Nurses and doctors go back to school for needle handling

A simple surgical procedure almost changed Nelly Bosire’s life for ever.

Ms Bosire, a 27-year-old doctor, pierced herself with an HIV/Aids contaminated needle while delivering a baby through Caesarean section.

At the time, the well-being of mother and child was her top priority. She cleaned the wound and resumed the operation.

After a successful operation she soon noticed the seriousness of the accident. She was likely to be infected with the HIV virus unless put under prevention medicine for three months.

Years later, Ms Bosire says, she is lucky not to have been infected.

Dr Boniface Musila, a 31-year-old Nairobi-based doctor, also accidentally pricked himself with an HIV/Aids stained needle while drawing blood from a patient.

After a series of tests he was put on infection prevention drugs — prophylaxis.

“His main fear was that the drugs might not work. He also looked very ill,” said Dr Alex Nyakundi, his friend.

In case of infection, Dr Musila worried about how to break the news to his wife.

He finally pulled through without being infected.

That health care workers are at risk of contracting diseases through needle pricks is a major concern in the sector.

Last week saw the launch of Kenya’s first School of Phlebotomy and Specimen Collection which will train health workers on needle use, among other disciplines.

Phlebotomy, also called venesection, is a practice of opening a vein by incision or puncturing to remove blood for examination and patient treatment.

The school, established through a partnership of the government with Becton Dickinson — a leading American medical technology company, the Centre for Disease Control, and Jhpiego — an affiliate of Johns Hopkins University, seeks to provide training in occupational safety and clinical and laboratory procedures.

The training aims at reducing needle related injuries.

“In the era of HIV/Aids, the opening of this centre of excellence is a milestone towards improvement of health worker safety and reduction of pre-analytical errors to ensure reliability of laboratory results,” said Dr Charles Onudi, the director of Kenya Medical Training Centre (KMTC).

Shortage of phlebotomists

Shortage of phlebotomists in the country has for years left the task of specimen collection in the hands of nurses and laboratory technologists despite their scanty knowledge and skills on the subject.

This has seen them burdened in addition to their normal duties. Laboratory technologists, for instance, handle blood drawing and specimen collection from patients, carry out tests, and interpret the results.

Having more specialised staff in the area will help reduce the workload of nurses and technologists and make blood drawing safer.

It is estimated that 2.5 per cent of new HIV/Aids cases reported in 2010 were a result of accidental needle injuries and exposure to contaminated blood.

According to Medical Services minister Anyang' Nyong’o, blood-filled needle injuries pose four times risks of blood borne disease transmission among health workers as non-blood-filled needles.

The partnership seeks to address this problem through the introduction of safer butterfly needles.

The needles use a syringe vacuum to draw blood and can collect more samples compared to the hypodermic needle.

Some private hospitals are already using the needles.

In-service training

The school, located at Kenya Medical Training College, Nairobi campus, is the first in East Africa.

The first beneficiaries of the facility are the current laboratory technology students at the institution.

It will also offer in-service training for healthcare providers with no formal training in the discipline.

Some mishaps experienced in the area of blood safety are attributed to misdiagnosis of patients’ illnesses due to faults at the blood drawing and specimen collection stage.

The errors account for 68 per cent of inaccuracies.

“Phlebotomy is the beginning of all tests and can cause wrong results if not done well,” said Mr Michael Wanga, the chief executive of the Kenya Medical Laboratory Technicians and Technologists Board.

Some of the inaccuracies recorded during the process include inadequate volume of specimen, specimen mix up, incorrect specimen collection, and incorrect collection time.

“We target to train 25 nurses, clinical medical personnel, and laboratory technologists every fortnight starting April,” said Mr Peter Kariuki, the head of medical laboratory services at KMTC.

The institution also plans to offer health workers refresher courses. One of the approaches being considered, Mr Kariuki said, is training individuals upon renewal of their practising licenses.

Becton Dickinson, one of the main funding partners, has injected $125,000 in the project.

The money will go towards renovation of the school and equipping it with modern technology, and curriculum development.

The amount is in addition to a $1 million pledge made in August 2009 by Becton Dickinson and the US President’s Emergency Plan for Aids Relief (PEPFAR) fund.