ASSESSMENT ON INJECTION SAFETY PRACTICES AMONG HEALTH WORKERS IN PRIVATE HOSPITAL IN ILORIN, KWARA STATE

CHAPTER ONE INTRODUCTION 1.1 Background of the study Globally, subcutaneous injections are among the most frequently performed medical operations. This is important because, in order to cure or prevent illnesses, it is usual to inject medications under the skin using a syringe and needle. However there are hazards associated with injections administration, such as infection at the injection site, anaphylaxis, and notably the potential of spreading blood-borne diseases to other patients, medical professionals, and the general public when administered incorrectly. According to Nichole and Hange (2017), in hospital disease treatment, particularly for severe disorders, injectable therapy plays a critical role hence the need to ensure it is safely administered. As opined by WHO report viz Safe Injection Global Network (2015), a safe injection is one that is administered using the proper tools, does not cause injury to the receiver, does not put the giver at unnecessary risk, and does not generate any waste that might endanger other people. Hence, safe injection practice involves the administration of rational injection by a qualified and well-trained person using a sterile device, right technique, proper disposal and management of the wastes generated. In underdeveloped nations, there have been rampant cases of unsafe injection practices. According to Simone's (2019) observation , sixteen million injections are administered yearly; the vast majority (95%) are administered for curative therapy whereas some injections are used significantly more frequently than they should be in some parts of the world, and this practice is not supported by sound medical theory. According to the World Health Organization (2000) cited in Oguamanan & Kelvin (2018), up to 90% of patients who receive apron injection from a healthcare provider, about 70% of which are unnecessary or could be administered orally. According to the World Health Organization (2004) cited in Musa (2020), the consequence of unsafe injections has caused millions of instances of hepatitis B and C as well as an estimated 250 000 cases of HIV every year. Prior 1950s and 1960s, single-use plastic syringes and disposable needles took the place of reusable glass syringes and needles, and for many years, it has been normal procedure to use a fresh, disposable, sterilized needle and syringe for each and every injection. However, with the emergence of HIV/AIDS in the 1980s, the potential of Hospital acquired infection with blood-borne viruses as a result of improper injection methods came into sharp focus. As a result of the hazardous injection practices that are widespread in many nations with more risk attached to developing nations, through the Safe Injection Global Network (SIGN), numerous international organizations including the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), the Center for Disease Control (CDC), the United Nations Development Programme (UNDP), the United States Agency for International Development (USAID), and the Programme for Appropriate Technology and Health (PATH) have jointly issued policy and procedural advice which aims to promote safe injection techniques and lower injection frequency (Sudesh, et al. 2019). Concurrently, in order to address the many technological and legislative concerns and alter user and service provider behavior toward safer practices, a safe injection strategy need a broad and coordinated approach. However, according to a cross-sectional survey on injection safety done in 2004 by the Federal Ministry of Health in collaboration with John Snow Incorporated/Making Medical Injection Safer in Nigeria (JSI/MMIS) (FMH 2016), injection safety procedures in Nigeria are subpar compared to what is existing in other. Thus, the National Programme on Immunization (NPI) introduced the use of auto-disable syringes and other injection safety equipment in immunization as early as 2001, but a national injection safety forum held later in 2005 led to the creation of a national policy on injection safety and healthcare waste management in January 2007 (Medubi, et al. 2016). Bizarrely, despite the effort of the government in providing a working framework, at all levels of the health care delivery system in Nigeria, this policy is still being badly implemented challenges by low level of compliance by healthcare workers which prompted this investigation . 1.2 Statement of the problem In recent times,Nigeria healthcare sector has been flooded with hazardous injection practices which are widespread because of an over reliance on injections. A study by Olufunmilola, et al, (2020) found that most of the injections used to treat febrile illnesses that did not necessitate hospitalization accounted for more than 90% of the AFP cases recorded in Ekiti State. However, it has been reemphasized that injection-related injuries, such as injection neuritis, can be avoided by following universal precautions and other best practices. Injections given by unqualified or poorly trained people have also been noted as a potential source of dangerous practices. Evidence by Eyam et al, (2019) suggests that in many third-world nations, healthcare workers who lack knowledge on safe injection practices administer injections which put them at risk of Hospital acquired infections. In addition abound cases the attitude / preference for injections over oral treatments even for uncomplicated malaria on the part of Health workers, according to Musa (2020), this trend has been bolstered by patients' belief that injections are the quickest way to recover from disease. Unfortunately, variable leading to infected healthcare workers are pionered by reusing injection equipment to provide injections or get access to shared drugs which is risky injection practice as stated by Oguamanan & Kelvin (2018). Other instances include injuries sustained by the injector or the recipient before, during, or after the disposal of a used needle; hence when sharps waste is improperly collected and disposed of, it poses a danger of sharps injuries and subsequent blood-borne diseases to the healthcare practitioner, waste handler, and the community at large. Although injection safety measures have been much improved in industrialized nations, this is unfortunately not the case in poorer nations like Nigeria. Against the backdrop, the study focuses on Assessment Of Injection Safety Practices Among Health Workers In Private Hospital in Ilorin, Kwara State. 