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SIGNpost 00811

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST

Post00811 World Hepatitis Day + Abstracts + News Catch-up   22 July 2015

CONTENTS
1. World Hepatitis Day: Prevent hepatitis. Act now
2. Abstract:Predictive factors for percutaneous and mucocutaneous exposure
among healthcare workers in a developing country
3. Abstract: Medication errors in anesthesia
4. Abstract: Survey: technique of performing intravitreal injection among
members of the Brazilian Retina and Vitreous Society (SBRV)
5. Abstract: Sterile compounding: clinical, legal, and regulatory
implications for patient safety
6. Abstract: From addiction to infection: managing drug abuse in the
context of HIV/AIDS in Africa
7. Abstract: Injecting buprenorphine-naloxone film: Findings from an
explorative qualitative study
8. Abstract: Methadone maintenance therapy and HIV counseling and testing
are associated with lower frequency of risky behaviors among injection
drug users in China
9. Abstract: Intramuscular risk at insulin injection sites–measurement of
the distance from skin to muscle and rationale for shorter-length
needles for subcutaneous insulin therapy
10. Abstract: Psychosocial determinants of self-reported hand hygiene
behaviour: a survey comparing physicians and nurses in intensive care
units
11. Abstract: Usability of the Novel Liraglutide 3.0 mg Pen Injector Among
Overweight or Obese Adult Patients With or Without Prior Injection
Experience
12. Abstract: Acceptability and Feasibility of Delivering Pentavalent
Vaccines in a Compact, Prefilled, Autodisable Device in Vietnam and
Senegal
13. News
– WHO urges world community to prevent hepatitis by acting against unsafe
injections, unsafe blood
– N.H. USA: Officials: Discarded needles continue to create problems
Ambulance company volunteers to clean up
– Ebola: Another Ebola Nurse Dies. Is Corporate Greed to Blame?UK:
– UK: Needles in recycling waste force Tewkesbury Borough Council to send
21 tonnes of rubbish to landfill
– Nigeria: Fake Doctor Who Targets Hotels In Hepatitis Scam Nabbed
– Global: Merck Manuals Health Guides Go Digital, and Free, in Global
Push
– USA: RI Health Clinic Provider Lacks Effective Blood Hazard Safeguards;
Employee Sustains Preventable Needlestick Injury
– Ireland: Hotlines for dirty needle collections to be established
– South Africa: Needle stick injuries in Gauteng hospitals on the
increase: DA
– Canada Kelowna toddler ill after putting used needle in mouth
14. New WHO Injection Safety Guidelines

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________________________________*_________________________________

1. World Hepatitis Day: Prevent hepatitis. Act now

http://worldhepatitisday.org/

Good InfoGraphics at
http://worldhepatitisday.org/en/campaign-materials/infographics
__________________________________________________________________

http://www.who.int/campaigns/hepatitis-day/2015/event/en/

World Hepatitis Day: Prevent hepatitis. Act now

World Hepatitis Day – 28 July 2015

On World Hepatitis Day, 28 July 2015, WHO and partners will urge policy-
makers, health workers and the public to act now to prevent infection and
death from hepatitis.

Viral hepatitis – a group of infectious diseases known as hepatitis A, B,
C, D, and E – affects hundreds of millions of people worldwide, causing
acute and chronic liver disease and killing close to 1.5 million people
every year, mostly from hepatitis B and C. These infections can be
prevented, but most people don’t know how.

In May 2014, World Health Assembly delegates from 194 governments adopted
a resolution to promote global action to prevent, diagnose, and treat
viral hepatitis.

On World Hepatitis Day, events will take place around the world focussing
on preventing hepatitis B and hepatitis C.

The date of 28 July was chosen for World Hepatitis Day in honour of the
birthday of Nobel Laureate Professor Baruch Samuel Blumberg, discoverer of
the hepatitis B virus and developer of the first hepatitis B vaccine.

Key messages of the World Hepatitis Day 2015

Prevent hepatitis – know the risks
Unsafe blood, unsafe injections, and sharing drug-injection equipment can
all result in hepatitis infection.

Prevent hepatitis – demand safe injections
2 million people a year contract hepatitis from unsafe injections. Using
sterile, single-use syringes can prevent these infections

Prevent hepatitis – vaccinate children
Approximately 780 000 persons die each year from hepatitis B infection. A
safe and effective vaccine can protect from hepatitis B infection for
life.

Prevent hepatitis – get tested, seek treatment
Effective medicines exist to treat hepatitis B and cure hepatitis C.

Related links

Fact sheets on hepatitis A, B, C, E
http://www.who.int/topics/hepatitis/factsheets/en/index.html
__________________________________________________________________
________________________________*_________________________________

2. Abstract:Predictive factors for percutaneous and mucocutaneous exposure
among healthcare workers in a developing country
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26164279

J Epidemiol Glob Health. 2015 Jul 8. pii: S2210-6006(15)00065-9.

Predictive factors for percutaneous and mucocutaneous exposure among
healthcare workers in a developing country.

Türe Z1, Ulu Kiliç A2, Cevahir F3, Altun D3, Özhan E3, Alp E2.

1Department of Infectious Diseases and Clinical Microbiology, Faculty of
Medicine, University of Erciyes, Kayseri, Turkey. Electronic address:
dr.zeynepture@gmail.com.
2Department of Infectious Diseases and Clinical Microbiology and Infection
Control Committee, University of Erciyes, Kayseri, Turkey.
3Erciyes University Faculties of Medicine Hospitals, Infection Control
Committee, Kayseri, Turkey.

The aim of this study is to determine the risk factors for percutaneous
and mucocutaneous exposures in healthcare workers (HCW) in one of the
largest centers of a middle income country, Turkey.

This study has a retrospective design. HCWs who presented between August
2011 and June 2013, with Occupational Exposures (OEs) (cases) and those
without (controls) were included. Demographic information was collected
from infection control committee documents. A questionnaire was used to
ask the HCWs about their awareness of preventive measures.

HCWs who work with intensive work loads such as those found in emergency
departments or intensive care units have a higher risk of OEs. Having
heavy workloads and hours increases the risk of percutaneous and
mucocutaneous exposures. For that reason the most common occupation groups
are nurses and cleaning staff who are at risk of OEs.

Increasing work experience has reduced the frequency of OEs.

Copyright © 2015. Published by Elsevier Ltd.

KEYWORDS: Healthcare worker; Mucocutaneous exposure; Percutaneous
exposure; Risk factor
__________________________________________________________________
________________________________*_________________________________

3. Abstract: Medication errors in anesthesia
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26062316

J Med Pract Manage. 2015 Mar-Apr;30(6 Spec No):41-3.

Medication errors in anesthesia.

Prabhakar A, Malapero RJ, Gabriel RA, Kaye AD, Elhassan AO, Nelson ER,
Bates DW, Urman RD.

