Sharps Disposal Research Articles

Comparative Usability of Three Platforms for Collecting Standard Precautions Surveillance Data

Background: Although standard precautions are considered a building block in the prevention of healthcare-associated infections (HAIs) and bloodborne pathogen (BBP) exposures, little is known about the rate of adherence to standard precautions among healthcare workers in US acute-care hospitals and the processes used for measurement and surveillance. Methods: We evaluated the development and usability of electronic platforms to collect standard precautions surveillance data in support of the Simulation to Improve Infection Prevention and Patient Safety (SIPPS) Trial. SIPPS is a 5-year group-randomized group-interventional study to develop and test a simulation intervention to improve provider performance of standard precautions and prevent HAIs and occupational BBP exposures. In the pilot study, standard precautions adherence data were collected and validated using the Standard Precautions Observational Tool (SPOT) in a paper format. Adherence was measured using 10 indicators across the categories of hand hygiene, personal protective equipment, linen handling, and sharps disposal. The SPOT allows users to observe healthcare workers providing routine care and to record when an SP action is indicated and whether it was completed or missed. The data did not contain personally identifiable information or protected health information. The aim of this project was to design an electronic version of the SPOT that is simple and affordable to create, allows for rapid and structured data collection, and can be disseminated for broad standardization of standard precautions surveillance. Results: Three electronic platforms, including 2 survey-based platforms (Qualtrics and REDCap) and 1 website-based platform (Google), were evaluated for the following characteristics: (1) design interface, (2) customizability, (3) data entry speed, (4) accessibility, and (5) total cost. Both survey platforms performed well in design interface, allowing for a no- or low-code design and offered mobile-friendly formats. Rigid survey formats created obstacles in customization and rapid data collection, involving large amounts of scrolling or screen advancement. Survey-based platforms also required a subscription or access fee. Conversely, the website-based platform had a more challenging design interface but was easily customizable with low-level knowledge of hypertext mark-up language (HTML) and application programming interface deployment. The website platform allowed for a single screen view, mobile-phone–friendly design, and rapid data collection. It was developed using freely available resources. Conclusions: A website-based HTML form allows for faster data collection and a higher level of customization than survey-based platforms and can be designed and implemented free of cost using minimal web-development skills. This surveillance methodology will be field tested for fidelity of implementation and for broad use in surveillance.Funding: The Agency for Healthcare Research and Quality provided Funding: for this study (grant no. 1R18HS026418).Disclosures: Amanda Hessels reports that she is the primary investigator for the studies titled “Impact of Patient Safety Climate on Infection Prevention Practices and Healthcare Worker and Patient Outcomes” (grant no. DHHS/CDC/NIOSH 1K01OH011186 to Columbia University) and “Simulation to Improve Infection Prevention and Patient Safety: The SIPPS Trial (AHRQ grant no. R18: 1R18HS026418 to Columbia University)

Impact of rigorous nursing training and reinforcement on incidence of thrombophlebitis at tertiary care centre

Background: Peripheral venous cannulation (PVC) is one of the commonest procedures carried out in hospital. It allows rapid and accurate administration of medication. However, there is dearth of formal training to nurses There are few studies which has shown benefits of offering formal training to improve clinical practice and patient care.Methods: In view of rising cases of thrombophlebitis, nurses were trained in hand hygiene, patient skin preparation, wearing gloves and aprons, establishing a clean environmental field, using sterile equipment, disposing of contaminated or soiled equipment and linen appropriately, safe disposal of sharps and adherence to universal precautions. Retrospective, observational, single centre study to analyse data of inpatients for 4 years duration was carried out. This included 2 years data prior to offering nursing training and 2 years post training.Results: There is statistically significant improvement in number of thrombophlebitis event for 2 years prior and 2 years post training. Total events in 2 years prior to training were 63 which reduced to 22 in later 2 years due to nursing training. A p value was 0.0297. Out of total 87 thrombophlebitis incidences, 40 and 47 incidences in males and females respectively were observed. Mean age for men was 58.39 and mean age for female was 52.62 with SD 27.39 and 22.06 respectively.Conclusions: When nurses were trained in patient assessment, Insertion site selection (prefer hand and forearm; to avoid joints and lower limbs), catheter selection, dwell time, early identification of phlebitis and appropriate corrective measures and compliance with best practice guideline, thrombophlebitis rates drastically reduced.

