Abstract
BackgroundUnsafe injection practices are an occupational hazard among the nursing staff. Awareness of nurses’ staff members about safe injection practices may vary between different hospitals according to the policies adopted for staff training and systematic auditing.AimTo assess awareness and practice of safe injection among nursing staff in a Maternal and Child Hospital, Qassim Region, Saudi Arabia, and Beni-Suef University Hospital, Egypt.MethodsA cross-sectional study using a structured questionnaire. Observations included 500 injections (250 from each hospital) from October to December 2017.ResultsThe mean awareness total scores in both hospitals were 9.98 ± 1.76 and 11.12 ± 0.96 respectively with a significant difference among observed nurses (P = 0.001). The mean safe injection practice total score was 27.13 ± 3.11 and 27.39 ± 2.17. Past year safe injection training was received for 95% and 70% for observed Egyptian and Saudi group of nurses. The majority of nurses (98.8%) were aware of the importance of safe injection practices to minimize blood-borne diseases, and 95.2% of them were aware of the placement of sharps disposal box beside the place of injection procedure. Exposure to the past year needlestick injuries (NSIs) was higher among the observed Egyptian nurses (P = 0.001). Using appropriately stored and refilled disinfectants was done by 48.5% and 51.5% of the observed nurses. Needle separation from its syringe inside sharps disposal box and sharps disposal boxes near patient care areas were observed in 95.2% and 95.6% of both hospitals respectively.Conclusions and recommendationNurses of both hospitals have good awareness and practice of injection safety. This might be attributed to the adoption of appropriate training courses. There is a need for continuous training sessions and auditing for nursing staff to ensure safe injection practices.
Highlights
Four main potential risks might pose a direct patient hazard, namely re-use of injection equipment, where administration of about 16 billion injections are encountered worldwide with about 40% of which involves re-use of injection equipment [2]; accidental needlestick injuries (NSIs) for health care provider resulting in a total of 3 million accidental NSIs in a World Health Organization (WHO) survey [3]; overuse of injections, where various surveys conducted in different settings indicated a high at least one injectable preparation
2.4 Sampling selection method We tried hard to make the total population as we included all nurses who offered injection (258/375 were selected from the Beni-Suef University Hospital (BSUH) in Egypt and 250/453 were selected from the Maternal and Child Hospital (MCH)-Qassim in Saudi Arabia)
A single observation was carried out by the research team who visited the clinical departments of the hospital to observe injection practices of the nurses; while on duty, a subsequent personal interview was carried out to fill out a questionnaire aiming to assess their awareness as regards safe injection practices
Summary
Unsafe injection practices by healthcare providers pose a risk for patients and healthcare workers especially infectious and non-infectious adverse events and often are associated with a variety of improper procedures and unsafe settings.Safe injection practices are a set of preventive measures aiming to optimally perform a safe patients’ injection manner; a “safe injection” should not harm theFour main potential risks might pose a direct patient hazard, namely re-use of injection equipment, where administration of about 16 billion injections are encountered worldwide with about 40% of which involves re-use of injection equipment [2]; accidental needlestick injuries (NSIs) for health care provider resulting in a total of 3 million accidental NSIs in a WHO survey [3]; overuse of injections, where various surveys conducted in different settings indicated a high (up to 56%) at least one injectable preparationAnwar et al Journal of the Egyptian Public Health Association (2019) 94:21 was prescribed with an annual ratio of 1.7 to 11.3 injections per person per year [4]; and unsafe sharps waste disposal, where inappropriate collection and disposal of sharp wastes put the health care practitioner and the waste handler including the community at risk of sharps injuries with consequential blood-borne infections [5].Safe injection practice is a component of standard precautions aimed at maintaining basic levels of patient safety and provider protections, which necessitates proper administration of an injection by a well-trained qualified healthcare provider under complete aseptic technique using a sterile device (syringe, needle, etc.) with its appropriate disposal in a puncture-proof sharps discard container [6, 7].Proper injection equipment disposal is required to check the reuse of disposable syringes and to minimize the opportunities of avoidable healthcare workers’ (HCWs) potential risks [8].Improper syringe disposal and NSI incidents reflect that there is a wide gap between healthcare provider knowledge and their practice; injection-related behavioral changes are required that might be brought by continuous training and regular audit and supervision. Unsafe injection practices by healthcare providers pose a risk for patients and healthcare workers especially infectious and non-infectious adverse events and often are associated with a variety of improper procedures and unsafe settings. Safe injection practice is a component of standard precautions aimed at maintaining basic levels of patient safety and provider protections, which necessitates proper administration of an injection by a well-trained qualified healthcare provider under complete aseptic technique using a sterile device (syringe, needle, etc.) with its appropriate disposal in a puncture-proof sharps discard container [6, 7]. Improper syringe disposal and NSI incidents reflect that there is a wide gap between healthcare provider knowledge and their practice; injection-related behavioral changes are required that might be brought by continuous training and regular audit and supervision. Awareness of nurses’ staff members about safe injection practices may vary between different hospitals according to the policies adopted for staff training and systematic auditing
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