Medication errors represent one of the most common causes of morbidity and
mortality in hospitalized patients. Anesthesia has specific medication-
related risks; providers must administer many potent intravenous
medications quickly, often with minimal to no supervision.

Well-described reasons for medication administration errors in anesthesia
include medication ampoules with similar appearance and packaging,
clinician inattention, ineffective communication, fatigue, and haste.

Technologies that are used widely in other parts of the hospital, such as
barcoding, are a challenge to implement in anesthesia, and systemic
approaches, including color-coding of syringe labels and barcoding
technology of syringes, have been evaluated with mixed results.

Emphasis should be placed on implementing forcing functions when possible,
utilizing technology, standardization, and education about the need for
awareness in specific situations.

More studies need to be done to define the epidemiology of medication
errors in anesthesia, and more importantly, to assess interventions for
preventing them.
__________________________________________________________________
________________________________*_________________________________

4. Abstract: Survey: technique of performing intravitreal injection among
members of the Brazilian Retina and Vitreous Society (SBRV)
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25714535

Arq Bras Oftalmol. 2015 Jan-Feb;78(1):32-5.

Survey: technique of performing intravitreal injection among members of
the Brazilian Retina and Vitreous Society (SBRV).

Shiroma HF1, Farah ME1, Takahashi WY2, Gomes AM2, Goldbaum M2, Rodrigues
EB1.

1Department of Ophthalmology and Visual Science, Paulista School of
Medicine, Federal University of São Paulo, São Paulo, Brazil.
2Division of Ophthalmology, Medical School, University of São Paulo, São
Paulo, SP, Brazil.

Free full text https://tinyurl.com/oy6l9gk

PURPOSE: To evaluate and describe the precautions involved in the
technique of intravitreal injection of antiangiogenic drugs adopted by the
ophthalmologists who are members of the Brazilian Society of Retina and
Vitreous (SBRV).

METHODS: A questionnaire containing 22 questions related to precautions
taken before, during, and after intravitreal injection was sent
electronically to 920 members of SBRV between November 15, 2013 and April
31, 2014.

RESULTS: 352 responses (38%) were obtained. There was a predominance of
men (76%) from the southwest region of Brazil (51%). The professional
experience varied between 6 and 15 years after medical specialization
(50%). Most professionals (76%) performed an average of 1 to 10
intravitreal injections a week, and 88% of the procedures were performed
in the operating room using povidone iodine (99%), sterile gloves, and
blepharostat (94%). For inducing topical anesthesia, usage of anesthetic
eye drops was the most used technique (65%). Ranibizumab (Lucentis®) was
the most common drug (55%), and age-related macular degeneration (AMD) was
the most treated disease (57%). Regarding the complications treated, 6% of
the ophthalmologists had treated at least one case of retinal detachment,
20% had treated cases of endophthalmitis, 9% had treated cases of vitreous
hemorrhage, and 12% had encountered cases of crystalline lens touch.

CONCLUSION: Intravitreal injection is a procedure routinely performed by
retina specialists and has a low incidence of complications. Performing
the procedure in the operating room using an aseptic technique was
preferred by most of the respondents. Ranibizumab was the most used drug,
and AMD was the most treated disease.

Free full text https://tinyurl.com/oy6l9gk
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Sterile compounding: clinical, legal, and regulatory
implications for patient safety
__________________________________________________________________
Free full text http://www.amcp.org/JMCP/2014/December/18850/1033.html

J Manag Care Spec Pharm. 2014 Dec;20(12):1183-91.

Sterile compounding: clinical, legal, and regulatory implications for
patient safety.

Qureshi N1, Wesolowicz L, Stievater T, Lin AT.

1Blue Cross Blue Shield of Michigan, 600 E. Lafayette Blvd., Mail Code
512C, Detroit, MI 48226-2998. nqureshi@bcbsm.com.

BACKGROUND: Poor compounding practices by the New England Compounding
Center resulted in the 2012-2013 fungal infections outbreak. Contaminated
injectable methylprednisolone led to the diagnosis of fungal infections in
751 patients and 64 deaths. In the United States, pharmacy compounding has
traditionally been regulated by state boards of pharmacy rather than the
FDA. To minimize safety risks related to pharmacy compounding, the Drug
Quality and Security Act (DQSA) was signed into law November 27, 2013, to
improve regulation of compounding pharmacies.

OBJECTIVES: To (a) review the literature regarding clinical, legal, and
regulatory implications of pharmacy compounding for patient safety during
the 2012-2013 fungal infections outbreak and (b) discuss strategies that
managed care organizations (MCOs) can use to promote safe compounding
practices.

METHODS: A literature search was conducted via PubMed for original
articles on fungal infections related to drug compounding published
October 2012 to March 2014. Specific search terms included “drug
compounding and fungal infection” and “fungal meningitis outbreak.” The
FDA website was also utilized for material related to the Food, Drug, and
Cosmetic Act and the DQSA.

RESULTS: Four articles met inclusion criteria. The 2012-2013 fungal
infections outbreak was attributed to 3 lots of preservative-free
methylprednisolone acetate, which comprised 17,675 vials distributed to 76
facilities across 23 states. Median incubation period (from time of last
injection to initial diagnosis) was 47 days, ranging from 0 to 249 days.
According to the FDA, a total of 30 recalls regarding compounded products
were issued by pharmacies during March through December 2013.

CONCLUSIONS: Pharmacy compounding has the potential for significant safety
risks. The purpose of the DQSA is to improve regulation of compounding
pharmacies. Since registration as an outsourcing facility is voluntary,
uncertainty still remains regarding advancement in safe compounding
practices. MCOs can employ multiple strategies to ensure patient safety
and promote appropriate drug therapy.

Free full text http://www.amcp.org/JMCP/2014/December/18850/1033.html
__________________________________________________________________
________________________________*_________________________________

6. Abstract: From addiction to infection: managing drug abuse in the
context of HIV/AIDS in Africa
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26050376

Afr J Reprod Health. 2014 Sep;18(3 Spec No):47-54.

From addiction to infection: managing drug abuse in the context of
HIV/AIDS in Africa.

Akindipe T, Abiodun L, Adebajo S, Lawal R, Rataemane S.

People who use drugs are at higher risk of HIV: directly through the
sharing of injecting equipment, indirectly through associated risk
behavior, and physiologically through the substances’ impact on the immune
system.

Drug users, especially people who inject drugs (PWID) are a bridge to the
general population. The treatment of drug addiction and provision of harm
reduction interventions have impact on HIV transmission and incidence.

Addiction treatment reduces the frequency of drug-related risky behaviors
and enhances access and adherence to HIV treatment, resulting in fewer new
infections. However, the drug policies of many African countries are
punitive and hostile to harm reduction programs. These fuel
criminalization of drug use and discrimination against the drug user
thereby preventing individuals with drug addiction from accessing
treatment programs.