1218-P: Interactive Insulin Teaching by Pharmacists Prior to Hospital Discharge

The primary objective of this study was to evaluate the impact on patient health outcomes of incorporating iPad insulin education videos into standardized pharmacist insulin teaching prior to inpatient discharge. Inclusion criteria comprised of hospitalized patients >18 years old with either new insulin orders or, if taking insulin prior to admission, a HbA1c ≥ 8.5%. Patients were excluded if they did not speak English or were discharged to a facility. From July 2018 to January 2019, control patients (n=180) received standard, bedside insulin-administration education from a trained pharmacist. From February to June 2019, intervention patients (n=114) received pharmacist-deployed educational videos on iPads that included the same content as the standard education. The primary outcome was the change in an eight-item survey administered pre- and post-education, assessing confidence in insulin administration and storage, hypoglycemia management, and sharps disposal on a scale of 1 to 5, with 5 indicating highest confidence. Secondary outcomes included 30-day hospital readmission and change in HbA1c post-discharge. Pharmacist-provided education significantly improved confidence across all survey items in both the intervention and control groups (mean (SD) increase = 0.57 (0.74), p < 0.01). There were no statistically significant differences between groups after adjusting for age, sex, race/ethnicity, and prior insulin use. Baseline HbA1c was similar in both groups (10.7 vs. 10.9, p= 0.51) and decreased within 4 months post-discharge (9.4 vs. 8.7, p= 0.09). The decrease did not differ between groups. Diabetes-related readmissions were similar between the two groups (14 vs. 13%, p= 0.93). Inpatient education by pharmacists prior to discharge improved patient confidence in insulin administration for both traditional and technology-enhanced education groups. Technology-enhanced insulin education may reduce pharmacist burden without negatively impacting patient outcomes. Disclosure J.M. Odom: None. A. Ghizzoni-Burns: None. M. Probst: None. M.W. Sutherland: None. M.L. Fair: None. S.L. Weber: None. Funding Prisma Health

HUBUNGAN MOTIVASI PERAWAT DAN GAYA KEPEMIMPINAN DENGAN PERILAKU PERAWAT DALAM PEMBUANGAN SAMPAH MEDIS BENDA TAJAM DI RSUD DR.A.DADI TJOKRODIPO KOTA BANDAR LAMPUNG

