18 Questions
Why should healthcare providers avoid giving unnecessary injections to patients?
To reduce the risk of transmitting infections
What should healthcare providers always do with needle and syringes?
Always use sterile needle and syringes—never reuse or decontaminate them
Why should medications not be administered from a syringe to multiple patients?
To prevent cross-contamination
What type of syringes should healthcare providers use if possible?
Single-use disposable safety engineered ‘SMART’ syringes
What should healthcare providers never do with a used syringe or needle when it comes to vials?
Never enter any vial with a used syringe or needle
What solution should be applied on the skin before injections?
60–70% alcohol-based solution (isopropyl alcohol or ethanol)
What are some consequences of unnecessary and unsafe injection practices?
Transmission of bloodborne viruses (HIV, hepatitis B, and C), viral haemorrhagic fevers (Ebola and Marburg viruses), malaria, bacterial infections, and abscesses at the injection site.
What percentage of injections given worldwide were estimated to be unsafe in the global burden of disease study in 2000?
40%
How many hepatitis B infections were estimated to be caused by unsafe injections according to a modelling-based study in 2010?
1.6 million
What is the role of infection prevention and control practices in preventing the spread of infections during injections?
Following proper IPC practices and maintaining aseptic technique during preparation and administration of injections.
What is the importance of providing practical training and education on injection safety to healthcare facility staff?
To prevent misuse of vials and ensure safe injection practices.
Why may the adverse impact of misusing a vial not be immediately seen?
Due to the long incubation period of bloodborne viruses and the challenges in tracing misuse of vials.
What should be done before piercing the vial's rubber septum?
Disinfect the rubber septum with sterile 70% isopropyl alcohol or other approved antiseptic swab.
What is the term used to describe using the same syringe to inject more than one patient from a multi-dose vial?
Double-dipping
Why is double-dipping considered dangerous in the context of safe injection practices?
It can lead to contamination of the entire multidose vial, even for the same patient, resulting in the potential transmission of infections to subsequent patients.
How can contamination of sterile injection equipment be avoided?
By using aseptic nontouch technique.
What can result from unsafe injection practices and circumstances that lead to the transmission of bloodborne viruses and other pathogens?
Infections
What is recommended practice regarding fluid infusion and administration sets like IV bags, tubing, and connectors?
Use them for one patient only and dispose appropriately after use.
Study Notes
Safe Injection Practices
- Avoid giving unnecessary injections to patients.
- Always use sterile needle and syringes, never reuse or decontaminate them as they are single-use items only.
- Do not administer medications from a syringe to multiple patients, even if the needle or cannula on the syringe is changed.
Infection Prevention and Control
- Never enter any vial with a used syringe or needle.
- Use single-use disposable safety engineered 'SMART' syringes with Re-Use Prevention (RUP) and Sharp Injury Protection mechanisms (SIP).
- Apply 60-70% alcohol-based solution (isopropyl alcohol or ethanol) on the skin for 30 seconds on a single-use swab or cotton ball and allow it to dry.
Single- and Multi-Dose Vials and IV Solutions
- Use single-dose vials for IV medications whenever possible.
- Do not administer medications from single-dose vials or ampoules to multiple patients or combine leftover contents for later use.
- Do not use medications packaged as single-dose or single-use for more than one patient.
Infection Risks and Burden
- Unnecessary and unsafe injection practices are common, especially in low- and middle-income countries, and have been associated with the transmission of bloodborne viruses (HIV, hepatitis B, and C), viral haemorrhagic fevers (Ebola and Marburg viruses), malaria, and other infections.
- The global burden of disease study in 2000 estimated that 40% of injections given worldwide were unsafe.
- Modelling-based studies estimated that unsafe injections are responsible for 1.6 million hepatitis B infections, up to 315,000 hepatitis C infections, and up to 33,800 HIV infections.
Prevention of Infection Transmission
- Disinfect the vial's rubber septum before piercing by wiping and using friction with a sterile 70% isopropyl alcohol or other approved antiseptic swab and allow the septum to dry before inserting a needle or other device into the vial.
- Avoid double-dipping: using the same syringe to inject more than one patient from a multi-dose vial is a dangerous and unsafe practice.
- Avoid contamination of sterile injection equipment by using aseptic non-touch technique.
- Use fluid infusion and administration sets (IV bags, tubing, and connectors) for one patient only and dispose appropriately after use.
Test your knowledge on safe injection practices based on guidance from WHO and CDC. Learn about the importance of using sterile needles and syringes, avoiding unnecessary injections, and not reusing medical equipment.
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