Safe Injections: One and Only Campaign

Oregon is a Partner State in the CDC's One & Only Campaign

The One & Only Campaign is a public health campaign, led by the Centers for Disease Control and Prevention (CDC) and the Safe Injection Practices Coalition (SIPC), to raise awareness among patients and healthcare providers about safe injection practices. The campaign aims to eradicate outbreaks resulting from unsafe injection practices.

Raising awareness among healthcare providers and patients is critical to eliminating preventable infections caused by unsafe injections.

Injection and Needle Safety Toolkit

Although injections and needle use in professional settings are generally safe, unsafe practices do happen and may cause serious harm.

Unsafe practices, like reusing vials or syringes, have the potential to spread disease by cross-contaminating body fluids. Since 2001, more than 150,000 people in the U.S. have been notified of potential exposure to viral hepatitis and HIV due to lapses in injection and needle safety.

Do your part. Three ways to help stop these infections:

1. Join the Oregon One and Only Campaign mailing list. Email Roza.P.Tammer@dhsoha.state.or.us for more information.
   
2. Learn about best practices by using this toolkit.
   
3. Share what you learn from the toolkit with those in your workplace.
4. Read our latest injection safety newsletter.

Disclaimer: The resources below contain overlapping information on best practices, but are by no means comprehensive, as new resources continually emerge. In addition, the links provided do not serve as an endorsement of the organizations.

Toolkit Contents

For the Public

• What to know about receiving healthcare involving needles
• At-home injections and needle use

For Health Professionals

• Guidelines and Recommendations
• Aseptic Technique
• Needle Safety
• Medication and Treatment Management
• Diabetes Care
• Reports of Disease Transmission
• Specialty Specific Resources
• Additional Resources
• References

Feedback

• We want to hear from you! Let us know what you think about this toolkit by completing this quick survey.

For the Public

What to know about receiving healthcare involving needles.

• One & Only Campaign What Patients Need to Know About Safe Medical Injections
  Brochure: Overview of the importance of safe injections and an overview of injection safety.
• One & Only Campaign Patient Information
  Informational webpage: Frequently asked questions and information on syringe reuse.

Needle Safety

Syringe Exchange Program

• North American Syringe Exchange Network (NASEN): Oregon Syringe Exchange Programs
  Search Tool: Alphabetically sorted syringe exchange programs across the state of Oregon.

Resources for Self-Injections

• American Association of Diabetes Educators Teaching Injection Technique to People with Diabetes
  Guidelines: Guidelines for those educating self-injecting patients, including medication preparation and storage, vial and syringe use and personal disposal.

Needle Disposal

• Safeneedledisposal.org
  Factsheet: Oregon-specific recommendations for sharps disposal and a list of disposal locations throughout the state.
• FDA: Safely Using Sharps (needles and syringes) at Home, at Work and on Travel
  Toolkit: Safe use and potential disposal locations for contaminated sharps used outside of the healthcare setting.
• CDC: Safe Community Needle Disposal
  Toolkit: Links to locating disposal sites near you.

For Health Professionals

Guidelines and Recommendations

• CDC's One & Only Campaign
  Toolkit: A collection of injection and needle safety resources that includes free print materials, multimedia materials and additional resources.
• WHO Injection Safety Campaign
  Toolkit: A collection of best practice resources that provides guidelines, educational and evaluation tools and print materials.
• Safe Injection Practices
  Online Training Module: Interactive 20 minute online training that describes the impact of unsafe needle and injection practices, CDC recommendations for best practices and how health professionals can champion needle and injection safety in their facilities. Developed by the OHA HAI program. Note: After clicking the link above, you will be prompted to create an iLearn account and will gain access to additional training resources. Please use Internet Explorer or Microsoft Edge for best results. 
• Safe Injection Practices Overview (pdf)
  PowerPoint: HAI Program presentation that describes the impact of unsafe needle and injection practices, CDC recommendations for best practices, and how health professionals can champion needle and injection safety in their facilities.
• CDC and CMS: Nursing Home Infections Preventionist Training, Module 8 - Injection Safety (relevant to a broad audience)
  Online Training Module: Provides an overview of injection safety, along with a review of recommended practices and consequences of failure to follow safe injection practices. This module is organized into five lesson and will take approximately 55 minutes to complete. 
• CDC Grand Rounds: Preventing Unsafe Injection Practices in the U.S. Health-Care System
  MMWR: CDC overview of the impact of unsafe injection practices, state and federal government response, public health's role, and an illustrative case study.
• CDC Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings (2007)
  Guidelines: The CDC summary of recommendations for infection control in healthcare settings, guidelines that, as of 1/1/18, are required for licensed health professionals in Oregon (see above).