Introduction: sharp medical waste is not only able to cause scratch and stab wounds but also to infect wounds when they are contaminated by pathogen. A pre-survey result done by the researcher in wards of dr. A. Dadi Tjokrodipo at 20 January 2019 to 10 nurses concerning activities of nursing care and medicla waste management including needle, syringe, and bandage that were disposed without sorting.Objective: the objective of this research was to find out the correlations of nurse’s motivation and leadership style to nurse’s behavior in sharp medical waste disposal in dr. A. Dadi Tjokrodipo public hospital in Bandar Lampung. Method: this was a quantitative analytic survey research by using cross sectional approach and it was conducted in dr. A. Dadi Tjokrodipo public hospital from March to April 2019. Population was all nurses and samples were of total sampling. Data were collected by using questionnaires and analyzed by using univariate (frequency distribution) and bivariate (chi square test) analyses.Result: there were 31 respondents (54.4%) with poor medical waste littering behavior, 34 respondents (59.6%) with low motivation, and 29 respondents (50.9%) with bad leadership style. There were correlations of nurse’s behavior (p-value 0.000; OR 11.70) and leadership style (p-value 0.012: OR 4.725) to sharp medical waste disposal in dr. A. Dadi Tjokrodipo public hospital in Bandar Lampung in 2019. Conclusion: there were correlations of nurse’s motivation and leadership style to nurse’s behavior in littering sharp medical waste in dr. A. Dadi Tjokrodipo public hospital in Bandar Lampung in 2019. The researcher expects nurse’s motivation improvement concerning medical waste disposal by joining training about effects of improper sharp medical waste disposal.Introduction: sharp medical waste is not only able to cause scratch and stab wounds but also to infect wounds when they are contaminated by pathogen. A pre-survey result done by the researcher in wards of dr. A. Dadi Tjokrodipo at 20 January 2019 to 10 nurses concerning activities of nursing care and medicla waste management including needle, syringe, and bandage that were disposed without sorting.Objective: the objective of this research was to find out the correlations of nurse’s motivation and leadership style to nurse’s behavior in sharp medical waste disposal in dr. A. Dadi Tjokrodipo public hospital in Bandar Lampung. Method: this was a quantitative analytic survey research by using cross sectional approach and it was conducted in dr. A. Dadi Tjokrodipo public hospital from March to April 2019. Population was all nurses and samples were of total sampling. Data were collected by using questionnaires and analyzed by using univariate (frequency distribution) and bivariate (chi square test) analyses.Result: there were 31 respondents (54.4%) with poor medical waste littering behavior, 34 respondents (59.6%) with low motivation, and 29 respondents (50.9%) with bad leadership style. There were correlations of nurse’s behavior (p-value 0.000; OR 11.70) and leadership style (p-value 0.012: OR 4.725) to sharp medical waste disposal in dr. A. Dadi Tjokrodipo public hospital in Bandar Lampung in 2019. Conclusion: there were correlations of nurse’s motivation and leadership style to nurse’s behavior in littering sharp medical waste in dr. A. Dadi Tjokrodipo public hospital in Bandar Lampung in 2019. The researcher expects nurse’s motivation improvement concerning medical waste disposal by joining training about effects of improper sharp medical waste disposal.

A Novel Transdermal Protein Delivery Strategy via Electrohydrodynamic Coating of PLGA Microparticles onto Microneedles.

Transdermal delivery of biological therapeutics is emerging as a potent alternative to intravenous or subcutaneous injections. The latter possess major challenges including patient discomfort, the necessity for trained personnel, specialized sharps disposal, and risk of infection. The microneedle (MN) technology circumvents many of the abovementioned challenges, delivering biological materials directly into the skin and allowing sustained release of the active ingredient both in animal models and in humans. This study describes the use of electrohydrodynamic atomization (EHDA) to coat ovalbumin (OVA)-loaded PLGA nanoparticles onto hydrogel-forming MN arrays. The particles showed extended release of OVA over ca. 28 days. Microscopic analysis demonstrated that EHDA could generate a uniform particle coating on the MNs, with 30% coating efficiency. Furthermore, the coated MN array manifested similar mechanical characteristics and insertion properties to the uncoated system, suggesting that the coating should have no detrimental effects on the application of the MNs. The coated MNs resulted in no significant increase in anti-OVA-specific IgG titres in C57BL/6 mice in vivo as compared to the untreated mice (paired t-test, p > 0.05), indicating that the formulations are nonimmunogenic. The approach of using EHDA to coat an MN array thus appears to have potential as a novel noninvasive protein delivery strategy.

Adherence to infection control practices in relation to neonatal care in major hospitals in a district of Sri Lanka

Introduction: Adherence to infection control practices are crucial for neonatal care. Objectives: To describe the adherence to clean birth and postnatal care practices by healthcare workers in selected procedures in major hospitals in a district of Sri Lanka Methods: This was a qualitative observational study. The study sample comprised healthcare workers (doctors, nurses and midwives) attached to the labour room (LR), postnatal ward (PNW), neonatal intensive care unit (NICU) and operating theatre (OT). A total of 70 healthcare workers from the LR, 90 from the PNW, 50 from the NICU and 60 from the OT were assessed in relation to each procedure they carried out. Four checklists were used to record the observations on infection control standards. The performance of each healthcare worker for each specific procedure was observed only once. Results: Hand washing practices among the healthcare workers in LR, NICU, PNW and OT varied, with better practices seen in NICU and PNW. Recapping of the needles was done by 18.6%, 18.0% and 31.2% in LR, NICU and PNW, respectively. Disposal of sharps to the bin was done by almost all healthcare workers in the LR, NICU and PNW, respectively. All the healthcare workers used 70% alcohol to disinfect the skin, of whom the majority used povidone iodine when drawing blood samples for blood culture in the NICU. Changing or washing gloves before cutting the umbilical cord was observed in the majority of healthcare workers in LR and the minority in OT. Conclusions: Adherence to infection control standards by healthcare workers in observed procedures was not up to the standard.

