Enjektörün Hatalı Kullanımı ve Güvenli Enjektörler

Emine Gürel; Sevim Ulupınar

Yıl 2013, Cilt: 17 Sayı: 1, 13 - 20, 01.06.2013

Öz

Injection is an invasive intervention and is one of the most commonly used medical procedures in the world. Non-adherence to an aseptic technique in injection application causes a serious risk in terms of blood-borne pathogens and bacterial nosocomial infections. It is known that unsafe injection practices are common in low-income countries. However safe injection practices have gained importance due to report of growing number of outbreaks resulting from unsafe injection practices also in developed countries recently. One of the major causes of unsafe injection is the reuse of syringes. Safety syringes are designed to prevent reuse. Today, safety syringes are used routinely in immunization applications in many countries. However, those are advised to be commonly used also in the therapeutical applications. In this review, the misuse of syringes, and the safety syringes and the necessity for using them are discussed in the light of the relevant literature

Anahtar Kelimeler

Syringe, safety syringe, injection safety, unsafe injection

Kaynakça

endoscopy clinic in Las Vegas- Nevada
–2008. Clin Infect Dis 2010;51(3):267-73. 10. Labus B, Armour P, Middaugh J, Rowley P
Sands L, Sizemore J, (Southern Nevada
Health District Outbreak Investigation Team).
Outbreak of Hepatitis C at Outpatient Surgical
Centers Public Health Investigation Report.
Las Vegas, Nevada. 2009 http://www.south
ernnevadahealthdistrict.org/download/out
breaks/final-hepc-investigation-report.pdf
Erişim: 07.07.2014 11. Hutin YJ. Injections given in healthcare set
tings as a major source of acute hepatitis B in
Moldova. Int J Epidemiol 1999;28(4):782-6. 12. Simonsen L, Kane A, Lloyd J, Zaffran M, Kane
M. Unsafe injections in the developing world
and transmission of bloodborne pathogens: a
review. Bull World Health Organ 1999
(10):789-800. 13. Pandit NB, Choudhary SK. Unsafe injection
practices in Gujarat, India. Singapore Med J.
49 (11): 936-9. 14. Perz JF, Thompson ND, Schaefer MK, Patel
PR. US Outbreak Investigations Highlight the
Need for Safe Injection Practices and Basic
Infection Control. Clin Liver Dis 2010;14(1): 137-51; x. 15. Pugliese G, Gosnell C, Bartley JM, Robinson
S. Injection practices among clinicians in
United States health care settings. Am J In
fect Control 2010;38(10):789-98. 16. Williams IT, Perz JF, Bell BP. Viral hepatitis
transmission in ambulatory health care set
tings. Clin Infect Dis 2004;38(11):1592-8. 17. Kane A, Lloyd J, Zaffran M, Simonsen L, Kane
M. Transmission of hepatitis B, hepatitis C and
human immunodeficiency viruses through un
safe injections in the developing world: model
based regional estimates. Bull World Health
Organ 1999;77(10):801-7. 18. DSÖ, Best Practices for injections and related
procedures toolkit. 2010. http://whqlibdoc.who.
int/publications/2010/9789241599252_eng.pdf
Erişim: 07.07.2014 19. Alter MJ. Healthcare should not be a vehicle for transmission of hepatitis C virus. J Hepatol
48(1):2-4. 20. Wilson WO. Infection control issue: Under