Rules and Regulatory Guidance

• Oregon Administrative Rule (OAR) 333-019-0061: Infection Prevention in Health Care Settings
  Requirements: Effective 1/1/18, all licensed health professionals are required to follow standard precautions defined in the CDC: Guideline for Isolation Precautions (2007). 
• CMS: Safe Injection Practices in Ambulatory Surgical Centers (ASCs) (pdf)
  Requirements: The Center for Medicare & Medicaid Services identifies the requirement that every ambulatory surgical center adhere to best practices for injection and needle use and establish a program to identify and prevent infections. Best practices are defined by CDC guidelines linked in the document.
• CMS: Infection Control Breaches Which Warrant Referral to Public Health Authorities (pdf)
  Requirements: The Center for Medicare & Medicaid Services describes facility-specific infection control requirements and who to report a breach to.
• Joint Commission: Requirements Relevant to the Use of Vials (pdf)
  Requirements: Infection prevention requirements specific to facility type.

Tools for Facility Assessment

• One and Only Campaign: Insulin Pen Safety 60 Second Check (pdf)
  Checklist: Colorado, a partner state of the One and Only Campaign, provides a 60-second checklist for assessing insulin pen safety practices.
• One & Only Campaign Finger-stick Lancing Device Safety 60 Second Check (pdf)
  Checklist: Colorado, a partner state of the One and Only Campaign, provides a 60-second checklist for assessing finger-stick lancing device safety practices.
• One & Only Campaign Blood Glucose Meter Safety 60 Second Check (pdf)
  Checklist: Colorado, a partner state of the One and Only Campaign, provides a 60-second checklist for assessing blood glucose meter safety practices.
• One & Only Campaign Injection Safety Checklist (pdf)
  Checklist: CDC-recommended minimum standards for care involving injections checklist for inpatient and outpatient settings.
• CDC's Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care - Fillable Checklist
  This guide has been created to help you evaluate Infection Prevention at your facility. This interactive PDF document is best viewed with Adobe Acrobat Reader.
• APIC Preventing Infection in Ambulatory Care - Winter 2011/2012 (part I p. 4-8)
  APIC Preventing Infection in Ambulatory Care - Spring 2012 (part II p. 9-14)
  APIC Preventing Infection in Ambulatory Care - Summer 2012 (part III p. 10-15)
  Checklists: Infection Prevention and Control Clinic Survey Tool (parts I, II and III) assesses compliance with needle and injection safety standards in ambulatory care settings.
  
• Centers for Medicare and Medicaid Services: Ambulatory Surgical Center (ASC) Infection Control Surveyor Worksheet (pdf)
  Checklist: Survey to assess infection control compliance for the Code of Federal Regulations sect;416.51 Conditions for Coverage - Infection Control for ambulatory surgical centers.
• Centers for Medicare and Medicaid Services: Hospital Infection Control Worksheet (pdf)
  Checklist: Survey to assess infection control compliance in the hospital setting.
• The Minnesota Hospital Association Road Map to Controlled Substance Diversion Prevention 2.0 (pdf)
  Checklist: An assessment tool for evaluating drug diversion prevention measures in place at a healthcare facility.

Aseptic Technique

Skin Preparation

• CDC: Safe Practices for Medical Injections (FAQs)
  FAQs: A question and answer forum for medication preparation, medication administration, single-dose/single-use vials, multi-dose vials, and general information including aseptic technique practices.
• WHO: Best Practices for Injections and Related Procedures Toolkit (pdf)
  Toolkit Section: General guidelines for aseptic preparation and administration of injections, hand hygiene, vial management, and guideline tables.

Rubber Septum

• CDC Safe Practices for Medical Injections (FAQs): Medication Preparation
  FAQs: A brief question and answer forum for safe injection preparation.

Accessing Central Lines

• CDC Central Line-associated Bloodstream Infections: Resources for Patients and Healthcare Providers
  Informational Webpage: CDC addresses the definition of a central line-associated bloodstream infection and basic guidelines for aseptic technique surrounding central line management.
• CDC and CMS: Nursing Home Infection Preventionist Training, Module 10b - Central Venous Catheters (relevant to a broad audience)
  Online Training Module: Discuss central venous catheters and recommended practices for their use. Module 10B is organized into two lessons; it will take you approximately 30 minutes to complete.

Needle Safety

• OSHA: Blood borne Pathogens and Needle-stick Prevention
  Toolkit: Hazard recognition tools to prevent needle-stick injuries and the spread of blood borne pathogens.
• WHO Calls for Worldwide Use of "Smart" Syringes
  Press release: Review of the consequences of unsafe injection practices and highlighting options to reduce risk.
• WHO: Safety Syringes
  Guidelines: WHO guideline on the use of safety-engineered syringes for intramuscular, intradermal and subcutaneous injections in healthcare settings.
• CDC Blood borne Pathogens Training
  Video Training: A video PowerPoint presentation (with text transcript available) presents the guidelines for safe practices (CDC), proper waste management (OSHA) and the signs associated with drug diversion.
• CDC and CMS: Nursing Home Infection Preventionist Training, Module 13 - Occupational Health Consideration for the Infection Prevention and Control Program (relevant to a broad audience)
  Online Training Module: Discusses occupational health considerations for the infection prevention and control program. This module is organized into 1 lesson and will take approximately 30 minutes to complete. 