The insulin sharps disposal study: Evaluation of a structured patient education initiative in an urban community health centre in India.

Context:India has witnessed an increase in people suffering from diabetes mellitus and also those on insulin. The issue of handling used sharps in the community is an area of concern.Aims:Our study aimed to assess the change in knowledge and practise concerning the disposal of used insulin sharps in patients with diabetes, pre- and post-evaluation, a structured, health provider-initiated, patient-centred insulin-use health education (PIHE)Settings and Design:A pre- and post-evaluation study of PIHE set in an urban health centre in south IndiaMethods and Materials:A pre-evaluation study was done on a cross-sectional sample of type II diabetes patients, who visited the urban health centre and were on insulin for at least 1 year. A semi-structured pilot-tested questionnaire was used for the study. For 18 months, PIHE was provided to all insulin users at outpatient contact, after which a post-evaluation study among another cross-sectional sample of patients in the same centre, was done to assess change in knowledge and practise.Statistical Analysis Used:Univariate analysis followed by logistic regression.Results:The participants in the pre- and post-evaluation studies had a mean (SD) age of 54.9 (11.33) years and 57.2 (11.01) years, respectively. The baseline characteristics of gender, socioeconomic status and diabetes duration were similar. There was a statistically significant (P < 0.001) difference in knowledge (19 [19%] to 81 [81%]) and practise (7 [7%] to 73 [73%]) of participants regarding the correct disposal method of used insulin syringes and sharps before and after PIHE.Conclusions:PIHE over an 18-month period for diabetic patients on insulin significantly improved knowledge and practises relating to insulin use and correct disposal of syringes and sharps.

Assessment of Injection Safety Practices among Health Workers in Ekiti State, Nigeria

Safety of injections been administered on daily basis is becoming of significant Public Health importance considering the increasing prevalence of complications and the negative impact this could have on the overall good intention of the Healthcare providers. It is on the basis of this that we assessed the level of awareness and compliance with injection safety practices among Healthcare workers in Ekiti State. A descriptive cross-sectional study was conducted using multistage sampling technique to recruit 582 HCWs across the State. In Stage One, 2 LGAs were selected from each of the 3 senatorial districts by simple random sampling technique through balloting and in stage two, a list of all the Health Facilities (Public and Private) in the selected LGAs was compiled and all were included in the study. In Stage three, A cluster sampling method was used to select all the staff who are eligible to administer injections in the selected HFs at the time of survey. A semi-structured questionnaire and an observational checklist was used for data collection. Data analysis was done using SPSS version 21. A total of 582 HCWs were interviewed and 151 HFs were directly observed for compliance with Injection safety procedures. The mean age of the respondents was 38.2 ± 9.6 years. Females constituted about 86.8% while 83.5% were married. Majority of the respondents were CHEW, Nurses, Doctors and Health Attendants. Awareness of injection safety was generally high as about 93.6% of respondents were aware. However, only about 62.9% of them has ever had any form of training on Injection safety. Only about 3% of the respondents have not reused syringes, while only about 41% has ever used an AD syringe, among whom about 32% always use AD syringes. Safety boxes were available and used in about 93% of the HFs, however, the final method of sharp waste disposal is transportation to a predetermined site for onward final disposal in about 50% of the HFs. Similarly, general waste disposal is predominantly by Open burning. Recapping of needles is still being practiced occasionally by about 78.5% of the respondents, while about 13% are still regularly recapping needles. Hand washing with soap and water was a regular practice among about 88% of the HWs before attending to patients and about 93.1% after attending to patients. On the contrary, only about 20.5% of those observed actually washed their hands before/after giving injections. Majority (75.4%) of the prescribers preferred oral medications for the treatment of uncomplicated malaria, while exit interview revealed that about 34.2% of the patients preferred injections to other forms of treatment. Although the awareness of the HCWs on injection safety is generally high, compliance with the standard safety precaution still needed to be accorded greater attention. Practices such as needle recapping, open burning of waste, poor hand hygiene, reuse of syringes and non-adherence to multidose vial policy should be totally discouraged. Regular training and unscheduled assessment of compliance could ensure that these instructions are clearly adhered to and confidence of the consumers could be built again.

