Abstract
Background: Injection is one of the most frequently used medical methods to introduce drugs or other substances into the body for purposes of treatment or prevention. Unsafe injection can cause adverse outcomes, such as abscess and anaphylactic shock, and increases the risk of blood-borne transmission of viruses to patients and health care workers, as well as the community. Recognizing the importance of injection safety, in 2000 the Vietnamese Ministry of Health (MOH) collaborated with the Vietnam Nurses Association to launch the “Safe injection” program throughout the country, including Hanoi. Methods: This cross-sectional study, combining quantitative and qualitative analysis, was conducted from February to August 2012 in Ha Dong General Hospital using a structured questionnaire and observation checklist. The target population of the study was 109 nurses working in clinical departments and 436 injections were observed. Results: The percentage of nurses who are familiar with injection safety standards was found to be 82.6%. The proportion of practical injections that met the 23 standards of injection safety set by the MOH amounted to 22.2%. The factors related to safe injection practice of nurses who are younger age group (OR=3.1; p<0.05) and lower amount of working years (OR=2.8; p<0.05). Conclusions: Despite the high level of knowledge about safety injection, a low proportion of nurses performed correct safety injection practice. Moreover, the results demonstrated that experience might not always guarantee better practice. The findings raise the need for further training about this issue, especially among older nurses.
Highlights
Injection plays an important role in medical treatment at hospitals and other medical institutions, especially those where many patients with serious health conditions are treated[1]
The World Health Organization (WHO) estimates that 50% of injections performed in developing countries are unsafe, and that as many as 20–80% of cases of hepatitis B virus infections are caused by unsafe injections[2,5]
In the in-depth interviews, where injection-performing nurses were interviewed about why gluteal muscles injections only accounted for 0.2% of the 3.6% of deep intramuscular injections, it was said that “using deep intramuscular gluteal muscles causes less pain for the patient, but both patient and staff are reluctant to use this method due to cultural reasons” (In-depth interview)
Summary
Injection plays an important role in medical treatment at hospitals and other medical institutions, especially those where many patients with serious health conditions are treated[1]. In terms of preventive medicine, vaccination has a significant impact on reducing the incidence and mortality of infectious diseases, which can be prevented by children’s vaccination[2] Despite such positive outcomes, injection can cause risk of abscess at the site of injection, nerve paralysis, allergic reaction, and anaphylaxis, and, in particular, the risks of transmission of blood-borne viruses to patients, healthcare workers (HCWs) and the community[3,4]. According to the World Health Organization (WHO), unsafe injection has become a very common issue and is practiced in many countries; it is the major cause of transmission of diseases such as hepatitis B, hepatitis C and HIV2,5,6. According to the first study the global burden of unsafe injections is 5.5% and the number of infections associated with unsafe injections is mentioned in the second paper. The findings raise the need for further training about this issue, especially among older nurses
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