Rizwana Riaz, Abida Sultana, Iffat Tehseen.
Malpractices in syringe disposal by paramedical staff.
Rawal Med J Jan ;34(2):176-9.

Objectives: To determine malpractices in syringe disposal by paramedics and to assess the awareness of this among patients. Methods This observational descriptive study was conducted in eight Teaching hospitals of Rawalpindi and Islamabad for a period of 3 months in 2006. The hospitals included were Holy Family Hospital (HFH), Rawalpindi General Hospital (RGH), District Head Quarters Hospital (DHQ), Cantonment General Hospital (CGH) Institute of Medical Sciences (PIMS), NASCOM hospital, Shifa International Hospital and Valley hospital. A total of 320 patients coming to emergency units of above hospitals were included in the study by quota convenient sampling (40 patients per hospital). Twenty paramedics of study hospitals were interviewed for assessment of awareness among them about syringe disposal practices using structured questionnaire. Results: Sterile syringes used for 92.5% cases in DHQ hospital while in 7.5% cases syringes were reused and all the syringes were discarded without cutting the needles. In RGH, seal of the syringes was opened in 95% cases while in 5% they were reusing the syringes and 50% were disposed off without cutting their needles. In HFH, syringes were used in the same manner as in RGH and 50% disposed off by cutting the needles. In PIMS, sterile syringes were used in 97.5% cases while 60% were thrown off by cutting the needles. In CGH, Shifa International Hospital and Valley Hospital, sterile syringes were used for 100% cases and 100% disposed off by cutting the needles. In NASCOM hospital, although 100% sterile syringes were used but none of them was disposed off without cutting the needles. Fifty percent paramedics were trained while 30% and 20% were under trained and untrained, respectively. 70% claimed to be supervised for syringe disposal and among these, 60% were supervised by staff nurse while 20% by medical superintendent of the hospital. 55% paramedics were fully aware while 20% were totally unaware of standardized syringe disposal practices. On the other hand, only 20% patients were well aware while 45% were not aware of syringe disposal practices. Conclusion: Although most of the paramedics were well aware of the hazards associated with improper syringe disposal and their reuse, still improper disposal was practiced at many public hospitals. There was little awareness of proper syringe disposal among patients.

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