This innovative idea is important. Marc Koska has drawn attention to the re-use of syringes by health care workers, which is not always addressed when it comes to the spread of HIV. It's not necessarily an effective or fool-proof idea, especially when the syringes are used by intelligent individuals like nurses. In Uganda, we used these syringes sometimes. And we were promptly taught how to get around the built in safety mechanism. The nurses had a system to get around it, which wa
s typically used in a safe way. For example, if you had a child who had regular oral electrolyte supplements through an NG tube. The large syringes used for this were in short supply, and also happened to lock after you pushed it all the way through. The stomach is not sterile, though, so the syringe was re-used-only for that child. We re-used a syringe for drawing up Quinine for malaria treatment. The syringe was used throughout the day, but never actually in contact with a patient's IV. The medication was injected directly into a sterile bottle of D5 (we used D5 with Quinine to prevent hypoglycemia). One thing that never occurred was actually injecting different people-be it subcutaneous or intramuscular-with the same syringe. [This is one of the problems Marc Koska addresses.]Along with the new syringes, it is necessary to implement measures to increase awareness in the areas at risk for the re-use of syringes. Education among staff at clinics has the potential to make a tremendous impact. Programs that ensure proper disposal and clean up
of the used syringes could go a long way. Most importantly, consideration of the context in which the re-use of syringes in clinics is essential. To an outsider, it probably seems disgusting and irresponsible that nurses could possibly do this. What if you had to treat fifty patients with the supplies shown in the picture to the right? Clearly this is not a black and white matter. With anything in nursing, there has to be a multifaceted approach to any problem. Nurses do more than give a medication for a simple solution. You assess, intervene, analyze, evaluate, and teach.I'm not sure if this problem exists in Western hospitals and clinics....any experiences of problems with syringes in these settings would be appreciated. It could be more of a problem with wasting syringes in Western health care. I have had nurses open a syringe packet simply to demonstrate something then dispose of it without putting the (sterile) syringe to use. I'm not implying that nurses look to re-use syringes. I did not approve of-and felt uncomfortable with-some of the times the nurses in Uganda re-used syringes. [I simply did not participate in medication administration that I thought was unsafe.]
Nurses and health care workers need to be aware of their potential role in spreading HIV when re-using syringes. Nurses everywhere have to realize the importance of syringe use to the situation in which they are working. And as for Marc Koska-he does do more than just distribute syringes! Check out Marc's non-profit: Safepoint. He has even done projects in Uganda!