Perceived changes in knowledge and skills of nursing personnel after the completion of training in safe injection practices: A study from the tertiary care hospital of Haryana, India

Background: Unsafe injection is an important cause of transmitting blood-borne infections such as hepatitis B virus, human immunodeficiency virus, and hepatitis C virus. In a country-like India, health system usually suffers from the paucity of workforce and nursing personnel are the most susceptible to unsafe injection and needle stick injury. Aim: The present study was carried out with the aim to assess the knowledge and skills among nursing personnel regarding safe injection practices and to measure the change following training session. Materials and Methods: This was a hospital-based cross-sectional study, included all 230 nursing personnel those who were currently working in the hospital. A pretested, predesigned, standardized questionnaire was used. Everyday activity of the study was divided into three parts. First part of activity included pretest second part of activity consisted of 3–4 h training session and third part was posttest. The collected data were tabulated and analyzed using the SPSS Statistics for Windows, version 22.0. Results: Nearly 52.9% of the participants were aware of diseases transmitted through unsafe injection and 45.5% of participants were aware about appropriate sharp waste disposal. Only 20.6% of participants wore gloves before injection administration, and 56.1% used needle destroyer for disposing off the needles. Conclusion: Periodic reinforcement of the nursing personnel with hands on training sessions is the need of the hour to protect them from needle stick injuries and prevent the spread of blood borne pathogens in public at large.

Proportion of needle stick injury and its characteristics among nursing staffs in a tertiary care teaching hospital in Trivandrum, South India

Introduction: A cross-sectional study was conducted among health care workers (Nurses) at a tertiary care hospital in Trivandrum, Kerala to study the proportion of needle stick injury and associated factors. A semi structured questionnaire was used to collect data from the study participants at their work place. Participants were asked to recall needle stick injuries (NSIs) in the preceding 6 months and definition of needle stick injury was formulated. Factors such as work experience, type of procedure, action taken following injury etc were also studied. Results: The prevalence of NSIs was 94(47%). Mean age of 200 participants was 32.8 years (+ 6.8), all were female. Emergency department accounted for highest (62.8%) of NSIs. & it was maximum (42.6%) during injection procedure. Heavy work load (37.2%) followed by inattention (32%) were prime causes. Following injury 34% of nurses washed injury site with soap & water and applied antiseptics as well. usage of personal protective equipment(PPE) was 84%. Prime causes for not using PPEs were lack of supply and inappropriate size of gloves respectively. Usage of PPEs were found to be significant in preventing NSIs. Conclusion: Prevalence of NSI is high and measure for safety concern. There is urgent need of close monitoring and implementation of uniform NSIs programme like safe practices, safe disposal of sharps, mandatory reporting of needle stick injury at work station. Provision of post exposure prophylaxis following NSIs. Limitation: Small sample size, purposive-sampling and impact of information broacher regarding NSIs could not be accessed. Keywords: Nurses, Cross-sectional study, Needle prick injury, Proportion

Safe injection awareness and practices among nursing staff in an Egyptian and a Saudi hospital

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.

Factors Contributing to Sharp Waste Disposal at Health Care Facility Among Diabetic Patients in North-East Peninsular Malaysia.

