Innovative solution to sharp waste management in a tertiary care hospital in Karachi, Pakistan.
BACKGROUND
Prevalence of hepatitis B and C in Pakistan is 2.5% and 4.5%, respectively. Major cause of these infections is reuse of syringes.


OBJECTIVE
To determine a cost-effective, innovative solution to prevent syringe reuse and break the transmission cycle of blood-borne infections. STUDY DESIGN, SETTINGS, AND DURATION: Analytical study in a tertiary care hospital, Jinnah Postgraduate Medical Centre, Karachi, Pakistan, July 2011 to June 2012.


METHODS
Healthcare workers from 30 wards included in the study were trained on injection safety, use of needle remover and needle pit, and management of needlestick injuries. Each ward was provided with 2 needle-removing devices, and a pit was constructed for disposal of needles. Usage of the device in wards and pit use were monitored regularly.


RESULTS
In 28 (93.3%) wards, sharp containers were accessible by public and were slack. Syringes were recapped using both hands in 27 (90%) cases; needlestick injury was reported by 30% of paramedics, while 25 (83.3%) of the interviewed staff had not received any formal training in injection safety. Vigilant monitoring and information sharing led to healthcare workers in 28 (96.5%) wards using the device. Needle containers were emptied in 27 (93.1%) wards, and needle pits were used in 26 (96.3%) wards. Needlestick injury was nil in follow-up.


CONCLUSIONS
Needle removers permanently disable syringes. The needle pit served as a cost-effective, innovative method for disposal of needles. The intervention resulted in reducing the risk of needlestick injury.
Health Foundation, Karachi, Pakistan.
Seher
S
Qaiser
Ambreen
A
Arif
Saeed
S
Quaid
Tasnim
T
Ahsan
Kashif
K
Riaz
Saad
S
Niaz
Huma
H
Qureshi
Waquaruddin
W
Ahmed
Syed Ejaz
SE
Alam
D017848:Blood-Borne Pathogens; D003906:Developing Countries; D019983:Guideline Adherence / Q000458:organization & administration*; D006779:Hospitals, Public; D006801:Humans; D007318:Inservice Training; D017744:Medical Waste Disposal / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D009339:Needles; D016602:Needlestick Injuries / Q000517:prevention & control*; D016273:Occupational Exposure / Q000517:prevention & control*; D010154:Pakistan; D010865:Pilot Projects; D017410:Practice Guidelines as Topic; D062606:Tertiary Care Centers
D017744:Medical Waste Disposal