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Every year, all over the world, millions of men, women and children are needlessly infected as a result of unsafe injection practices. Unskilled personnel working in unhygienic settings too often unwittingly pass on infectious blood borne diseases through the re-use of insufficiently sterilized needles and/or syringes. In many cases, health care workers will merely rinse equipment in a pot of soapy water between injections or dispense with such measures altogether. According to the Safe Injection Global Network (SIGN), the proportion of injections administered with unsterilized equipment range from between 1.2% in industrialized nations to an alarming 75% in transitional or developing countries.

Injection Safety

WHO Guidelines on drawing blood: best practices in phlebotomy
Phlebotomy uses large, hollow needles to remove blood specimens for lab testing or blood donation. Each step in the process carries risks - both for patients and health workers. Patients may be bruised. Health workers may receive needle-stick injuries. Both can become infected with bloodborne organisms such as hepatitis B, HIV, syphilis or malaria. Moreover, each step affects the quality of the specimen and the diagnosis. A contaminated specimen will produce a misdiagnosis. Clerical errors can prove fatal.

The new WHO guidelines provide recommended steps for safe phlebotomy and reiterate accepted principles for drawing, collecting blood and transporting blood to laboratories/blood banks.
UNICEF Reports


WHO best practices for injections and related procedures toolkit
Medical treatment is intended to save life and improve health, and all health workers have a responsibility to prevent transmission of health-care associated infections. Adherence to safe injection practices and related infection control is part of that responsibility – it protects patients and health workers.

Unsafe injections can result in transmission of a wide variety of pathogens, including viruses, bacteria, fungi and parasites. They can also cause non-infectious adverse events such as abscesses and toxic reactions. Reuse of syringes or needles is common in many settings. It exposes patients to pathogens either directly (via contaminated equipment) or indirectly (via contaminated medication vials) }. The risks of unsafe injection practices have been well documented for the three primary bloodborne pathogens – human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV).

A safe injection is one that does not harm the recipient, does not expose the provider to any avoidable risks and does not result in waste that is dangerous for the community. Unsafe injection practices can lead to transmission of bloodborne pathogens, with their associated burden of disease.

The purpose of this toolkit is to promote implementation of safe practices associated with the following medical procedures:
  • intradermal, subcutaneous and intramuscular needle injections;
  • intravenous infusions and injections;
  • dental injections;
  • phlebotomy; and
  • lancet procedures.
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