Background: Type 2 diabetic patients are major users of medical sharps in the community. Proper sharp disposal practice among them, however, was reported to be low. The current study was aimed to determine the factors contributing to sharp waste disposal at a health care facility among Type 2 diabetic patients. Methods: In this cross-sectional study, Type 2 diabetic patients who were on insulin therapy attending health clinics were randomly selected and interviewed using a validated questionnaire. Binary logistic regression analysis was applied. Results: Out of 304 respondents, only 11.5% of them brought their used sharps to be disposed at health care facilities. Previous advice on sharp disposal from health care providers, knowledge score, and duration of diabetes were significant contributing factors for sharp waste disposal at health care facilities: (Adj. OR 6.31; 95% CI: 2.63, 15.12; p < 0.001), (Adj. OR 1.05; 95% CI: 1.03, 1.08; p < 0.001), and (Adj. OR 2.51; 95% CI: 1.06, 5.93; p = 0.036), respectively. Conclusion: Continuous education and a locally adapted safe sharp disposal option must be available to increase awareness and facilitate diabetic patients adopting proper sharp disposal behavior.

Practical guidance on insulin injection practice in diabetes self-management in the Indian setting: an expert consensus statement

This consensus statement aimed to provide a simple and easily implementable practical educational guide- line for healthcare professionals (HCPs) and patients regarding insulin injection practice in diabetes self- management in the Indian setting. A group of experts analysed published data from guidelines, clinical trials and real world evidence to reach consensus recommendations on optimal insulin injection practices in terms of a) the injection sites (preparation of site of injection, choosing the injec- tion site, site rotation), b) choice of device and storage of insulins, and c) safety precautions, sharp disposal practice and complications. Findings from Global and Indian arm of 2014-2015 ITQ Study were considered to emphasize a need for improved practice by HCPs covering all the vital topics essential to proper injection habits. The consensus statement provides a simple and easily implementable practical educational guideline for HCPs and patients to optimize insulin injection practices in accordance with recent advances in device manufac- turing, newer research findings, and updated interna- tional guidelines as well as widespread concerns about neglected safety precautions such as single-patient use of pens and appropriate sharp disposal practices.

MON-021 Patterns of Sharps Handling and Disposal Among Insulin Using Patients with Diabetes

Background: Nearly 7 million patients with diabetes mellitus (DM) in the U.S. use insulin. Both Insulin therapy and self-monitoring of blood glucose (SMBG) have the potential to generate a large volume of biohazardous waste via use of “sharps” (needles and lancets). Unless safely disposed of these sharps could present a public health risk, placing unaware individuals at risk of needle sticks. However, there is a paucity of data on whether patients safely handle and dispose of used insulin needles and lancets. Objective: Assess patterns of sharps use and disposal among a clinic and hospital based population of DM patients on insulin therapy. Method: A survey was administered to a convenience sample of adult insulin treated DM patients recruited from an outpatient endocrinology clinic and an inpatient hospital setting. Patients were asked about patterns of sharps use (frequency of daily SMBG and insulin injections), how often sharps were used prior to disposal, sharp disposal technique, and education received regarding safe sharp disposal. Results: The survey was completed by 142 patients (94 outpatients and 48 inpatients). Mean age was 56 years, self-reported DM duration 20 years, hemoglobin A1c was 8.4%, and BMI 30.2 kg/m2; 57% were men and 75% were white. No differences in characteristics (p>0.1) were seen between outpatient and inpatient respondents. The average number of insulin injections was 3/day, and frequency of SMBG was 3.5/day. A minority (22%) used an insulin needle 2 or more times, and 32% threw the needles directly into the garbage as opposed to a sealable or red sharps container. Most (56%) respondents used a lancet 2 or more times, sometimes changing the lancet once only every few months. Around a third (35%) threw used lancets directly into the garbage; one patient flushed them down the toilet. No differences were seen between outpatients and inpatients (p> 0.3) in patterns of needle use, lancet use, or disposal method. The majority (63%) of respondents indicated they had never received instruction on safe disposal of sharps. Conclusion: In this population of both outpatients and inpatients, repeated use of the same insulin needle and lancet was noted. Moreover, nearly a third of respondents disposed of their sharps in an unsafe manner. If similar data are confirmed in broader studies, this could translate into a large number of insulin using patients improperly disposing of their sharps waste—a potentially important public health hazard. With the rising prevalence of DM and need for insulin, further study is needed to determine sharps disposal practices of these patients. Improved education is needed on both a population and patient level regarding proper handling of these biohazardous materials.

