Plan of Action

to improve injection Safety

Within the EPI

Overall objective

To ensure the safety of all EPI injections by 2006

Strategies - 1

• Use of AD syringes in all immunization services by the end of 2002.

• Ensure the safe collection, disposal and destruction of used injection equipment using safety boxes and appropriate high temperature incinerators.

• Investigate alternative methods for the safe disposal of used injection equipment.

• Expand training and improve the knowledge of health workers and managers on injection safety.

Strategies - 2

• Establish reliable estimates for equipment requirements, minimum stock levels and effective supply and distribution systems for injection and disposal equipment.

• Institute monitoring and supervision procedures to ensure adequate supplies at all levels and correct practices by health workers.

• Secure the required budget for injection safety including safe disposal and destruction of used equipment.

injection equipment

Autodisable syringe for all EPI injections

Disposable syringe for reconstitution of vaccines

requirements

• The basis for the calculation is based on the planned

number of injections with 10% wastage

• A buffer stock of 25% of the annual routine requirement

is needed to reduce the risk of stock-outs.

• Calculations for safety boxes are based on 100 syringes

per box

Requirements of Safe injection equipment for routine EPI

Item 2003 2004 2005 2006 BCG 2,235,782 1,822,163 1,849,495 1,877,237

AD sysinges 21,566,592 18,052,167 18,525,422 18,822,089

Reconst. Syringes

536,588 544,637 552,806 561,098

Safety boxes 270,162 226,651 232,298 235,991

Training

Training requirements include the following:• The correct use of AD syringes and safety boxes as per

national policy • The appropriate disposal and destruction of used

injection equipment• The accurate calculation of supply requirements and

monitoring of stock• The routine reporting of equipment supply levels to EPI

managers

Advocacy requirements

• A strategy for advocating issues related to injection safety and safe disposal and destruction of used injection equipment is to be developed targeting all levels.

• A specific plan of action for advocacy and communication should be developed by the end of 2003.

Monitoring and indicators

Supervisory visits will include an assessment of injection safety and disposal practices. In addition, surveys when necessary will validate the information from data collected during supervisory visits. Indicators will be based on the following targets:

• 100 % of Provinces with adequate access to appropriate disposal system

• 100 % of Districts with 100% AD use for all EPI vaccines and safe disposal practices

Budget estimates and funding Activity 2003 2004 2005 Incinerators 90,000 150,000 260,000 Training 361,000 381,500 379,500 Mornitoring 60,000 60,000 60,000 Computer network 5,000 50,000 5,000

Review meeting 27,000 27,000 27,000 Evaluation 30,000 45,000 IEC 10,000 20,000 30,000 Equipment 1,457,464 1,259,735 1,292,707 Total 2,010,464 1,978,235 2,099,207

Plan to improve injection safety

within the curative area

Pham Duc Muc

Dept.of Therapy-MOH-SRV

Back ground

- Hos.system consists of 970 hospitals,

approximately 120.000 beds,

- Public hospitals accounts for 98.5%.

- Injection Safety is a major concern

- MOH, NNA,EPI &WHO promote SIGN in VN

Initial achievements

- Pilot study conducted in Hanoi (2001)

- NNA launched a National SI campaign (2001)

- Technical transfer for producing AD products

- Involvement of all concern institutions

The overall objective is to:

Reduce risk to patients, HCWs and public

Strategy to reduce risk to patients

- Eliminate reuse of syringes

- Reduce unnecessary injections

Elimination of reuse

Strategy to reduce risk for HCWs & public

1. Handle of needles properly

2. Use appropriate technology for sharp

waste disposal (safety boxes, needle

removers, & Incinerators

Reduce risk to the HCWs & Public

Plan for the next

1. Production of AD syringes locally & Use of AD

products.

2. Implementation of a nation-wide assessment

3. Development of policies to monitor the practice of

Injection safety

4. Advocacy for SIGN through workshops &

publications

Thank you