1.1 BACKGROUND

Injection safety, or safe injection practices, is a set of measures taken to perform injections in an optimally safe manner for patients, healthcare personnel, and others. The Standard Precautions section of the 2007 Guideline for Isolation Precautions provides evidence- based recommendations for safe injection practices and reflects the minimum standards that healthcare personnel should follow to prevent transmission of infections in healthcare settings.(Brokensha,1999). Despite these recommendations, outbreaks and patient notifications resulting from healthcare personnel failing to adhere to Standard Precautions and basic infection control practices continue to be reported.(Bhattarai,2000). Unsafe injection practices that have resulted in disease transmission have most commonly included:(Brokensha,1999; Bhattarai,2000).

Using the same syringe to administer medication to more than one patient, even if the needle was changed or the injection was administered through an intervening length of intravenous (IV) tubing(Drucker,2001).

Accessing a medication vial or bag with a syringe that has already been used to administer medication to a patient, then reusing contents from that vial or bag for another patient   Using medications packaged as single-dose or single-use for more than one patient  Failing to use aseptic technique when preparing and administering injections  For these reasons, CDC reminds healthcare personnel of thefollowing practices that are critical for patient safety(Reeler,1990):

Never administer medications from the same syringe to more than one patient, even if the needle is

• changed or you are injecting through an intervening length of IV tubing.

• Do not enter a medication vial, bag, or bottle with a used syringe or needle.

• Never use medications packaged as single-dose or single-use for more than one patient. This includes ampoules, bags, and bottles of intravenous solutions.

• Always use aseptic technique when preparing and administering injections.

1.2 STATEMENT OF THE PROBLEM

According to the WHO(2004), the most recent study indicates that each year, unsafe injections cause an estimated 1.3 million early deaths, a loss of 26 million years of life, and an annual burden of USD 535 million in direct medical costs. Unsafe injection practices are a powerful engine to transmit blood-borne pathogens, including hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV). Because infection with these viruses initially presents no symptoms, it is a silent epidemic. However, the consequences of this are increasingly recognized.

Hepatitis B virus: HBV is highly infectious and causes the highest number of infections: in developing and transitional countries 21.7 million people become infected each year, representing 33% of new HBV infections worldwide WHO(2004).

 Hepatitis C virus: Unsafe injections are the most common cause of HCV infection in developing and transitional countries, causing two million new infections each year and accounting for 42% of cases. WHO(2004).

 Reuse of syringes and needles in the absence of sterilization exposes millions of people to infections. Assessments carried out in numerous countries have revealed that syringes and needles are often just rinsed in a pot of tepid water between injections. WHO(2004).

Many injections around the world are unnecessary and often unsafe. Unsafe injections put lives at risk and every year cause 1.67 million hepatitis B infections, up to 315 120 hepatitis C infections and up to

33 877 human immunodeficiency virus (HIV) infections.(WHO,2015)1,2 The World Health Organization (WHO,2015) Guidelines recommend rational use of injections, safe injection practices and the exclusive use of safety-engineered syringes for all types of injections by 2020. Safety- engineered syringes exist for both immunization and therapeutic use and have mechanisms preventing re-use of the device [re-use prevention(RUP) syringe] and/or protecting health care providers from needle-stick injuries [sharp injury protection (SIP) feature]. Prescribers and health care providers have a key role to play in making the right choices that support safe injections and reduce unnecessary injections.

1.3 JUSTIFICATION OF THE STUDY

The study was conducted to highlight and show the clearly the important of safe injection practice and also show the implications and risks of practicing unsafe injection procedures to other community health practitioners that did not adhere safe injection practice.

1.4 OBJECTIVES OF THE STUDY

The objectives of this study are to:

1. Review the status of safe injection practice

2. Highlight importance of safe injection practice and

3. Mention interventions and highlight the challenges towards safe injection practice in Nigeria.

4. To examine the injection safety measures put in place by the community health practitioners.