There is need to formulate policies aimed at protecting the rights of
people with drug addiction and address the ethical aspects of treatment.
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Injecting buprenorphine-naloxone film: Findings from an
explorative qualitative study
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26179339

Drug Alcohol Rev. 2015 Jul 14.

Injecting buprenorphine-naloxone film: Findings from an explorative
qualitative study.

White N1, Flaherty I2, Higgs P3,4, Larance B5, Nielsen S5, Degenhardt L5,
Ali R1, Lintzeris N6,7.

1Discipline of Pharmacology, School of Medical Sciences, University of
Adelaide, Adelaide, Australia.
2Department of Sociology and Social Policy, Sydney University, Sydney,
Australia.
3National Drug Research Institute, Faculty of Health Sciences, Curtin
University, Melbourne, Australia.
4Centre for Population Health, The Burnet Institute, Melbourne, Australia.
5National Drug and Alcohol Research Centre, University of New South Wales,
Sydney, Australia.
6The Langton Centre, South Eastern Sydney Local Health District Drug and
Alcohol Services, NSW Health, Sydney, Australia.
7The Central Clinical School, Sydney Medical School, University of Sydney,
Sydney, Australia.

INTRODUCTION AND AIMS: Experiences of buprenorphine-naloxone (BNX)
sublingual film injection are not well documented or understood. We
examined how people who inject BNX film seek and share information about
this practice, document the methods used to prepare BNX film for
injection, and report participants’ experiences of this practice.

DESIGN AND METHODS: Interviews were (n?=?16) conducted with people who
indicated that they had injected BNX film since its introduction onto the
Australian market. Semistructured interviews were recorded and
transcribed. NVivo10 program (QSR International) was used to analyse the
data using qualitative description methodology.

RESULTS: Participants largely reported similar BNX film preparation
techniques, although the texture of BNX film during preparation to inject
was reported to be unusual (gluggy), and there were many varied accounts
associated with the amount of water used. Physical harms reported as
associated with injecting BNX film were described (including local and
systemic issues); participants reported injecting the film to enhance its
immediate effects, yet generally reported that sublingual administration
provided longer-lasting effects.

DISCUSSION AND CONCLUSIONS: Understanding knowledge acquisition about
injecting new formulations of opioid substitution therapy is crucial in
developing more effective harm-reduction strategies. Dissemination by peer
networks to those who are currently or planning to inject BNX film
regarding the ‘gelatine like’ texture when mixing, using only cold water
and double filtering is important to ensure safer injecting practices.
Findings from this study highlight the importance of peer networks for the
dissemination of harm-reduction information. Introduction of new
formulations internationally requires more qualitative studies to inform
safer practices. [White N, Flaherty I, Higgs P, Larance B, Nielsen S,
Degenhardt L, Ali R, Lintzeris N. Injecting buprenorphine-naloxone film:
Findings from an explorative qualitative study. Drug Alcohol Rev 2015].

© 2015 Australasian Professional Society on Alcohol and other Drugs.

KEYWORDS: buprenorphine-naloxone; harm reduction; intravenous drug abuse;
patient non-adherence; qualitative research
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Methadone maintenance therapy and HIV counseling and testing
are associated with lower frequency of risky behaviors among injection
drug users in China
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/25295376

Subst Use Misuse. 2015 Jan;50(1):15-23.

Methadone maintenance therapy and HIV counseling and testing are
associated with lower frequency of risky behaviors among injection drug
users in China.

Wang M1, Mao W, Zhang L, Jiang B, Xiao Y, Jia Y, Wu P, Cassell H, Vermund
S.

1 Institute for Global Health, Vanderbilt University School of Medicine ,
Nashville, TN , USA.

Three consecutive cross-sectional surveys were conducted among injection
drug users (IDUs).

Of 2,530 participants, 47.7% reported ever sharing needles, 78.2% having
had unprotected sex in the last month, 34.4% not receiving either
methadone maintenance therapy (MMT) or HIV voluntary counseling and
testing (VCT), 4.8% ever receiving MMT-only, 36.6% ever receiving VCT-
only, and 24.2% ever receiving both MMT and VCT.

MMT-only and the combination of MMT and VCT had significant associations
with needle sharing and on unprotected sexual behaviors. Effectively
integrating VCT into MMT services is a logical way to maximize the impact
of both interventions on risky behaviors among IDUs.

KEYWORDS: HIV behavior; HIV prevention; HIV voluntary counseling and
testing; injection drug use; methadone maintenance treatment; needle
sharing; sexual risk behavior; substance use
__________________________________________________________________
________________________________*_________________________________

9. Abstract: Intramuscular risk at insulin injection sites–measurement of
the distance from skin to muscle and rationale for shorter-length
needles for subcutaneous insulin therapy
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/25329935

Diabetes Technol Ther. 2014 Dec;16(12):867-73.

Intramuscular risk at insulin injection sites–measurement of the distance
from skin to muscle and rationale for shorter-length needles for
subcutaneous insulin therapy.

Hirsch L1, Byron K, Gibney M.

1Diabetes Care , BD, Franklin Lakes, New Jersey.

BACKGROUND: Intramuscular (IM) injection can increase insulin absorption,
causing hypoglycemia. Available needle lengths today are 4-12.7?mm for
pens and 6-12.7?mm for syringes. We describe the distance (D) from skin
surface to muscle fascia at injection sites for subcutaneous (SC) insulin
therapy and recommend needle lengths to reduce IM injection risk.

MATERIALS AND METHODS: At two locations in the United States, skin and SC
fat thicknesses were measured by ultrasound at the abdomen, arm, thigh,
and buttock in diverse adults (body mass index [BMI] range, approximately
19-65?kg/m²) with diabetes (n=341 with one or more paired skin and SC
measurement, permitting calculation of D). The natural log of D by body
site, BMI, and gender were analyzed using a mixed model to estimate IM
risk.

RESULTS: D varied significantly by body site, BMI, and gender (each
P<0.001), increasing with higher BMI and in women. Median D ranged from
10.9?mm (95% confidence interval, 10.3, 11.6) at the thigh to 16.9?mm
(15.9, 18.1) at the buttock. Minimum D was <3?mm at the thigh and <5?mm
elsewhere. When inserted 90° without pinch-up, the most commonly used
needle worldwide (8?mm) has estimated IM risks of 25% and 9.7%,
respectively, in the thigh and abdomen, versus 1.6% and 0.1%,
respectively, with a 4?mm needle. A 45° insertion reduces, but does not
eliminate, IM risk with longer needles.

