Post00240 INJECTION SAFETY 07 April 2000 CONTENTS 1. FIELD EVALUATION OF VACCINATION MATÉ’IEL: REPORT 2. UNIVEC CONTACT INFORMATION 3. LAUNCH OF AUTODISABLE SYRINGE WEB SITE 1. FIELD EVALUATION OF VACCINATION MATÉ’IEL: REPORT Technologies have been developed as our responses to identified field needs and problems at the front line of service delivery. Usually these technologies are evaluated in fairly controlled field introductions. Infrequently evaluations are conducted in real health delivery situations , and it is even rarer that we get the feedback from these evaluations. Florence Fermon, MSF, kindly posts their recent evaluation of AD syringes and safety boxes in a meningitis mass immunization campaign in Sudan in 1999. "EVALUATION OF VACCINATION MATERIAL" by Florence FERMON. MSF, Vé²¯nique Perron. MSF Logistics, November 1999 The evaluation report files are available for download: send an email to: [email@example.com]firstname.lastname@example.org[/email] with this message: get technet EvaluationAD-SafetyBoxesSudan-MSFNov99French.pdf get technet EvaluationAD-SafetyBoxesSudan-MSFNov99english.pdf or on the web at: ftp://ftp.acithn.uq.edu.au/Technet/1-ClickHereForTECHNETfiles/Injection then click on the files: EvaluationAD-SafetyBoxesSudan-MSFNov99French.pdf EvaluationAD-SafetyBoxesSudan-MSFNov99english.pdf ___________________________________________________________________________ Date: Thu, 30 Mar 2000 13:14:03 +0100 From: [email=FFERMON@paris.msf.org]FFERMON@paris.msf.org[/email] (Florence FERMON) To: [email@example.com]firstname.lastname@example.org[/email] Subject: Evaluation of vaccination material Hi, I'm sure you will be interested in our evaluation of vaccination material (autodestruct syringes and safety container). This work was done by the MSF team in Sudan during the meningitis mass immunization campaign in 1999. I'm sure that some technet members will have interest. Very often we discuss the implementation of new material, but unfortunately, the evaluation of implementation and quality of material is not really follow. You've got two files, one in French and the other in English. Any comments are really welcome. By and best regards, Florence ---- Date: Fri, 31 Mar 2000 09:14:11 +1000 To: [email=FFERMON@paris.msf.org]FFERMON@paris.msf.org[/email] (Florence FERMON) From: Allan Bass Subject: Re: Evaluation of vaccination material Dear Florence, Thanks! Very interesting! I have 4 questions: 1. Burning the syringes/boxes: Were the needles fully trapped in the residues? 2. Workers protection against smoke and fumes? Distance? 3. Workers attitude or reluctance to incinerate the syringes? 4. What were the MSF specifications on the syringe packaging? regards and very best wishes, allan ___________________________________________________________________________ * Extracts from the English version ___________________________________________________________________________ EVALUATION OF VACCINATION MATERIAL Florence FERMON. MSF, Vé²¯nique Perron. MSF Logistics November 1999 The purpose of this report is to carry out a review of the vaccination material (in terms of quantity and quality) used during epidemic response in Sudan. Method and evaluation tools - Physical control of the material - Interview with the users - Quantitative data gathered during the vaccination campaigns - Evaluation grids of the containers and of the autodestruct syringes I) NEEDLES - SYRINGES 5L SAFETY BOX FOR INCINERATION MSF has selected the Polynor 5 litre safety box as its reference product in its medical catalogue. Due to the extent of the epidemic in Sudan, we had to use other manufacturers [products] in order to deliver the supplies required by the teams on time. The 3 types of containers that were used are: - Pa-Hu OY (UNICEF), Finland (yellow container) - POLYNOR - Danapak Cartons Ltd, UNIVEC. The three types are referenced in the PIS catalogue under "Fiches signalé´©ques d'articles",[E10] 1998 Edition. WHO/UNICEF (page 203-204). These containers were also included in the treatment kits that were distributed in the health structures responsible for curative treatments (oily chloramphenicol, syringes needles 19G and 21G and container). We noticed that the personnel was familiar with this material and used it on a regular basis. They receive it through the vaccination program ---- Table: Safety Boxes ---- General Remarks on the incineration safety boxes: - For the vaccination campaigns, the 5 litre boxes are too small; they need to be changed too often. 10, 15 or 20 litre containers should be tested. - The diameter of the orifice is too small for mass vaccination campaigns. - The triangular orifice that has a pre-cut dotted line for burning is not necessary - Several persons have been accidentally pricked due to manipulation errors when handling the boxes (container too full) and when opening them for burning. It would be interesting to have a closer watch over those accidents. ---- II) AUTODESTRUCT SYRINGES 0,5 ML MSF has selected the UNIVEC autodestruct syringes 0,5 ml as reference product in its medical catalogue. These syringes are referenced in the PIS catalogue under " Fiches signalé´©ques d'articles ", 1998 Edition WHO/UNICEF (page 172). The personnel was familiar with the autodestruct syringes and used them. They are distributed within the vaccination program. EVALUATION PRESENTATION: The syringes are delivered in 2 different presentations: - Package with