Intra-Urban Solid Waste Disposal Practice in Selected Hospitals in Ota, Nigeria

The study examined waste disposal options employed by the different hospital authorities in Ota, Ogun State, Nigeria. This is with a view to ascertaining whether the methods are environment-friendly. Data for the research were obtained through questionnaire administration and interview. There are thirty eight (38) hospitals distributed within the five (5) wards in Ota Township. For the purpose of this study, 25% of the hospitals were sampled. Using stratified sampling technique, two hospitals were selected from each ward. This translated to 10 hospitals. Questionnaires were administered to all cleaners in each of the hospitals, while interview was conducted on head of the hospitals and waste management team where available. Data collected were analyzed using descriptive and inferential statistics. The study shows that virtually all the surveyed hospitals adopted the same methods for disposing their medical waste components.It could be concluded that methods employed in the disposal of pathological, pharmaceutical, sharps, radioactive, infectious and general waste were inadequate. The study recommends the use of modern approach and technology in the disposal of medical waste in order to forestall inherent hazards.

Home Disposal of Used Insulin Syringes and Needles by the Patients With Diabetic in Rwanda

For many people living with diabetes, using needles to inject insulin and test blood glucose levels is a part of their everyday lives. Improper disposal of these highly contaminating sharp materials can cause injuries to people as well as pollute water sources and agricultural land.Approximately 3.4% of the population in Rwanda lives with diabetes. There is no law specifying how these individuals should dispose of home-used syringes and lancets, and prior to this study, home disposal practices for sharp instruments including needles and lancets used for diabetes self-management were unknown.A cross-sectional study design was used to identify the common methods used by people living with diabetes to dispose of sharps after home use. A total of 201 people living with diabetes participated in the study. Only 107 (53.3%) of them could identify the proper methods of sharp disposal and only 69 (34.3%) reported using these proper disposal methods. The top three challenges to the use of proper disposal practices reported by participants included not being informed of such practices (76, 37.8%), not having appropriate containers (66, 32.8%) and having to travel a long distance to return safety boxes containing sharp materials (47, 23.4%).Future studies should be conducted to understand the financial feasibility of health facility provision of safe disposal boxes for patients. Education focusing on training people living with diabetes to use hard plastic bottles as an acceptable alternative to boxes is also needed. Convenient and effective mechanisms for obtaining and returning used safety boxes should be established. Larger scale studies including more patients could generate more representative data.

Unpacking healthcare waste management at rural village health clinics in the Ntcheu District (Malawi).

Management of healthcare waste in low- and middle-income countries lacks a straightforward solution, especially where rural healthservices are provided. The purpose of our case study was to explore the knowledge and practices of health surveillance assistants operating at rural village health clinics in Ntcheu District, Malawi, with regard to the collection, segregation, transportion, treatment, and disposal of healthcare waste. Data were collected from 81 clinics. The results indicated that while general gaps in both knowledge and practice were observed, sharps (e.g., needles) management was generally being done well. An opportunity for scale-up was found in one clinic, in which local materials had been used to construct a low-cost innovative sharps disposal receptacle that had been modified from a pit latrine design. This study recommends waste management training suitable for rural settings, the promotion of low-cost sharps disposal receptacles using local materials, further opportunities for low-cost incinerators, central waste collection, and encouraging grassroots innovation in healthcare waste management.