CONCLUSIONS: Gender, BMI, and body site affect D; when combined with
needle length and insertion angle, these factors permit detailed estimates
of IM insulin injection risk. Such risk varies across sites, appears
greatest at the thigh, is unnecessarily increased with 8?mm and 12.7?mm
needles, and is greatly reduced with shorter-length needles and good
injection technique.
__________________________________________________________________
________________________________*_________________________________

10. Abstract: Psychosocial determinants of self-reported hand hygiene
behaviour: a survey comparing physicians and nurses in intensive care
units
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26184662

J Hosp Infect. 2015 Jun 9. pii: S0195-6701(15)00211-X.

Psychosocial determinants of self-reported hand hygiene behaviour: a
survey comparing physicians and nurses in intensive care units.

von Lengerke T1, Lutze B2, Graf K3, Krauth C4, Lange K2, Schwadtke L3,
Stahmeyer J4, Chaberny IF3.

1Medical Psychology Unit, Hannover Medical School, Hannover, Lower Saxony,
Germany. Electronic address: lengerke.thomas@mh-hannover.de.
2Medical Psychology Unit, Hannover Medical School, Hannover, Lower Saxony,
Germany.
3Institute for Medical Microbiology and Hospital Epidemiology, Hannover
Medical School, Hannover, Lower Saxony, Germany.
4Institute for Epidemiology, Social Medicine and Health Systems Research,
Hannover Medical School, Hannover, Lower Saxony, Germany.

BACKGROUND: Research applying psychological behaviour change theories to
hand hygiene compliance is scarce, especially for physicians.

AIM: To identify psychosocial determinants of self-reported hand hygiene
behaviour (HHB) of physicians and nurses in intensive care units (ICUs).

METHODS: A cross-sectional survey using a self-administered questionnaire
that applied concepts from the Health Action Process Approach on hygienic
hand disinfection was conducted in 10 ICUs and two haematopoietic stem
cell transplantation units at Hannover Medical School, Germany. Self-
reported compliance was operationalized as always disinfecting one’s hands
when given tasks associated with risk of infection. Using seven-point
Likert scales, behavioural planning, maintenance self-efficacy and action
control were assessed as psychological factors, and personnel and material
resources, organizational problems and cooperation on the ward were
assessed as perceived environmental factors. Multiple logistic regression
analysis was employed.

FINDINGS: In total, 307 physicians and 348 nurses participated in this
study (response rates 70.9% and 63.4%, respectively). Self-reported
compliance did not differ between the groups (72.4% vs 69.4%, P = 0.405).
While nurses reported stronger planning, self-efficacy and action control,
physicians indicated better personnel resources and cooperation on the
ward (P < 0.02). Self-efficacy [odds ratio (OR) 1.4, P = 0.041], action
control (OR 1.8, P < 0.001) and cooperation on the ward (OR 1.5, P =
0.036) were positively associated with HHB among physicians, but only
action control was positively associated with HHB among nurses (OR 1.6, P
< 0.001).

CONCLUSION: The associations between action control (self-regulatory
strategies where behaviour is evaluated continuously and automatically
against guidelines) and compliance indicate that HHB is a habit in need of
self-monitoring. The fact that perceived cooperation on the ward was the
only environmental correlate of HHB among physicians stresses the
importance of team-directed interventions.

Copyright © 2015 The Healthcare Infection Society. Published by Elsevier
Ltd. All rights reserved.

KEYWORDS: Hand hygiene compliance; Intensive care personnel; Nosocomial
infection prevention; Self-regulation; Social work environment
__________________________________________________________________
________________________________*_________________________________

12. Abstract: Usability of the Novel Liraglutide 3.0 mg Pen Injector Among
Overweight or Obese Adult Patients With or Without Prior Injection
Experience
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/26183599

J Diabetes Sci Technol. 2015 Jul 16. pii: 1932296815593295.

Usability of the Novel Liraglutide 3.0 mg Pen Injector Among Overweight or
Obese Adult Patients With or Without Prior Injection Experience.

Fujioka K1, Sparre T2, Sun LY2, Krogsgaard S2, Kushner RF3.

1Scripps Clinic, San Diego, CA, USA fujioka.ken@scrippshealth.org.
2Novo Nordisk A/S, Søborg, Denmark.
3Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

BACKGROUND: Obesity is associated with multiple comorbidities and
increased mortality, making it an important target for treatment. However,
achieving and maintaining weight loss by diet and physical activity
remains challenging, and may often require pharmacotherapy. Liraglutide
3.0 mg has recently been approved for weight management in the United
States, Canada, and EU. The current analysis used a summative usability
test to assess safety and effectiveness, ease of use, and training
requirements for the novel liraglutide 3.0 mg pen injector.

METHODS: Of the 234 participants, half received instructions for use and
video- based training and/or opportunity to handle the device. All
participants (excluding pharmacists) performed 6 tasks followed by post-
task interviews on task difficulty, device ease of use, and any use
errors, close calls, and operational difficulties. Tasks included
differentiation of correct box and pen injector, medication clarity
assessment, normal, dose reversal, and end-of-content injection.
Number/type of use errors, close calls, and operational difficulties were
evaluated.

RESULTS: All assessed participants interpreted the instructions for use
correctly. No potentially serious use errors, and low numbers of
nonserious errors, were reported. Overall, participants committed 105 use
errors related to handling, with no potential for harm. A total of 25
close calls and 44 operational difficulties were reported without any
pattern indicative of a design flaw. Marked differences in the incidence
of events were observed for trained versus untrained participants
regardless of prior injection experience. Participants rated ease of use
as 6.4/7.

CONCLUSIONS: The liraglutide 3.0 mg pen injector is safe and easy to use
for liraglutide administration. New device features allow for safe use
after brief training.

© 2015 Diabetes Technology Society.

KEYWORDS: liraglutide; obesity; pen injector; pharmacotherapy; usability
testing
__________________________________________________________________
________________________________*_________________________________

13. Abstract: Acceptability and Feasibility of Delivering Pentavalent
Vaccines in a Compact, Prefilled, Autodisable Device in Vietnam and
Senegal
__________________________________________________________________
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0132292

PLoS One. 2015 Jul 17;10(7):e0132292.

Acceptability and Feasibility of Delivering Pentavalent Vaccines in a
Compact, Prefilled, Autodisable Device in Vietnam and Senegal.

Guillermet E1, Dicko HM1, Mai LT2, N’Diaye M3, Hane F4, Ba SO3, Gomis K3,
Tho NT2, Lien NT2, Than PD2, Dinh TV2, Jaillard P1, Gessner BD1, Colombini
A1.

1Agence de Médecine Préventive (AMP), Ferney-Voltaire, France.
2Ministry of Health, National Institute of Hygiene and Epidemiology, Hai
Ba Trung, Ha Noi, Viet Nam.
3Ministry of Health, Fann Résidence, Dakar, Senegal.
4University of Ziguinchor, Ziguinchor, Senegal.

