Assessment of safe injection practices in health facilities in Oman

Background: Unsafe injection practices put patients and providers at risk of infectious and noninfectious adverse events. A 2001 Ministry of Health survey on injection practices in Oman indicated that, while overall standards were good, in some areas there was a need for improvement.

Aim: We aimed to evaluate injection safety practices to determine whether facilities meet the requirements for practices, equipment, supplies and waste disposal, and to identify unsafe practices.

Methods: We conducted a national cross-sectional survey in 2007 using the World Health Organization tool to evaluate injection safety practices. Using 2-stage cluster sampling, 80 government and 61 private health facilities were randomly selected and evaluated.

Results: There was no shortage of injection equipment nor evidence of attempts to sterilize disposable devices. Care providers immediately disposed of the used needle/syringe in sharps containers. Phlebotomy devices were taken from sealed packets in 96% of facilities. In private facilities, 66.3% of the care providers were fully immunized against hepatitis B. Wearing a new pair of gloves for phlebotomy was observed in only 46% of government and 38% of private health facilities. Many health facilities lacked alcohol-based handrub.

Conclusions: Many injection safety aspects were satisfactory. However there are still opportunities for improvement. Actions are required to make alcohol-based handrub and appropriate sharps containers available and to provide hepatitis B vaccine and training to health care workers in all facilities

retrospective analysis of dialysis events over a 3-year period in an outpatient dialysis unit in the state of kuwait

Objective: To determine the difference in the rates of dialysis events stratified by vascular access type and to describe the microbiological profile and sensitivity patterns of positive blood cultures over a 3-year period

Subjects and Methods: The dialysis event data of 10,751 chronic hemodialysis patients collected from March 2013 to February 2016 at an outpatient dialysis unit in Kuwait were reviewed. The dialysis events studied were: intravenous [IV] antimicrobial use, a positive blood culture, and signs of inflammation at the vascular access site. Dialysis event rates were stratified by the type of vascular access used for the dialysis, i.e., fistula, graft, and tunneled/nontunneled central line.Rates were ex-pressed per 100 patient-months

Results: The overall dialysis event rate was [10.7/100 patient-months]. The rate of IV antimicrobial use was higher [12.53/100 patient-months] in patients with tunneled central lines than in all other vascular access types [10.29/100 patient-months]. Positive blood culture and inflammation at the vascular access site were highest in patients with nontunneled central lines [1.65 and 1.54/100 patient-months, respectively] when compared to those with other types of vascular access. Gram-negative rod isolates were predominant in patients with central lines [n = 35; 46.67%]; however, common skin commensals and gramnegative rods were also identified in patients with fistula or graft [n = 4; 44.45%]

Conclusion: Dialysis event rates were higher among patients with tunneled or nontunneled central lines than in patients with fistula or graft. Gram-negative rods were the most commonly isolated microbial group