Effectiveness of Plan-Do-Check-Act approach in improving the safe injection practice among healthcare workers in a secondary-level healthcare facility - A pre- and post-study design.

Abstract

Background: 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.

Materials and methods: 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.

Results: 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% (P = 0.03), after receiving the training. However, there was no significant change in the habit of disposing of biomedical waste properly after use (P = 0.03).

Conclusion: 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.