BACKGROUND: Prefilled syringes are the standard in developed countries but
logistic and financial barriers prevent their widespread use in developing
countries. The current study evaluated use of a compact, prefilled,
autodisable device (CPAD) to deliver pentavalent vaccine by field actors
in Senegal and Vietnam.

METHODS: We conducted a logistic, programmatic, and anthropological study
that included a) interviews of immunization staff at different health
system levels and parents attending immunization sessions; b) observation
of immunization sessions including CPAD use on oranges; and c) document
review.

RESULTS: Respondents perceived that the CPAD would improve safety by being
non- reusable and preventing needle and vaccine exposure during
preparation. Preparation was considered simple and may reduce immunization
time for staff and caretakers. CPAD impact on cold storage requirements
depended on the current pentavalent vaccine being used; in both countries,
CPAD would reduce the weight and volume of materials and safety boxes
thereby potentially improving outreach strategies and waste disposal. CPAD
also would reduce stock outages by bundling vaccine and syringes and
reduce wastage by using a non-breakable plastic presentation. Respondents
also cited potential challenges including ability to distinguish between
CPAD and other pharmaceuticals delivered via a similar mechanism (such as
contraceptives), safety, and concerns related to design and ease of
administration (such as activation, ease of delivery, and needle diameter
and length).

CONCLUSIONS: Compared to current pentavalent vaccine presentations in
Vietnam and Senegal, CPAD technology will address some of the main
barriers to vaccination, such as supply chain issues and safety concerns
among health workers and families.

Most of the challenges we identified can be addressed with health worker
training, minor design modifications, and health messaging targeting
parents and communities.

Potentially the largest remaining barrier is the marginal increase in
pentavalent cost – if any – from CPAD use, which we did not assess in our
study.

Free full text
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0132292
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14. News

– WHO urges world community to prevent hepatitis by acting against unsafe
injections, unsafe blood
– N.H. USA: Officials: Discarded needles continue to create problems
Ambulance company volunteers to clean up
– Ebola: Another Ebola Nurse Dies. Is Corporate Greed to Blame?UK:
– UK: Needles in recycling waste force Tewkesbury Borough Council to send
21 tonnes of rubbish to landfill
– Nigeria: Fake Doctor Who Targets Hotels In Hepatitis Scam Nabbed
– Global: Merck Manuals Health Guides Go Digital, and Free, in Global
Push
– USA: RI Health Clinic Provider Lacks Effective Blood Hazard Safeguards;
Employee Sustains Preventable Needlestick Injury
– Ireland: Hotlines for dirty needle collections to be established
– South Africa: Needle stick injuries in Gauteng hospitals on the
increase: DA
– Canada Kelowna toddler ill after putting used needle in mouth

Selected news items reprinted under the fair use doctrine of international
copyright law: http://www4.law.cornell.edu/uscode/17/107.html
__________________________________________________________________
https://tinyurl.com/o4ln2da

WHO urges world community to prevent hepatitis by acting against unsafe
injections, unsafe blood

Dr. Lalit kishore, Merinews, India (21.07.15)

Ahead of World Hepatitis Day (WHD) to be observed on July 28, the World
Health Organisation (WHO) has urged its partners, health workers, common
public and policy makers in various countries to act now to prevent
infection and death from hepatitis.

In medical fraternity, WHD is celebrated to honour the birthday of Nobel
Laureate Professor Baruch Samuel Blumberg, the discoverer of the hepatitis
B virus and developer of the first hepatitis B vaccine.

In Focus According to WHO, Viral hepatitis A, B, C, D, and E affects
hundreds of millions of people worldwide, causing acute and chronic liver
disease and killing close to 1.5 million people every year, mostly from
hepatitis B and C which can be prevented by taking some precautions.

Key messages of the WHD this year is “Prevent hepatitis. Act now.” WHO has
cautioned the public against unsafe blood, unsafe injections, and sharing
drug-injection equipment which have become one of the major causes of
hepatitis infection.

According to WHO, about 2 million people contract hepatitis from unsafe
injections every year which can be prevented. Therefore, it is essential
to insist on using sterile single-use syringes that can prevent these
infections. Also, it is essential to get children vaccinated to prevent
hepatitis. Moreover, one needs to get tested periodically and seek
treatment since medicines exist to treat hepatitis B and cure hepatitis C,
informs WHO.

WHD is observed on July 28 every year to raise global awareness of
hepatitis and encourage prevention, diagnosis and treatment. It is
observed in over 100 countries each year through events such as free
screenings, poster campaigns, demonstrations, concerts, talk shows, flash
mobs and vaccination drives, amongst many others, informs WHO.

The other observances coordinated by the WHO are the World Health Day,
World Blood Donor Day, World Immunization Week, World Tuberculosis Day,
World No Tobacco Day, World Malaria Day and World AIDS Day.
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https://tinyurl.com/pefee87

N.H. USA: Officials: Discarded needles continue to create problems
Ambulance company volunteers to clean up

By Jean Mackin, WMUR Manchester, New Hampshire USA (20.07.15)

MANCHESTER, N.H. —The spike in heroin use is creating a new concern in New
Hampshire: protecting children from dangerous needles, frequently left in
the places where kids play. There’s a campaign underway to clean up parks
before children arrive each day.

Parks across Manchester are now swept for used syringes, spoons and other
dangerous items left behind by heroin users.

“I think that’s phenomenal, because I have another little one so I think
it’s really important,” said parent Shauna Pendleton. “So the kids can
enjoy the game as much as the kids playing.”

Don Pinard of the parks and recreation department said they’re finding
needles just about every day.

“We’re finding them from Little League fields and parks to rail trails,”
said Pinard.

The city’s ambulance service has volunteered to clean up parks before
children play there. They’re concerned about the diseases used needles can
carry. AMR paramedic supervisor Jason Tredo said they average one or two
needle pickups a day and sometimes more.

“You can contract communicable diseases, HIV, hepatitis, tetanus,” said
Tredo.

Parents said needles are something they hope their children don’t see or
touch.

“It is scary. You never know,” said mother Beth Garcia. “But if they are
grooming the field, it gives parents great peace of mind.”

Father Glenn Milner said the city is doing the right thing.

“They’re taking every precaution they can to make sure it’s safe for our
kids to play this beautiful game on a beautiful night,” said Milner.

You are asked to contact police, fire or the health department if you spot
a needle. They say to let a professional dispose of it safely.

Copyright 2015 by WMUR.com. All rights reserved
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https://tinyurl.com/n9cpxk8

Ebola: Another Ebola Nurse Dies. Is Corporate Greed to Blame?