units that guarantee the sterility of the material. This presentation was prepared according to a specific demand on behalf of MSF, - Self-protected syringes with tip protectors + needle. Each box contains 100 syringes. REMARKS : - Self-protected syringes There is no way to identify the manufacturer There is no information on how to sterilise them The term " sterile " is not mentioned; neither is the sentence "check the integrity and the sterility of the package before use " The protectors ensure a physical protection (plunger and needle) and preserve the sterility. Under no circumstances can they GUARANTEE sterility, since there is no device that indicates whether the package has been opened before or not. Some protectors have come apart and the users were pricked when taking the syringes from the plastic wrapping. - Single packaging: The information is printed on the package " Tuberculin 1 ml " or " WHO+ logo " There is no way to identify the manufacturer In both cases, the information about the product that is printed on the boxes containing 100 units is wrong or incomplete. LOSSES Altogether, 570,750 syringes were used to vaccinate 548,913 persons, which corresponds to a 4% loss. This loss is minimal. These losses are due to manipulation errors and quality problems of the product. The evaluation carried out did not enable us to quantify the different causes of loss. The users have underlined the fact that the reduced diameter of the syringe limits the volume occupied by the product, especially when refilling the containers. MANUFACTURING DEFECTS The following paragraph mentions defects that were noticed by the users of the product. Samples are available. The proportion of syringes presenting these defects was minimal and was not precisely quantified. REMARKS: - Needles: Length of needles sometimes different Bevels damaged Bevels Missing Needles coming apart from the syringe and remaining in the rubber of the flask or once in the person's arm Needles missing or fallen - Syringes: Joint of the rubber bulb of the plunger comes apart Joint of the rubber bulb of the plunger is not there The suction is sometimes difficult The angles of the finger flange are slightly sharp after being handled a lot Metal blocking ring is not there or is placed too low CONCLUSION: The presentation in single packaging is preferable, as it is the only one that guarantees sterility. The information printed on the package and the box must be exact and complete. The percentage of loss is minimal. Some defects must undergo a stricter verification when being manufactured. Other models of autodestruct syringes must be appraised. _________________________________*_________________________________________ 2. UNIVEC CONTACT INFORMATION Action, comments and additions please: [email@example.com]firstname.lastname@example.org[/email] or use your reply button ___________________________________________________________________________ From: "Alan H. Gold, M.D." To: "Technet Moderator" Subject: Re: Post00337 WASTE MANAGEMENT + INJECTION SAFETY Date: Thu, 30 Mar 2000 07:54:12 -0500 Dear Allan, As part of the most recent Technet communication, a list of BD contact numbers was included to facilitate communications from Technet field personnel. I would appreciate your including the UNIVEC contact information as well. There need only be a single point of communication for any of the Technet members to be able to obtain information or request auto-destruct syringe products from UNIVEC. It can be done through a single email address: [email@example.com]firstname.lastname@example.org[/email] or directly through a single telephone call to: (1) 516 -777- 2000 (USA) or even a single fax communication to: (1) 516- 777- 2786 (USA) Thank you, Alan Gold CEO UNIVEC _________________________________*_________________________________________ 3. LAUNCH OF AUTODISABLE SYRINGE WEB SITE Star Syringe is an autodisable syringe technology company. The K1 AD syringe is manufactured by independent syringe companies that license the K1 technology. The E8 injection device specifications are in the WHO/V&B document: EPI Standard Equipment Specifications and Test Procedures: E8: Injection devices (Ordering code: WHO/EPI/LHIS/97.11) http://www.who.int/vaccines-documents/DocsPDF/www9512/e08-9512.pdf Action, comments and additions please: [email@example.com]firstname.lastname@example.org[/email] or use your reply button ___________________________________________________________________________ Date: Wed, 05 Apr 2000 07:32:00 +1000 To: [email@example.com]firstname.lastname@example.org[/email] From: Marc Koska Subject: Launch of Autodisable Syringe Web Site K1 AUTODISABLE (AD) SYRINGES HAVE A WEB SITE! Please look up and then bookmark http://www.k1.adsyringes.com K1 AD syringes meet the WHO E8 specification for Immunisation. This web site has been set up to allow access to AD syringes, to anyone, from anywhere. Enquiries for K1 AD syringes will be serviced by the most appropriate manufacturing licensee of K1. Please forward this to anyone you feel will be looking for Autodisable syringes, now, or in the future. One Injection - One Syringe Marc Koska Tel: 44 1342 302502 Mobile: 44 410 305064 E Mail: [email@example.com]firstname.lastname@example.org[/email] Web Site: http://www.k1.adsyringes.com ____________________________________*______________________________________
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