Assessment of the safety of injection practices and injection-related procedures in family health units and centers in Alexandria.

BACKGROUND: The Safe Injection Global Network (SIGN) developed an intervention strategy for reducing overuse of injections and promoting the administration of safe injections. Tool C--Revised is designed to assess the safety of the most common procedures that puncture the skin within health services. OBJECTIVE: The aim of the study was to assess injection safety within the primary healthcare facilities in Alexandria using Tool C--Revised. STUDY SETTING: A total of 45 family health units and centers in Alexandria were selected by proportional allocation from the eight regions of Alexandria. DATA COLLECTION: The Tool C--Revised of the WHO was used for observation of the entire facility, injection practices and injection-related procedures, and sterilization practices. Interview of different health providers and immediate supervisor of injections was carried out. RESULTS: Indicators that reflect risk included: deficiency of alcohol-based hand rub for cleansing hands (13.3%), compliance with hand wash before preparing a procedure (56.9% before injection practices, 61.3% before phlebotomy, and 67.6% before lancet puncture), and wearing a new pair of gloves before new procedures (48.6% before injection practices, 9.7% for phlebotomy, 11.8% for lancet puncture, and 80% for both intravenous injections and infusions). Enough disposable equipment in all facilities for at least 2 weeks dependent on the statement of the average numbers of procedures per week was shown. Only 38% of the providers had received training regarding injection safety in the last 2 years and 62.5% had completed their three doses of hepatitis B vaccine. Only 42.2% of staffs who handled healthcare waste had access to heavy gloves. CONCLUSION: Indicators related to injection and injection-related practices that reflect risk to patients include deficiency of alcohol-based hand rub tools, nonadherence to hand hygiene before preparing an injection, and inadequate adherence to using a clean barrier when opening a glass ampule and use of gloves. Indicators that may reflect risk to patients and providers include inadequate injection safety training and incomplete hepatitis B vaccination of healthcare providers. Indicators that may reflect risk to providers include nonadherence to safety precautions related to injection practices, such as inadequate access to heavy gloves by staff handling healthcare waste.

Opinion of community pharmacists on use of nonprescription medications in Alexandria, Egypt.

BACKGROUND: Many studies have reported the use of over-the counter (OTC) or nonprescription medications (medications that are available to consumers without a prescription) to be inappropriate and associated with risks to consumers. Among healthcare professionals, pharmacists have a key role in providing information and helping customers make a safe choice of nonprescription medicines. OBJECTIVE: This study aimed to measure the attitudes and beliefs of community pharmacists toward the use of nonprescription medications by Egyptian customers. SUBJECTS AND METHODS: A cross-sectional descriptive study was carried out among community pharmacies in Alexandria. A self-administered questionnaire was used to collect data from 335 pharmacists working in community pharmacies. RESULTS: The use of nonprescription medicine among patients/consumers was reported by 66.9% of pharmacists to have increased in the past 4 years and 94.1% of them considered such a use to be very serious or somewhat serious. Long-term or chronic use was cited by 76.7% of pharmacists as the most common reason for the widespread inappropriate use of nonprescription medications, and 82.4% of the pharmacists considered the most common contributing factor to be lack of knowledge of patients/customers about the active ingredients in a branded product. The most common medications enquired about by patients/consumers were those for cough, cold, or sore throat, as reported by 73.5% of pharmacists, whereas 79.4% of pharmacists reported that patients asked about how to use nonprescription drugs. Sixty percent of pharmacists reported that the main reason that patients/customers did not seek consultation for nonprescription medicines was that they believed that nonprescription medicines were safe, and 52.5% reported that patients believed that taking advice on how to use it was unnecessary. To learn about nonprescription medicine, 93.7% of pharmacists turned to drug product labeling. CONCLUSION AND RECOMMENDATIONS: Use of nonprescription drugs is a serious problem that has increased over the past few years. Long-term or chronic use of nonprescription medicine was the most common form of inappropriate use of nonprescription medications and lack of knowledge on the part of patients/customers about the active ingredient in a branded product was the most common factor contributing to its inappropriate use. Pharmacists should receive continuous professional education to increase their knowledge on and improve their practice of prescribing nonprescription medication; further, drug companies should be precise when disclosing information on OTC drug labels as the majority of pharmacists consult the drug label as a source of information about OTC.