Pal Debkumar, Patnaik Asmita, Mishra Abhisek, Singh Arvind Kumar, Parida Swayam Pragyan, Mourougan Mohanasundaram
Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
J Educ Health Promot. 2025 Apr 30;14:171. doi: 10.4103/jehp.jehp_947_24. eCollection 2025.
The strengthening of the health system ensured a significant increase in the number of different healthcare facilities in India. The number of injection procedures and the risk of potential needle stick injuries also increased. The Plan-Do-Check-Act (PDCA) approach is an accepted approach to improving healthcare facilities, which must be explored in the context of safe injection practices. This study aimed to assess the change in injection practices among healthcare workers using the PDCA approach in a rural community health center.
We conducted a pre- and poststudy using the PDCA approach in the community health center, Tangi, the rural health training center of All India Institute of Medical Sciences, Bhubaneswar. The PDCA cycle was planned and implemented to assess the changes in the injection practices of healthcare workers posted in the center. We collected the basic demographic information related to the study participants using a self-developed questionnaire. The practices related to safe injection were observed using the checklist developed based on recommendations given by the Ministry of Health and Family Welfare, Government of India, and the National Center for Disease Control, along with Kayakalp and Laqashya initiatives.
At the baseline, unsafe injection practice was found in most of the activities, varying from zero to as high as 93%. There was a statistically significant improvement in avoiding flushing syringes or needles before injections, that is, from 85.37% to 88.11% ( = 0.03), after receiving the training. However, there was no significant change in the habit of disposing of biomedical waste properly after use ( = 0.03).
This study at a secondary care rural hospital setting highlights factors like usage of proper cannula size, proper handwashing practices, proper waste disposal, and prevention of leaving the needles in the multidose vial that need to be improved when immunization practice is concerned.
卫生系统的加强使得印度不同医疗保健设施的数量显著增加。注射程序的数量以及潜在针刺伤的风险也随之增加。计划-执行-检查-行动（PDCA）方法是改善医疗保健设施的一种公认方法，必须在安全注射实践的背景下进行探索。本研究旨在评估在农村社区卫生中心采用PDCA方法的医护人员注射实践的变化。
我们在布巴内斯瓦尔全印度医学科学研究所的农村卫生培训中心坦吉的社区卫生中心采用PDCA方法进行了一项前后研究。规划并实施了PDCA循环，以评估该中心医护人员注射实践的变化。我们使用自行编制的问卷收集了与研究参与者相关的基本人口统计学信息。根据印度政府卫生与家庭福利部、国家疾病控制中心以及“清洁卫生行动”和“优质产科服务行动”的建议制定了检查表，观察与安全注射相关的实践。
在基线时，大多数活动中都存在不安全注射实践，比例从0到高达93%不等。接受培训后，在注射前避免冲洗注射器或针头方面有统计学上的显著改善，即从85.37%提高到88.11%（P = 0.03）。然而，使用后正确处理生物医疗废物的习惯没有显著变化（P = 0.03）。
这项在二级农村医疗保健机构开展的研究突出了在免疫实践方面需要改进的因素，如使用合适的套管尺寸、正确的洗手做法、正确的废物处理以及防止将针头留在多剂量瓶中。