standing and addressing the prevalence of un
safe injection practices in healthcare. AANA J
76(4):251-3. 21. Schaefer MK, Shehab N, Perz JF. Calling it
multidose doesn’t make it so: Inappropriate
sharing and contamination of parenteral med
ication vials. Am J Infect Control 2010; 38(7):580-1. 22. Macedo de Oliveira A, White KL, Leschinsky
DP, Beecham BD, Vogt TM, Moolenaar RL, et
al. An outbreak of hepatitis C virus infections
among outpatients at a hematology/oncology
clinic. Ann Intern Med 2005;142(11):898-902. 23. Trépanier CA1, Lessard MR, Brochu JG, De
nault PH. Risk of cross infection related to the
multiple use of disposable syringes. Can J
Anaesth 1990;37(2):156-9. 24. CDC and the Safe Injection Practices Coali
tion (SIPC). The One & Only Campaign. http://
www.oneandonlycampaign.org/.
Erişim Tarihi:12.076.2014. 25. Perry AG. Potter PA. Klinik Uygulama Becer
ileri ve Yöntemleri. Aştı TA, Karadağ A, ed
itörler. Adana: Nobel Kitapevi Yayın Dağıtım
ve Pazarlama Ltd.Şti.; 2011. p.609, 693-707. 26. Taylor C, Lillis C, LeMone P, Lynn P. Skill
Checklists for Fundamentals of nursing: The
art and science of nursing care. 7thed.
Philadelphia, USD: Lippincott, Williams &
Wilkins; 2011 (Skill 29-4). 27. White L. Foundations of Basic Nursing. 2nded.
USA. Thomson Delmar Learning. p.420.
ISBN: 140182692X, 9781401826925. 28. Rice J. Medications & Mathematics for the
Nurse. 9thed. Albany, NY: Delmar Publishers; 2002. p.162. 29. Blogg CE, Ramsay MAE, Jarvis JD. Infection
Hazard From Syringes. Br J Anaesth 1974; 46(4):260-2. 30. Pervecal A. Consequence of syringe-plunger contamination. Med J Aust 1980;1(10):487-9. 31. Huey WY, Newton DW, Augustine SC, Ve- jraska, Mitrano FP. Microbial contamination potential of sterile disposable plastic syringes.
Am J Hosp Pharm 1985;42(1):102-5. 32. Olivier LC, Kendoff D, Wolfhard U, Nast-Kolb
D, Yazıcı MN, Eschey H. Modified syringe de
sign prevents plunger-related contamination
results of contamination and flow-rate tests. J
Hosp Infect 2003;53(2):140-3. 33. Favier B, Gilles L, Latour JF, Desage M, Gi
ammarile F. Contamination of syringe plun- gers during the sampling of cyclophosphamide solutions. J Oncol Pharm Pract 2005;11:(1)1- 5. 34. Kiffmeyer TK. Comparative Study of Syringe
Contamination by Hazardous Drugs. 2009
http://www.equashield.com/pdf/article.pdf
Erişim Tarihi: 20.01.2013 35. Gürel E. Sağlık profesyonellerinin aseptik
teknik açısından güvenli enjeksiyonlara yöne
lik uygulama ve gözlemlerinin belirlenmesi.
Marmara Üniversitesi Sağlık Bilimleri En
stitüsü Yüksek Lisans Tezi, İstanbul, 2013. 36. Hersh BS, Carr RM, Fitzner J, Goodman TS
Mayers GF, Everts H, et al. Ensuring Injection
Safety during Measles Immunization Cam
paigns: More than Auto‐Disable Syringes and
Safety Boxes. J Infect Dis 2003;87(1):299- 306. 37. Safety of Injections: WHO-UNICEF-UNFPA
Joint Statement on the Use of Auto-Disable
Syringes in Immunization Services. http://
www.who.int/injection_safety/toolbox/en/ Bundling.pdf
Erişim: 10.07.2014 38. Altaf A. Injection Safety in Pakistan: Auto Dis
able (AD) Syringes in the Curative Sector.
JPMA 2003;53(11):510.

