Manual for Male Circumcision under Local Anaesthesia

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Male circumcision under local anaesthesia Version 3.1 (Dec09) SAFE HANDLING OF HYPODERMIC NEEDLES AND SYRINGES All clinic staff should be trained in the safe handling of sharp instruments. Single-use autodisable syringes with integrated needles are safer because they cannot be used again, but are expensive. Hypodermic (hollow-bore) needles are the most common cause of injuries to all types of clinic workers: • Health care workers are most often stuck by hypodermic needles during patient care. • Cleaning staff are most often stuck by needles when washing soiled instruments. • Housekeeping staff are most often stuck by needles when disposing of waste material. Tips for safe use of hypodermic needles and syringes • Disposable needles and syringes must be used only once. • Do not disassemble the needle and syringe after use. • Do not bend or break needles before disposal. • Dispose of the needle and syringe together in a puncture-resistant container. In general, it is safer to dispose of a needle and syringe directly into a sharps container without recapping. If a needle must be recapped, use the “one-handed” recapping method: • Place the needle cap on a firm, flat surface. • Holding the syringe with one hand, use the needle to “scoop up” the cap (see Fig. 8.3). • With the cap over the needle tip, turn the syringe upright (vertical), so that the needle is pointing towards the ceiling. • With the forefinger and thumb of your other hand, grasp the cap just above its open end and push it firmly down onto the hub (the place where the needle joins the syringe). Sharps containers Fig. 8.3 One-handed needle recapping method Clearly labelled, puncture- and tamper-proof sharps safety boxes or containers are a key component in efforts to keep injuries from disposable sharps to a minimum. • Place sharps containers as close to the point of use as possible and practical (ideally within arm’s reach), but away from busy areas. Avoid placing containers near light switches, overhead fans, Prevention of Infection Chapter 8-10
Male circumcision under local anaesthesia Version 3.1 (Dec09) or thermostat controls, where people might accidentally put their hand into them. • Attach containers to walls or other surfaces, if possible, at a convenient height, so that staff can use and replace them easily. • Mark the container clearly, so that people will not mistakenly use it as a rubbish bin. • Mark the fill line (at the three-quarters full level). Do not shake the container to settle its contents, to make room for more sharps. • Never attempt to empty the sharps container. Fig. 8.4 Puncture-proof containers for disposal of sharps PROCESSING OF INSTRUMENTS, ENVIRONMENTAL CLEANING AND MANAGEMENT OF SPILLS Soiled instruments and other reusable items can transmit infection if they are not properly reprocessed. Effective and safe reprocessing includes disinfecting instruments and equipment immediately after use, cleaning to remove all organic matter and chemicals, and highlevel disinfection or sterilization for instruments that will be used in normally sterile critical sites, i.e. within the body, in sterile tissue, cavities or the bloodstream. Before sterilization, all equipment must be disinfected and then cleaned to remove debris. Sterilization is intended to kill living organisms, but is not a method of cleaning. Disinfection Disinfectant solutions are used to inactivate any infectious agents that may be present in blood or other body fluids. They must always be available for cleaning working surfaces, equipment that cannot be autoclaved and non-disposable items, and for dealing with any spillages involving pathological specimens or other known or potentially infectious material. Used instruments should routinely be soaked in a chemical disinfectant for 30 minutes before cleaning. Disinfection decreases the viral and bacterial burden of an instrument, but does not clean debris from the instrument or sterilize it. The purpose of disinfection is to reduce the risk to those who have to handle the instruments during further cleaning. Disinfection is not a sterilizing process and must not be used as a substitute for sterilization. Prevention of Infection Chapter 8-11
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Manual for Male Circumcision under Local Anaesthesia

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