuries to Health-Care Workers at National and Local Levels
This guide can be used to conduct a study into the burden of disease associated with sharps injuries, notably infection with HIV and hepatitis B and C. The guide can help to specifically target protection measures by assessing the number of such infections attributable to sharps injuries and how many infections could be avoided with the use of post-exposure prophylaxis. There is a completed example of an assessment using the guide. Tables provide estimates of hepatitis and HIV prevalence, sharps injuries, and hepatitis B vaccination coverage in the World Health Organization (WHO) regions, but the latest data used are from 2001. The WHO aide-memoire for health care worker safety is also included.
Making Medical Injections Safer Supervision Checklist for Hospital and Lower-Level Facilities
Health care workers can use this set of Excel spreadsheets to observe injection practices and assess safety. There are six versions in all: four for use on a computer and two that can be used in hard copy. There are versions covering selected aspects of injection safety and versions using the full set of 36 questions and observations. All can be used as a checklist for hospitals and other health care facilities. There are questions designed to elicit information from health facility directors, injection providers, and medical waste handlers; recommended observations include storage, injection administration, and waste management facilities.
Guiding Principles to Ensure Injection Device Security
This two-page document from the World Health Organization (WHO) describes the background to injection safety, including the extent of unnecessary and unsafe injections worldwide, particularly in developing and transitional countries. It describes the range of sterile, single-use injection devices available and spells out WHO’s policy on injection safety practices. WHO urges the phasing out of reusable injection devices and calls for single-use devices and safety boxes for disposal to be provided whenever injectable products are supplied. The document directs readers to the WHO’s injection safety website, www.injectionsafety.org, where there are tools for assessment planning, implementation, and evaluation of injection safety policies.