By Rene Steinhauer, Outbreak New Today (18.07.15)

Posted by Guest Author

Another nurse has died of Ebola. Did you know the outbreak was still
active in Sierra Leone? The International Medical Corps (IMC) has
acknowledge the death of one of its nurses in the West African nation. It
is a tragedy, but this what I expected. I was in Liberia, West Africa as
an Ebola nurse at Ebola Treatment Unit run by AmeriCares and I had the
opportunity to train with the IMC nurses at their Bong County Ebola
Treatment Unit.

While working with AmeriCares and training with IMC in Liberia, I quickly
realized that safety was not a consideration by these and other
organizations. It is just not part of their DNA. Fundraising to pay six
figure salaries is most certainly part of their DNA, but keeping their
medical staff safe was not part of the corporate culture of these multi-
million dollar NGOs.

These organizations certainly met the basic minimum standards that they
were required to meet. They did not send staff into treatment units
without any safety gear. However, these organizations found it was more
cost effective to utilize the bare minimum standards rather than spend
more money to improve safety. For example, despite the fact that these
organizations received millions of dollars from USAID to staff and
purchase medical supplies for the Ebola Treatment Units, they routinely
used the cheapest supplies.

In a more detailed example, even though safety needles (IV needles or
medication syringes that automatically cover the contaminated needle) were
available to all organizations working with Ebola, I personally witnessed
that IMC and AmeriCares chose not to purchase these needles and instead
decided to save money and purchase needles that have no safety features at
all.

On my first day in the Ebola ward, I found myself starting an IV on an
Ebola patient, in a dark room and with limited viability from my goggles.
When I was finished, I realized there was no sharps container in the room.
So I had to take an Ebola contaminated needle and walk it out of the room
and down a hallway to the sharps container. In the decreased visibility, I
could have easily stuck myself or another healthcare worker with the
contaminated sharp. To date, only one person has ever survived an Ebola
needle stick injury.

This was just one example of many obvious dangers that the NGOs ignored,
not because they were unaware, but because they did not care. Simply put,
these organizations do not have a culture of safety. It is about time
change was made. It was about time they started valuing the safety of the
medical staff as much as they value their six figure salaries.

Rene Steinhauer is a MSN Grad student and author of Saving Jimani

Tags: Americares, Ebola, International Medical Corps

http://outbreaknewstoday.com/
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https://tinyurl.com/oqlda4v

UK: Needles in recycling waste force Tewkesbury Borough Council to send 21
tonnes of rubbish to landfill

By Gloucestershire Echo, U.K. (14.07.15)

Hypodermic needles have contaminated 21 tonnes of recycling in Tewkesbury,
forcing the borough council to send all of the rubbish to landfill.

All of the recycling waste collected from blue bins in the borough gets
hand sorted and needles have been found on a number of occasions since
January this year.

The needles pose a real threat to the health of workers when they sort
through the borough’s rubbish at a material recycling facility near
Bishop’s Cleeve.

As a result the borough council is taking dramatic action to keep them
safe.

The authority has identified the collection round that the needles and
needle boxes come from as the Perry Hill area.

The recycling from these rounds is now being processed in a different way
with all material now being visually inspected for needles.

Any material found to be contaminated with needles and needle boxes is
sent straight to landfill.

To date 21 tonnes of recycling waste has been lost in this way to
landfill.

The borough council is working hard with Grundon, Ubico, Turning Point,
Gloucestershire police and local housing associations to raise awareness
of residents’ responsibilities to dispose of their waste correctly.

This includes taking needles used for legal and illegal drug taking as
well as medical conditions in the appropriate containers to the various
needle exchanges available or to a local pharmacy.

Tewkesbury Borough Council’s deputy chief executive, Rachel North, is
urging people to keep recycling in the normal way while the problem is
resolved.

“Due to the ongoing investigations and sampling exercises taking place, it
is imperative that residents continue to put their recycling in the blue
bin,” she said.

“We really appreciate residents’ co-operation and understanding during
this extremely difficult time.”

Tewkesbury Borough Council has a statutory duty to recycle the materials
collected from residents’ blue bins.

All of the waste collected at the kerbside in the borough is taken to the
material recycling facility near Bishop’s Cleeve where it is hand sorted.

Over the last year more than 8,000 tonnes of recycling has been collected.

The Echo reported on the issue of syringes being found at the end of May
this year.
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https://tinyurl.com/o6bu66e

Nigeria: Fake Doctor Who Targets Hotels In Hepatitis Scam Nabbed

by Judd-Leonard Okafor, Daily Trust, Nigeria (13.07.15)

A man claiming to be a doctor has been arrested after years of duping
staff of establishments keen on personnel health.

Sunday Bartholomew was first detained by management of Excel Hotel in
Abuja, where he had duped staff into testing for sexually transmitted
infections and paying for hepatitis vaccine, before police took custody of
him on Monday evening.

Daily Trust learnt he approached the hotel under guise of a Centre for
Hepatitis and Disease Control, recommended hepatitis screening for staff,
and injected those who tested negative with vaccine at N1, 000 a shot.

Bartholomew told police investigators he injected a total of 35 workers in
days around his anti-hepatitis campaign programme, and offered
Lamivudine—a controlled antiretroviral drug—for sale.

He claimed his clients needed them for hepatitis.

Strip test

All women at the establishment tested positive in a “syphilis strip” test
he conducted, and he asked them to meet him at a location in Apo for three
doses of injections for which he charged N9, 000.

Bartholomew offered hair clippers for men at N4, 800, which he said would
help them prevent sexually transmitted infections.

The hotel got concerned when its staff began coming down with unexplained
reactions, Excel manager Joy Nyesom told investigators.

A female staff fainted twice on Monday, others complained of diarrhoea and
some men complained of severe waist pain.

Investigators from the Medical and Dental Council of Nigeria, which
regulates Nigerian doctors, uncovered on Bartholomew a first-aid box
filled with syringes and drug vials, a vaccine cooling box and several
records of previous clients.

No idea

Bartholomew said he injected the women with 2ml of the antibiotic
streptomycin to treat the sexually transmitted infections his “syphilis
strip” test showed, but during questioning by the council’s investigators
to test any medical training, he had no idea how many milligrammes a 2ml
shot contained.

Documents believed to be forged claim he did a six-month industrial
training at 44 Nigerian Army Reference Hospital, Kaduna in 2012 but the
document was simply signed “HOD Public Health” without a name.
It also emerged that he is a health school dropout.

Investigators also found past records of previous patients that suggest
Bartholomew has been on his scam since 2011.

He claimed he had done personnel health campaign for other big-name hotels
in Abuja, including Ajuji and Ibeto, providing testing, aid and vaccine to
people affected by hepatitis while claiming to be a representative of
“Centre for Hepatitis and Disease Control on awareness exercise.”

