Assessment of Injection Safety Practices in Health Facilities in Bongo and Talensi Districts in the Upper East Region

Abstract

Injections are one of the most common health care procedures, with some 16 billion injections administered world-wide each year. Most injections (90% to 95%) are given for therapeutic purposes, and only 5% to 10% are given for immunization. (Immunization essentials, a practical field guide. 2003) Among other things, injection safety assessment includes; Competence of the staff on injection practice, the availability of injection equipment, logistics and supplies, Injection waste disposal system of the facilities and the availability of injection safety and waste disposal plans and systems. A good injection practice in health facilities is a reflection of adequate resource allocation, adequate supportive supervision and good technical support. The main objective of the study was to assess the injection safety practice and management system that promotes injection safety in health facilities in Bongo and Talensi Nabdam districts in the Upper East region. A cross-sectional study was conducted in the two districts. Personnel who were giving injections in the prevention and curative sections as well as the heads of the facilities were observed and interviewed. These include Community Health Nurses, Midwives, Medical assistants (Mostly in vcharges) and General Nurses. The waste disposal systems and disposal sites of the facilities were also assessed. A total of thirty-one (31) staff were observed and interviewed in 8 health facilities. In all twenty- one (21) were observed and interviewed in Bongo and ten (10) in Talensi Nabdam districts. Twenty-two (78.6%) prepared injections on clean table and tray. Fourteen (50%) of respondents reused mixing syringes for reconstitution. Eight (17.9%) had shortage of cotton wool. Community Health Nurses who experienced shortage of cotton wool used syringe wrappers in place of cotton wool after injection. Two hand recapping was observed in 10.7% of respondents. Two (25%) of facilities had sharps scattered at the disposal site. Other two facilities that have incinerators were not using them at the time of the visit. The weaknesses seen on injection practice such as use of improvised items, reuse of syringes for reconstitution, shortage of logistics and supplies, unattended, open and unrestricted disposal sites leading to sharps scattered around disposal site and non-use of incinerators were clearly a problem of weak and apathetic management style of facility heads. National EPI office should consider holding a national review of EPI logistics management and waste disposal system to enable complete overhaul of the system through facility strengthening and staff capacity building to avoid shortage resulting in dangerous practices that puts the provider, the recipient and the community at risk