What to Do After a Needle-stick

• Clinician Consultation Center: Post-Exposure Prophylaxis Quick Guide for Occupational Exposures
  Quick Links: An abbreviated toolkit to assist in urgent response to exposure.
• Clinician Consultation Center: Post-Exposure Prophylaxis
  Hotline: Needle-stick "urgent exposure management" hotline: (888) 448-4911 (M-F 6am - 5pm PT, 8am - 5pm weekends & holidays).
• CDC: Needle stick prevention and care of laundry (pdf)
  Checklist: Standard precautions observation categories
• The Society for Healthcare Epidemiology of America Updated US Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus and Recommendations for Post Exposure Prophylaxis (pdf)
  Peer-reviewed publication: Updated national guidelines for suggested response to possible HIV exposure.

Waste Disposal

• U.S. FDA: Be Smart with Sharps Pamphlet (pdf)
  Pamphlet: Safe disposal of sharps with infographics and definitions.
• U.S. FDA: Safe Sharps Disposal Label (For Garbage Container) (pdf)
  Printable Label: Garbage container label warning against sharps disposal in general waste bins.
• U.S. FDA: Safe Sharps Disposal Medication Insert (pdf)
  Pamphlet: Safe disposal of sharps with infographics and definitions.
• U.S. FDA: Sharps Container Poster (pdf)
  Poster: Printable poster of the safe disposal of sharps.
• OSHA: Protecting Yourself When Handling Contaminated Sharps
  Fact Sheet: Appropriate disposal and handling of contaminated sharps and disposal containers.
• OSHA: Requirements for Needle-stick/Sharps Injuries
  Guidelines: Federal directives for needle safety, handling, and blood borne pathogen risk.
• OSHA: Disposal of Contaminated Needles and Blood Tube Holders Used for Phlebotomy
  Guidelines: Phlebotomy-specific national policies regarding blood-contaminated sharps, with specific instructions regarding blood tube holders for blood draw procedures.
• CDC National Institute for Occupational Safety and Health (NIOSH): Selecting, Evaluating, and Using Sharps Disposal Containers (pdf)
  Publication: Published guidelines for the selection and implementation of sharps disposal containers.

Medication and Treatment Management

Storage

• CDC: Centralized medication area (pdf)
  Checklist: Medication preparation room observation categories
• CDC: Vaccine Storage and Handling Toolkit
  Toolkit: Guidance on vaccine storage, handling, and administration procedures.

Preparation

Mixing (Admixture)

• ISMP: Safe Practice Guidelines for Adult IV Push Medications
  Guidelines: Recommendations that address mixing (termed "admixture"), compounding, reconstituting and IV medication administration.

Compounding

• INCRI, ANRI, NORI, & IRB: Best Practice Guidelines for IV Preparation
  Toolkit: Guidelines for safe compounding and aseptic environment practices for naturopathic medicine. [USP 797] guidelines are translated into applicable practices for alternative and naturopathic medicine.
• Revision Bulletin USP 797 Pharmaceutical Compounding: Sterile Preparations
  Guidelines: The US Pharmacopeial Convention presents foundational standards for compounding medication in a sterile environment and using aseptic technique. [Note: USP includes reconstituting and mixing under this section and describes applicable aseptic environment procedures that apply to these activities]. 
• Oregon Patient Safety Commission: Safe Medication Practices in Your ASC: [USP 797] Sterile Compounding Guidelines (pdf)
  PowerPoint: Summary slides of the US Pharmacopeial sterile compounding guidelines chapter.
• APIC Safe Injection, Infusion, and Medication Vial Practices in Health Care (2016)
  Guidelines: Recommendations for compounding, aseptic technique and injectable medication usage (see pages 3-4, 8).

Reconstituting

• Immunization Action Coalition: Vaccines with Diluents: How to Use Them (pdf)
  Table: Table of vaccines requiring reconstitution prior to administration, includes information about the diluent and time allowed between reconstitution and use.
• ISMP: Safe Practice Guidelines for Adult IV Push Medications
  Guidelines: Recommendations that address mixing (termed "admixture"), compounding, reconstituting and IV medication administration.