Enjektörün Hatalı Kullanımı ve Güvenli Enjektörler

Yıl 2013, Cilt: 17 Sayı: 1, 13 - 20, 01.06.2013

Emine Gürel Sevim Ulupınar

Öz

Enjeksiyon bir invaziv girişimdir ve dünyada en sık kullanılan medikal işlemlerden biridir. Enjeksiyon uygulamalarında aseptik tekniğe bağlı kalınmaması, kan kaynaklı patojenler kadar bakterial nozokomiyal enfeksiyonlar açısından da ciddi risk oluşturmaktadır. Güvenli olmayan enjeksiyon uygulamalarının düşük-gelirli ülkelerde yaygın olduğu bilinmektedir. Bununla birlikte son zamanlarda gelişmiş ülkelerde de giderek artan sayıda salgınların rapor edilmesi nedeniyle güvenli enjeksiyon uygulamaları önem kazanmıştır. Güvenli olmayan enjeksiyonların en önemli nedenlerinden biri, enjektörlerin yeniden kullanımıdır. Güvenli enjektörler, yeniden kullanımı engellemek için tasarlanmıştır. Günümüzde pek çok ülkede güvenli enjektörler bağışıklama uygulamalarında rutin olarak kullanılmaktadır. Ancak tedavi edici uygulamalarda da kullanımının yaygınlaştırılması önerilmektedir. Bu derlemede enjektörün kullanım hataları, güvenli enjektörler ve kullanım gerekliliği ilgili literatür doğrultusunda tartışılmaktadır.