Green diabetes mellitus: a pilot project

ABSTRACT INTRODUCTIONMost of approximately 422 million people globally have diabetes mellitus use sharps for glucose monitoring. Many adults with diabetes are unaware of safe disposal methods, posing a risk of injury or potential infection to others. AIMTo determine how adults with diabetes dispose of diabetes care-related waste and to assess changes in their disposal habits after receiving brief targeted education during medical visits. METHODSAmbulatory adults with diabetes (aged ≥18 years) were enrolled during their medical visit. After completing an initial questionnaire, a handout on safe disposal practices was discussed with them, which was followed by a second questionnaire 3 months later. RESULTSThere were 111 participants at baseline (mean age 55 years, 50.4% had diabetes for &amp;gt;10 years, 52% female, 74.7% insulin users, 59.4% had home sharps containers, 53.1% had previous diabetes education). Of these, 40.5% reported disposing of sharps in their household trash. Insulin use, previous diabetes education or having a ‘Red Sharps’ container at home were each significantly associated with safe disposal (all P&amp;lt;0.05). Of the 96 (86.5%) participants who completed the second questionnaire, unsafe disposal of sharps fell from 39.6% to 10.4% (P&amp;lt;0.001). Preferred method of container disposal was the use of drop-off sites (pharmacies, doctors’ offices and hospitals). Outside their homes, 18.8% of completers had used regular trash for sharps disposal. Post education, this fell to 8.7% (P=0.065). Post education, reuse of sharps decreased from 38.3% to 14.9% (P&amp;lt;0.001) and improper handling of sharps (eg bending or cutting) fell from 18.8% to 9.4% (P=0.004). CONCLUSIONSSafe sharps disposal can be improved by providing a simple handout with a brief discussion at the time of medical visits. Disposal methods that are easy, convenient and free-of-charge are needed to further increase safety.

Assessment of Diabetes Knowledge Among Renal Transplant Recipients With Posttransplant Diabetes Mellitus: Kuwait Experience.

Diabetes knowledge among kidney transplant recipients with posttransplant diabetes has not been exhaustively assessed. We evaluated levels of diabetes knowledge among our kidney transplant patients using a 35-item diabetes self-care management questionnaire. The study comprised renal transplant patients with posttransplant diabetes mellitus who were referred from Hamed Al-Essa Organ Transplant Center of Kuwait to the Dasman Diabetes Institute. Patient data were collected through patient identification forms, metabolic control parameters forms, and diabetes self-care scale questionnaires (with score from 0-7). Of 356 (25.6%) kidney transplant recipients with posttransplant diabetes, 210 patients were enrolled in this study. Most were Kuwaiti (60%), men (48.8%), and with high school education level (43.8%). Some were smokers (11.9%), and the original kidney disease was glomerulonephritis in 37.6% of patients. Most patients (71.9%) received hemodialysis pretransplant. Most patients (> 88%) reported low mean score of healthy diet (0-3), with > 93% reporting low mean score of practicing exercise (0-3), > 62% not checking blood sugar at home, 85% not following the recommended frequency, and > 72% not caring for their feet (except washing in 86.7%). Moreover, most patients lacked information about sharp disposal, diet regimen, using logbooks, hypoglycemia and hyperglycemia, sick day management, and the importance of hemoglobin A1c and regular fundus examination. Mean score of practicing exercise was significantly higher in men (especially non-Kuwaiti; P < .05); otherwise, other mean scores were comparable between sexes and different nationalities (P > .05). Diabetes knowledge is deficient in patients with posttransplant diabetes. Seminars, counseling sessions, and workshops should be arranged periodically for renal transplant recipients to improve their low level of diabetes knowledge. This is a preliminary report of our randomized controlled study evaluating the impact of structured diabetes education on self-care activities and metabolic control variables.

Effectiveness of a prevention and training program to reduce work accidents involving exposure to biological materials.

The frequency of work accidents involving exposure to biological materials (WAEMB) is significantly increasing. The most relevant epidemiological consequences of this type of accidents are due to the transmission of pathogens including the human immunodeficiency and hepatitis B and C viruses. To assess the effectiveness of a prevention and training program to reduce the incidence of WAEMB at a teaching hospital along 8 years of implementation. Retrospective descriptive study based on data obtained from the hospital Human Resource Technology Department. We analyzed records of 1,445 hospital employees who suffered sharps injuries. About 50% of the incidents were caused by inadequate sharps disposal. The overall rate of sharps injuries decreased by 0.21%/year and that of accidents due to inadequate sharps disposal by 0.36%. The results of the present study indicate that the implemented program was associated with significant reduction of the incidence of WAEMB.