الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Injections are one of the most common health care procedures. Every year at least 16 billion injections are administered globally. Unsafe injection practices are a work-related risk for nurses. Nurses’ awareness regarding injection safety practices are based on the policies adopted for nurses training.
The aim of the present study was to assess nurses’ knowledge and practices regarding injection safety during routine vaccination and to identify possible determinants that could affect knowledge and practices of nurses regarding injection safety during routine vaccination.
A descriptive cross-sectional study was conducted among all nurses (104) working in routine vaccination clinics in PHC settings in Damanhur city during the study period. A self-administered questionnaire was utilized to gather data about personal and socio-demographic characteristics and knowledge. Practices of the nurses regarding injection safety were assessed by a checklist.
The study revealed the following results:
• About three quarters (74.0%) of the nurses who showed a fair practice level, had a fair level of knowledge.
• About less than one quarter (22.9%) of the nurses who showd a fair practice level, had a good level of knowledge.
• There was no significant association between nurses’ total practice score and total knowledge score.
• About less than three quarters (73.1%) of the nurses had fair knowledge, less than one quarter (24.0%) of them had good knowledge while 2.9% had poor knowledge.
• Most (92.3%) of the nurses had fair practice and only 7.7 % of them had poor practice.
• There was no significant difference between knowledge score and age group.
• There was strongly statistically significant difference between nurses’ total level of knowledge and hepatits B vaccine.
• The qualification of all nurses who had fair practices score was technical nursing diploma of nursing (5 years).
• The majority of nurses (86.5%) were married.
• Near one third (30.8%) of nurses didn’t attend any training program.
• About two thirds (62.5%) of the nurses stated that the complete correct answer regarding the key components of SPs.
• The highest percentage (82.7%) of the nurses stated complete correct answers regarding the definition of injection safety.
• The highest percentage (83.7%) of the nurses stated the correct answer regarding steps of hand washing.
• Concerning practices of injection safety in routine vaccination, the highest percentage (71.2%) of the nurses stated the complete correct answer.
• More than three quarters (77.9%) of the nurses stated the incomplete correct answer regarding using of multi-dose vial.
• Highest percentages (91.3%) of the nurses stated incomplete correct answer regarding diseases that can transmit through unsafe injection.
• Regarding precautions followed in case of needle stick injury, most of the nurses (98.1%) gave incomplete correct answers.
• The majority (83.7%) of the nurses stated that disposal syringes immediately after use as one in safety box without bending.
• Concerning types of waste disposal, one third (33.7%) of the nurses stated the complete correct answer.
• More than one third (36.5%) of the nurses stated the necessity of getting rid of the waste bags when they reach 1/3 of their size (incorrect)
• Hands were washed in 19.2% of the observation.
• 5.0% of nurses removed their rings before washing hands.
• The injection site was not cleaned before injection in all (100%) of the observations.
• items of injection safety prepared on a clean tray in more than one quarter (28.8%) of the observations.
• A new closed syringe was used every time before injection in all (100%) of the observations.
• The vial kept between 2c-8c during the period of use in majority (89.4%) of the observations.
• Expire and validity of vaccination were checked in less than one half (46.2 %) of the observations.
• Nurses applied non touch techniques in 17.3% of the observations.
• Nurses’ hands were washed with soap and running water after injection, only in 1.0 % of the observations.
• Syringes or needles disposed of immediately after injection in most (98.1%) of the observations.
6.2. Conclusion
Injections are among the most common procedures in healthcare settings. Malpractices of injection safety are responsible for millions of patients with HBVs, HCVs and HIVevery year. from the results of the current study, it could be generally concluded the following:
Less than three quarters of the nurses had fair knowledge while less than one quarter of them had good knowledge. Most of the nurses had fair practice, while only 7.7 % of them had poor practice. There is no significant association between nurses’ total practice score and total knowledge score (p=0.539)
6.3. Recommendations:
In view of previous conclusions, the following recommendations are suggested:
1. Strengthening the implementation of policies and guidelines on injection safety and appropriate waste management among health professionals to be in compliance with international standards of safe injection delivery and secure disposal of used syringes at healthcare facilities.
2. Improve primary health care nurses’ awareness of injection safety, ongoing education, training programmes, refresher courses, and periodic workshops are provided. Which will reflect on their practices while working with patients for reducing the high rate of NSIs and the unsafe practices like reusing, recapping, bending, inappropriate collection and disposal syringe and needles.
3. Reporting of NSI is mandatory to higher officials of infection control committee; regular screening of nurses and laboratory technicians for infections transmitted through contaminated needles should be done on regular intervals.
4. Implementation of MOHP guideline of IC in all primary health care units
5. Continuous supervision and evaluation of injection safety practices of nurses.
6. Investigation of injection safety practices of nurses in other vaccination clinics to know the magnitude of the problem.
A. Further research:
Further research is highly needed to replication of the study on a large probability sample acquired from different geographical areas in Egypt to figure out the main aspects of this problem.