The introductory letter which he signed as a Dr EO Robinson gives an Abuja
address but without a house number, and two separate addresses in Jos and
Lagos.
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http://www.medscape.com/viewarticle/846607

Global: Merck Manuals Health Guides Go Digital, and Free, in Global Push

By Kylie Gumpert, Reuters Health Information via Medscape.com (17.06.15)

(Reuters) – Merck Manuals, the widely used health guides provided by
drugmaker Merck & Co, are moving to a digital-only format in 10 different
languages as part of an effort to educate the global community on medical
issues.

The new version of Merck Manuals debuted in the U.S. in April, offering
free online access to both professional and consumer audiences. The
professional manuals have been distributed in print since 1899 and most
recently carried a price tag of nearly $80.

New websites will launch in other English-speaking countries in July,
while sites translated into nine other languages are expected in the next
12 to 18 months. An English-language mobile app is set to launch by at
least early 2016, with translated apps to follow, the company said.

Outside of the U.S. and Canada, the sites and apps will be known as MSD
Manuals.

By offering both professional and consumer-oriented content free of
charge, users can find what they are looking for in as much detail as they
need, said Merck Manuals editor-in-chief Robert Porter. The information is
compiled by hundreds of medical experts across the world.

“We would like to show information as a universal right, not a commodity,”
Porter said in an interview.

Over 100 videos for performing medical procedures will be included in the
professional mobile app, “so if you’re up the Amazon and haven’t delivered
a baby in a while, we’ll have that available” for healthcare providers,
Porter said.

The switch to digital is also an effort to help readers quickly access
authoritative health content among the hundreds of results that can pop up
in an Internet search.

In a survey of over 2,000 people conducted for Merck Manuals by Harris
Poll, 28% of Americans say that overwhelming amounts of information online
is their biggest barrier to increasing medical knowledge, while 79%
believe that having access to the same information as their doctor would
improve how they understand their health.

The new U.S. websites have had about 4 million unique visitors since their
April launch, and Merck Manuals will continue to invest millions of
dollars each year to maintain the digital publication.
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https://tinyurl.com/oxwz7hv

USA: RI Health Clinic Provider Lacks Effective Blood Hazard Safeguards;
Employee Sustains Preventable Needlestick Injury

By WorkersCompensation.com USA (15.06.15)

Providence, RI (WorkersCompensation.com) – An East Greenwich company that
conducts wellness clinics throughout the U.S. inadequately protected its
employees against exposure from contaminated needlesticks and bloodborne
pathogen hazards*, an inspection by the U.S. Department of Labor’s
Occupational Safety and Health Administration has found.

OSHA began an inspection of Provant Health Solutions LLC in November 2014,
after an employee complained that a used needle punctured him as he
unpacked a box in the company’s mailroom. The company ships clean needles
and other medical supplies to clinics. After use, the contaminated needles
are shipped in unmarked boxes back to the company’s headquarters for
disposal by a private biohazard removal service.

OSHA inspectors determined that the packages in use did not effectively
protect employees from needlesticks as boxes were unpacked. They also
noted that needles could fall out of boxes into a shipping container,
which happened at least twice. Boxes lacked required warning labels, and
the company did not use an authorized carrier to return the contaminated
needles to Provant’s headquarters. The company also lacked an effective
program to minimize needlestick injuries. It also failed to train
employees about hazards, as required, and did not record injuries
properly.

“This company needlessly exposed its employees to preventable injuries and
illnesses that can result from being punctured by contaminated needles and
also lacked required safeguards,” said Patrick Griffin, OSHA’s area
director for Rhode Island. “Unless Provant Health Solutions updates,
changes and improves its handling of needles and other bloodborne pathogen
hazards, its employees will remain at risk.”

The inspection has led OSHA to cite Provant for nine serious and one
other-than-serious violation of OSHA standards. Proposed fines total
$62,000.

Provant Health Solutions has more than 13,000 employees. The company has
15 business days from receipt of its citations and proposed penalties to
comply, meet with OSHA’s area director, or contest the findings before the
independent Occupational Safety and Health Review Commission.
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https://tinyurl.com/njgbd2d

Ireland: Hotlines for dirty needle collections to be established

by Sean O’Riordan, Irish Examiner, Cork, Ireland (05.06.15)

Hotlines are being set up in Cork City to contact specially trained
personnel who will safely dispose of the increasing number of dirty
needles being discarded on the streets by heroin addicts.

The initiative is being coordinated by the HSE’s Drug & Alcohol Task
Force, which is also planning to distribute “drug litter information
leaflets” to schools, businesses, and community organisations.

It is estimated that there are up to 500 heroin addicts in Cork City and
county. More than 100 of them are not getting treatment and are not
involved in needle-exchange programmes.

These are the addicts who are regularly dropping used needles in the city
streets, it is believed.

David Lane, the area operations manager of the HSE Drug & Alcohol
Services, said a new outreach worker had recently been appointed to work
with street addicts and he was also disposing of discarded needles.

Mr Lane said his organisation was also exploring methods of encouraging
heroin addicts not to inject in public by bringing them into “medically
supervised centres”.

He said similar centres had been opened in other countries. He pointed to
one example in Sydney, Australia, which he said was proving very
successful as it cut down considerably on overdosing and the spread of
infections such as HIV and hepatitis B and C.

Special needle disposal boxes have been built into the walls of the public
toilets at Grand Parade, Cork City, which is a known haunt for heroin
users.

Mr Lane said it was proving successful because they were collecting
hundreds of needles from these boxes every month.

He said they were looking to expand this service to other public areas
used by heroin injectors and were also talking to some city centre
businesses whose toilets are frequented by addicts.

Mr Lane said distributing leaflets on drug litter was important to educate
the public about discarded needles.

While the chances of catching HIV or hepatitis from a dirty needle are
low, it could still happen, especially if the needle pierces the skin.

“If that happens the person should immediately seek medical assistance,”
Mr Lane said.

“But we don’t want people to pick them up, we want them to report their
location to any of the three hotlines. It’s important they make that phone
call,” he added.
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https://tinyurl.com/o9otzou

South Africa: Needle stick injuries in Gauteng hospitals on the increase:
DA

Times LIVE, RDM News Wire, South Africa (02.06.15)

Medical staff in Gauteng’s public hospitals are suffering a “worrying”
increase in the number of needle stick injuries‚ the Democratic Alliance’s
Jack Bloom said.

According to a written reply to Bloom’s questions in the Gauteng
Legislature‚ the province’s health MEC Qedani Mahlangu said there had been
2330 such injuries in the past three years – 685 in 2012‚ 807 in 2013 and
838 in 2014.

“The highest number of needle stick injuries last year occurred at the
Chris Hani Baragwanath Hospital‚ which recorded 252 injuries‚ followed by
Steve Biko Hospital (154 injuries)‚ Charlotte Maxeke Johannesburg (100)‚
Ann Latsky Nursing College (66) and Kalafong (48)‚” Bloom said.