1.3 Objective of the study The broad objective of this study is focused on assessment Of injection safety practices among health workers in Private Hospital in Ilorin, Kwara State. In succinct terms, the study seeks to: i. Assess the Level of awareness and knowledge of healthcare workers on safe injection practices. ii. To determine whether the critical steps of injection are executed according to the recommended best practice. iii. Determine the level of compliance with injection safety practice. iv. To identify unsafe practice that may lead to infection for both nurses and patients i v. To pinpoint the applications of preventive measures following accidental exposure to needle stick injuries 1.4 Research Questions The research will be guided by the following question constructed in line with th research objectives: i. What is the level of awareness and knowledge of healthcare workers on safe injection practices in Private Hospital in Ilorin, Kwara State? ii. Are the critical steps of injection a executed according to the recommended best practice in Private Hospital in Ilorin, Kwara State? iii. What is the level of compliance with injection safety practices in Private Hospital in Ilorin, Kwara State? iv. What are the unsafe practice that may lead to infection for both nurses and patients in Private Hospital in Ilorin, Kwara State? v. What are the preventive measures applied following accidental exposure to needle stick injuries in Private Hospital in Ilorin, Kwara State? 1.5 Research Hypotheses Ho1: Level of awareness and knowledge of healthcare workers on safe injection practices in Private Hospital in Ilorin, Kwara State is low. Ho2: Critical steps of injection are not executed according to the recommended best practice in Private Hospital in Ilorin, Kwara State. Ho3: The level of compliance with injection safety practices in Private Hospital in Ilorin, Kwara State is low. 1.6 Significance of the study Popularity of injections and needless use of injections in many developing countries like Nigeria is becoming a major public Health problem. In Ebonyi State, the last PEER Review exercise revealed that over 90% of cases of AFP reported in the state in the year 2017 were due to injection neuritis and preliminary assessment and record review revealed that most of the injections were not administered by qualified health personnel. A study to assess compliance of Health care workers in the various PHC facilities to WHO guidelines on injection safety practices has become imperative in Afikpo Ebonyi State since similar studies has not been conducted in the State before now. Findings of the study will : improve awareness of both patients and nurses to decrease over use of injection and on achievement of safety, improve vaccination coverage with hepatitis B vaccine and make it obligatory for all health care workers.The findings of this study will be useful to policymakers, government officials, and security personnel because they will provide them with a wealth of information on how to enforce compliance to on safe injection practices in Private Hospital in Ilorin, Kwara State. Furthermore, students and scholars who are pursuing additional research in this subject may find the study incredibly valuable.Empirically, the study will add to the current body of knowledge and provide a foundation for future research in a related topic. 1.7 Scope of the study The scope of this borders on assessment of injection safety practices among health workers in Private Hospital in Ilorin, Kwara State. The study will further discuss the level of awareness and knowledge of healthcare workers on safe injection practices, determine whether the critical steps of injection are executed according to the recommended best practice, determine the level of compliance with injection safety practices, identify unsafe practice that may lead to infection for both nurses and patients and pinpoint the applications of preventive measures following accidental exposure to needle stick injuries. The study is delimited to healthcare providers in Private Hospital in Ilorin, Kwara State. 1.8 Limitation of the study The researchers faced a few minor obstacles while conducting the study, just as in every scientific endeavour. Lack of literature on the assessment Of Injection Safety Practices Among Health Workers In Private Hospital in Ilorin, Kwara State. was a key barrier. Hence, locating the pertinent resources, books, or information and the data gathering procedure took a lot of effort and organization. The study solely covers healthcare providers in Private Hospital in Ilorin, Kwara State and with limited sample size since the researcher lacks resources to cover the the whole Ebonyi State, thus the accuracy of the result will totally base on the data provided to the researcher by the responses of healthcare providers in Mater Misericordiae Hospital Afikpo. Hence, the results of this study cannot be generalized, leaving a space for further research. Time restrictions were also an issue because the researcher had to complete this research while still going to classes and performing other necessary educational tasks. However all aspects were minimized in order to deliver the best results possible and ensure the success of the research, despite the limitations that were faced during the study. 1.9 Definition of terms Safe Injection also called aseptic injection practice is a medical procedure that neither causes harm to the patient nor exposed the nurses to any avoidable risk and also not results in waste that is hazardous to the community (WHO, 2010). Unsafe Injection include number of harmful practices considered harmful to either patients, healthcare providers or the community around such as multiple use of single-use needles and syringes, recapping of needles and improper disposal of sharps