Anahtar Kelimeler

Enjektör, güvenli enjektör, enjeksiyon güvenliği, güvenli olmayan enjeksiyon

Kaynakça

endoscopy clinic in Las Vegas- Nevada
–2008. Clin Infect Dis 2010;51(3):267-73. 10. Labus B, Armour P, Middaugh J, Rowley P
Sands L, Sizemore J, (Southern Nevada
Health District Outbreak Investigation Team).
Outbreak of Hepatitis C at Outpatient Surgical
Centers Public Health Investigation Report.
Las Vegas, Nevada. 2009 http://www.south
ernnevadahealthdistrict.org/download/out
breaks/final-hepc-investigation-report.pdf
Erişim: 07.07.2014 11. Hutin YJ. Injections given in healthcare set
tings as a major source of acute hepatitis B in
Moldova. Int J Epidemiol 1999;28(4):782-6. 12. Simonsen L, Kane A, Lloyd J, Zaffran M, Kane
M. Unsafe injections in the developing world
and transmission of bloodborne pathogens: a
review. Bull World Health Organ 1999
(10):789-800. 13. Pandit NB, Choudhary SK. Unsafe injection
practices in Gujarat, India. Singapore Med J.
49 (11): 936-9. 14. Perz JF, Thompson ND, Schaefer MK, Patel
PR. US Outbreak Investigations Highlight the
Need for Safe Injection Practices and Basic
Infection Control. Clin Liver Dis 2010;14(1): 137-51; x. 15. Pugliese G, Gosnell C, Bartley JM, Robinson
S. Injection practices among clinicians in
United States health care settings. Am J In
fect Control 2010;38(10):789-98. 16. Williams IT, Perz JF, Bell BP. Viral hepatitis
transmission in ambulatory health care set
tings. Clin Infect Dis 2004;38(11):1592-8. 17. Kane A, Lloyd J, Zaffran M, Simonsen L, Kane
M. Transmission of hepatitis B, hepatitis C and
human immunodeficiency viruses through un
safe injections in the developing world: model
based regional estimates. Bull World Health
Organ 1999;77(10):801-7. 18. DSÖ, Best Practices for injections and related
procedures toolkit. 2010. http://whqlibdoc.who.
int/publications/2010/9789241599252_eng.pdf
Erişim: 07.07.2014 19. Alter MJ. Healthcare should not be a vehicle for transmission of hepatitis C virus. J Hepatol
48(1):2-4. 20. Wilson WO. Infection control issue: Under
standing and addressing the prevalence of un
safe injection practices in healthcare. AANA J
76(4):251-3. 21. Schaefer MK, Shehab N, Perz JF. Calling it
multidose doesn’t make it so: Inappropriate
sharing and contamination of parenteral med
ication vials. Am J Infect Control 2010; 38(7):580-1. 22. Macedo de Oliveira A, White KL, Leschinsky
DP, Beecham BD, Vogt TM, Moolenaar RL, et
al. An outbreak of hepatitis C virus infections
among outpatients at a hematology/oncology
clinic. Ann Intern Med 2005;142(11):898-902. 23. Trépanier CA1, Lessard MR, Brochu JG, De
nault PH. Risk of cross infection related to the
multiple use of disposable syringes. Can J
Anaesth 1990;37(2):156-9. 24. CDC and the Safe Injection Practices Coali
tion (SIPC). The One & Only Campaign. http://
www.oneandonlycampaign.org/.
Erişim Tarihi:12.076.2014. 25. Perry AG. Potter PA. Klinik Uygulama Becer
ileri ve Yöntemleri. Aştı TA, Karadağ A, ed
itörler. Adana: Nobel Kitapevi Yayın Dağıtım
ve Pazarlama Ltd.Şti.; 2011. p.609, 693-707. 26. Taylor C, Lillis C, LeMone P, Lynn P. Skill
Checklists for Fundamentals of nursing: The
art and science of nursing care. 7thed.
Philadelphia, USD: Lippincott, Williams &
Wilkins; 2011 (Skill 29-4). 27. White L. Foundations of Basic Nursing. 2nded.
USA. Thomson Delmar Learning. p.420.
ISBN: 140182692X, 9781401826925. 28. Rice J. Medications & Mathematics for the
Nurse. 9thed. Albany, NY: Delmar Publishers; 2002. p.162. 29. Blogg CE, Ramsay MAE, Jarvis JD. Infection
Hazard From Syringes. Br J Anaesth 1974; 46(4):260-2. 30. Pervecal A. Consequence of syringe-plunger contamination. Med J Aust 1980;1(10):487-9. 31. Huey WY, Newton DW, Augustine SC, Ve- jraska, Mitrano FP. Microbial contamination potential of sterile disposable plastic syringes.
Am J Hosp Pharm 1985;42(1):102-5. 32. Olivier LC, Kendoff D, Wolfhard U, Nast-Kolb
D, Yazıcı MN, Eschey H. Modified syringe de
sign prevents plunger-related contamination
results of contamination and flow-rate tests. J
Hosp Infect 2003;53(2):140-3. 33. Favier B, Gilles L, Latour JF, Desage M, Gi
ammarile F. Contamination of syringe plun- gers during the sampling of cyclophosphamide solutions. J Oncol Pharm Pract 2005;11:(1)1- 5. 34. Kiffmeyer TK. Comparative Study of Syringe
Contamination by Hazardous Drugs. 2009
http://www.equashield.com/pdf/article.pdf
Erişim Tarihi: 20.01.2013 35. Gürel E. Sağlık profesyonellerinin aseptik
teknik açısından güvenli enjeksiyonlara yöne
lik uygulama ve gözlemlerinin belirlenmesi.
Marmara Üniversitesi Sağlık Bilimleri En
stitüsü Yüksek Lisans Tezi, İstanbul, 2013. 36. Hersh BS, Carr RM, Fitzner J, Goodman TS
Mayers GF, Everts H, et al. Ensuring Injection
Safety during Measles Immunization Cam
paigns: More than Auto‐Disable Syringes and
Safety Boxes. J Infect Dis 2003;87(1):299- 306. 37. Safety of Injections: WHO-UNICEF-UNFPA
Joint Statement on the Use of Auto-Disable
Syringes in Immunization Services. http://
www.who.int/injection_safety/toolbox/en/ Bundling.pdf
Erişim: 10.07.2014 38. Altaf A. Injection Safety in Pakistan: Auto Dis
able (AD) Syringes in the Curative Sector.
JPMA 2003;53(11):510.

Toplam 85 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	Türkçe
Bölüm	Research Article
Yazarlar	Emine Gürel Bu kişi benim Sevim Ulupınar Bu kişi benim
Yayımlanma Tarihi	1 Haziran 2013
Yayımlandığı Sayı	Yıl 2013 Cilt: 17 Sayı: 1

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