Eight hospitals – Pretoria West‚ Weskoppies‚ Cullinan‚ Sizwe‚ Kopanong‚
Sebokeng‚ Tambo Memorial and Heidelberg – reported no injuries in 2014.

Bloom called for more use to be made of “safety needles and special
training to ensure that needle injuries are minimised as much as
possible”.

As there is a high risk of HIV/Aids exposure with needle stick injuries‚
said Bloom‚ a 28-day antiretroviral course‚ “which is often unpleasant and
debilitating”‚ is prescribed.

“I am concerned that no formal survey has been done to determine the
causes of the high number of needle injuries‚ but the department says
there are plans to do this‚” he said.
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https://tinyurl.com/o572888

Canada Kelowna toddler ill after putting used needle in mouth

By Angela Jung, South Okanagan reporter, Global News (Canada (31.05.15)

KELOWNA — Kelowna mother Emily Krebs says it all happened in a matter of
moments.

Krebs was playing in her apartment’s yard in the middle of May with her
young toddler, 17-month-old Xavier, when he found a used needle.

Krebs says she turned around for a split second to fetch a ball, but by
the time she turned around, Xavier put the needle in his mouth and ear.

“We feel violated, scared, sad and angry because so much could’ve been
prevented if there was word out there that there was needles,” says Krebs.

Her young son was rushed to the emergency room. Krebs is still waiting for
test results to see if Xavier has a viral infection.

Due to the toddler’s age, the family must wait six months before he can be
tested for HIV and hepatitis.

The day after the incident, Xavier began throwing up and appeared like he
was convulsing. Nine days after, he’s lost almost six pounds and appears
more tired than normal.

This weekend, Xavier threw up and Krebs believes it’s related to the
contaminated needle.

It happened at an apartment complex owned by Kelson Group. Vice-President
Jason Fawcett says needles have been found on the property in the past,
but only in the parking lot.

He says staff regularly sweep the area, and the company didn’t feel the
need to add notices.

“We believe that the needles that we did find have always been visible and
we took care of it right away,” says Fawcette. “We didn’t believe that
there was a risk to the residents and unfortunately, this young child
found one that we couldn’t see.”

Krebs believes staff need to do a more thorough job and is collecting
signatures of people in her building who feel the same way.

“I have nine signatures already saying they’ve seen garbage in the back
for consecutive days, which means [the garbage is] not being picked up.”

Krebs is warning other parents that this can happen to anyone and hopes
her story will encourage parents to check their yards and playgrounds.

If you find a needle

Interior Health suggests the safest thing to do to prevent yourself or
others from being injured is to pick it up with protective gloves and
using a pair of tongs, pliers, or tweezers while pointing the needle tip
down and away from you.

* You should never try to put a cap back on a needle. Place the needle in
a sturdy, puncture proof container, with a lid that is tightly closed.

* A sharps container is ideal but if you do not have one, a bleach
container, plastic peanut butter jar or similar puncture proof sealed
container will work.

* Avoid thin plastic containers and milk cartons because needles can poke
through these. Glass jars should be avoided because they can break.

* Wash your hands with soap and water.

Contact your local pharmacy or public health centre to find out about how
to dispose of the needles.

* If you are not comfortable picking up the needle, your community may
have a service that can do this. Contact your local public health centre
or municipal government office for more information.

Interior Health says the risk of HIV or hepatitis infection is low but you
should always go see a doctor after touching a contaminated needle.
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15. New WHO Injection Safety Guidelines

WHO is urging countries to transition, by 2020, to the exclusive use of
the new “smart” syringes, except in a few circumstances in which a syringe
that blocks after a single use would interfere with the procedure.

The new guideline is:

WHO Guideline on the use of Safety-Engineered Syringes for Intramuscular,
Intradermal and Subcutaneous Injections in Health Care

It is available for free download or viewing at this link:
www.who.int/injection_safety/global-campaign/injection-safety_guidline.pdf

PDF Requires Adobe Acrobat Reader [620 KB]
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________________________________*_________________________________
Making all injections safe brochure

This is an illustrated summary brochure for the general public.

pdf, 554kb [6 pages]

www.who.int/injection_safety/global-campaign/injection-safety_brochure.pdf

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SIGN Meeting 2015

The Safe Injection Global Network SIGN meeting was held on 23-24 February
2015 at WHO Headquarters in Geneva Switzerland

The main topic of the meeting was the new injection safety policy
recommendation and developing the appropriate strategies for
implementation in countries worldwide.

A report of the meeting will be posted ASAP
__________________________________________________________________
________________________________*_________________________________
* SAFETY OF INJECTIONS brief yourself at: www.injectionsafety.org

A fact sheet on injection safety is available at:
http://www.who.int/mediacentre/factsheets/fs231/en/index.html

* Visit the WHO injection safety website and the SIGN Alliance Secretariat
at: http://www.who.int/injection_safety/en/

* Download the WHO Best Practices for Injections and Related Procedures
Toolkit March 2010 [pdf 2.47Mb]:
http://whqlibdoc.who.int/publications/2010/9789241599252_eng.pdf

Use the Toolbox at: http://www.who.int/injection_safety/toolbox/en/

Get SIGN files on the web at: http://signpostonline.info/signfiles-2
get SIGNpost archives at: http://signpostonline.info/archives-by-year

Like on Facebook: http://facebook.com/SIGN.Moderator

The SIGN Secretariat, the Department of Health Systems Policies and
Workforce, WHO, Avenue Appia 20, CH-1211 Geneva 27, Switzerland.
Facsimile: +41 22 791 4836 E- mail: sign@who.int
__________________________________________________________________
________________________________*_________________________________
All members of the SIGN Forum are invited to submit messages, comment on
any posting, or to use the forum to request technical information in
relation to injection safety.

The comments made in this forum are the sole responsibility of the writers
and does not in any way mean that they are endorsed by any of the
organizations and agencies to which the authors may belong.

Use of trade names and commercial sources is for identification only and
does not imply endorsement.

The SIGN Forum welcomes new subscribers who are involved in injection
safety.

* Subscribe or un-subscribe by email to: sign.moderator@gmail.com, or to
sign@who.int

The SIGNpost Website is http://SIGNpostOnline.info

The SIGNpost website provides an archive of all SIGNposts, meeting
reports, field reports, documents, images such as photographs, posters,
signs and symbols, and video.

We would like your help in building this archive. Please send your old
reports, studies, articles, photographs, tools, and resources for posting.

Email mailto:sign.moderator@gmail.com
__________________________________________________________________
________________________________*_________________________________

The SIGN Internet Forum was established at the initiative of the World
Health Organization’s Department of Essential Health Technologies.

The SIGN Secretariat home is the Department of Health Systems Policies and
Workforce, Geneva Switzerland.

The SIGN Forum is moderated by Allan Bass and is hosted on the University
of Queensland computer network. http://www.uq.edu.au
__________________________________________________________________

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