Most frequently injected medications are antibiotics. Contention about ‘patient gratification’ injections was raised in February 2011 during a revival of the long standing professional discussion on the safety of health workers, reported in The Standard in Nairobi, Kenya.
Health authorities in South Africa have run several programmes to assess and manage sheq and workplace violence risks suffered by health workers, including handling and disposal of ‘sharps’, hazardous and biological waste.
In some countries, health care providers feel obliged to give injections to satisfy their clients. This unnecessarily exposes nurses to the risk of needle sticks.
“Three studies in Sub-Saharan Africa and Asia found that between 60 and 80 per cent of all injections given were unnecessary and sometimes dangerous. The most frequently injected medications were antibiotics,” reads a WHO Nursing Matters fact sheet by Mireille Kingma.
“Kenyans are obsessed with negligence of medical staff and no one wants to talk about it when a nurse or a surgeon contracts a disease from the patient,” explained Luke Kodambo, chairman of the National Nurses Association of Kenya.
Kodambo says a nurse who has been pricked by a needle should be put on antiretroviral treatment within 72 hours to reduce the chances of contracting the virus.
Preventive measures are also in place but have largely been ignored, reports The Standard in Nairobi, Kenya.
Medical staff are constantly exposed to physical abuse by patients, and the risk of contracting deadly diseases.
The commonest risk is shraps and needle sticks where nurses accidentally prick themselves with used needles. This exposes them to the risk of contracting HIV, hepatitis B virus (HBV) or hepatitis C virus (HCV), and other infections.
A nurse who had accidentally priced herself after injecting an HIV positive child, commented; “Even though I was given post-exposure prophylaxis (PEP) I am still afraid and I am not that confident as before when handling children who are living with HIV… I went for HIV tests for the following six months just to be sure.”
PEP is short-term antiretroviral treatment to reduce the likelihood of HIV infection after exposure, either occupationally or through sexual intercourse.
Infection risk is high
Another nurse accidentally pricked herself with a needle she had just used to inject a HIV positive patient at a Meru Missionary Hospital, and she later tested positive for the virus.
Another doctor contracted the virus when he handled an accident patient without gloves as he tried to save the patient’s life, reports The Standard.
Kodambo says incidents of medical personnel contracting HIV and other diseases from their patients are widespread.
Global infection risk
The World Health Organisation (WHO) reports that American health workers suffer between 800 000 and one million needle sticks annually, excluding the vast number that go unreported.
In the UK, about 100 000 such cases are reported annually. The WHO’s Nursing Matters fact sheet authored by Mireille Kingma, however, observes that needle sticks are virtually undocumented in developing countries, but probably equal or exceed those in the industrialised world.
Kenyan state statistics show that about 2.5% of new HIV infections annually are health-facility related.
“Needle prick is very common but the Kenyan nurses and doctors are not very keen to remember at what point they contracted a disease … that poses a serious health risk to medical staff,” admitted Kodambo.
During the typhoid outbreak that hit Embu municipality and its environs between February and April 2001, two medical officers and four nursing staff involved directly in patient care contracted the fever.
Oubreaks raise occupational risks
In May of same year, a hospital cleaner contracted cholera and died when there was an outbreak of the disease in Wajir.
And at a hospital in Nyeri, Kodambo says nurses were caught in crossfire of an incident involving a patient and members of an illegal gang who had trailed him to the hospital.
But what concerns the nurses more is the increasingly high exposure to needle sticks and cuts from used scalpels and other sharp objects.
“More than 20 blood borne diseases can be transmitted as a result of exposure to blood,” says the WHO.
WHO adds that inadequate waste disposal systems also put cleaners, laundry workers, porters, ‘rag pickers’ and the general community at risk of contracting such infections. “There are instances where even the cleaners are pricked by these needles in the dustbins,” Kodambo said.