Administration

• One & Only Campaign: Rx for Safe Injections Poster (pdf) (Spanish version)
  Poster: Reminder to use just one needle and one syringe only once.
• One & Only Campaign: Injection Safety Pocket Card (pdf)
  Pocket Card: A brief description of the CDC guidelines for safe injection practices.
• One & Only Campaign: Injection Safety - What every healthcare provider needs to know
  Brochure: Summary of CDC injection safety guidelines and a visual demonstration of how improper needle, syringe, or vial use can spread disease.
• CDC Safe Practices for Medical Injections (FAQs): Medication Administration
  FAQs: A brief question and answer forum for safe injection administration.

Vial Safety

• One & Only Campaign: Single-dose or Multi-dose? (pdf)
  Infographic: The CDC's One & Only Campaign provides an intuitive visual for the safe handling of single-dose and multi-dose vials for the provider and patient.
• CDC Safe Practices for Medical Injections (FAQs): Single-dose/Single-use Vials
  FAQs: A brief question and answer forum for single-dose/single-use vials.
• CDC Safe Practices for Medical Injections (FAQs): Multi-dose Vials
  FAQs: A brief question and answer forum for multi-dose vials.
• Joint Commission: The Misuse of Vials: A Follow-Up to the Sentinel Event Alert
  PowerPoint: Slides on the recent impact of unsafe injection practices, opportunities for improvements, and specific guidelines for vial and syringe safety.
• Infusion Nurses Society (INS) Infusion Therapy Standards of Practice
  Guidelines: Comprehensive injection safety practices for needle use, compounding, sharps waste and safety, environmental cleaning, and vial septum and ampoule disinfection (p. S40).
• CDC Position Paper and Misperception Clarification on Single-dose/Single-use Vials (pdf)
  Position Paper: A 2012 clarification on the CDC's position on the use of single-dose/single-use vials to clarify misunderstandings among health professionals.

Special Topics

• Oregon Health Authority: Drug Diversion and Safe Injections: Risks, Recommendations, & Resources
  PowerPoint: Information on how drug diversion can spread disease from health professionals to patients and practical ways to prevent this.
• Oregon Health Authority: Drug Diversion in Healthcare Settings, June 02, 2014
  Video: Dr. Joesph Perz (CDC) discusses collective action required to mitigate drug diversion.
• Oregon Health Authority: Bold Bugs, Broken Drugs, and Risky Sticks: Keeping Residents Safe when Care Presents Perils
  PowerPoint: A description of public health's role and relationship to healthcare facilities (specifically long-term care settings) regarding surveillance, injection safety, and appropriate antimicrobial use.
• Oregon Health Authority: Injection Safety, Hand Hygiene, and Healthcare Worker Influenza Vaccination
  PowerPoint: An overview of best practices for infection control related to syringe and vial safety, drug diversion, and increasing the health professional influenza vaccination use.
• Oregon Health Authority: Interfacility Transfer Communication & Injection Safety
  PowerPoint: A description of effective inter-facility communication use and the impact of safe injection and needle use practices.
• CDC Steps for Evaluating an Infection Control Breach
  Informational Webpage: The CDC presents the recommended approach to an infection control breach when blood borne pathogen transmission is a possible risk.
• CSTE Drug Diversion Planning and Response Toolkit for State and Local Health Departments
  Toolkit: The Healthcare Associated Infections (HAI) Drug Diversion Planning and Response Toolkit for State and Local Health Departments focuses on drug diversion response to define best practices, provides resources informed by past drug diversion investigations, and recommends the enhancement of collaborations among public health agencies and partners representing regulatory affairs: Law enforcement, healthcare facility licensing, certification and accreditation. 

Diabetes Care

• Oregon Patient Safety Commission: Preventing Infection During Blood Glucose Monitoring and Insulin Administration
  Video: This 10-minute video provides best practices that can be implemented in any setting.
• One & Only Campaign Insulin: Pen Safety Poster (pdf)
  Poster: Reminder that insulin pens are for individuals and should not be shared.
• One & Only Campaign: Insulin Pen Safety Brochure (pdf)
  Brochure: Recommendations for safe insulin pen use for health professionals.
• CMS Finger-stick Device Standards (pdf)
  Guidelines: Point-of-care testing standards of practice from the CDC and FDA, requiring only one finger-stick device be used for each person (p. 651).
• CMS State Operations Manual: &#sect;483.80 Infection Control (pdf)
  Guidelines: Regulations and guidelines pertaining to medical equipment use. The specified section addresses handling of blood glucose meters and infection control measures for use.

Disease Transmission and Outbreaks

• Oregon Health Authority: Taking a Shot at Injection Safety (pdf)
  CD Summary: An Oregon-specific summary report on the recent impact of lapses in injection safety practices, and OHA's work in addressing this in Oregon. (CME credits available).
• One & Only Campaign: The Impact of Unsafe Medical Injections in the U.S.
  Infographic: A description of recent infection outbreaks and impact due to unsafe injection practices. A summary of steps to ensure safe injection practices are provided.
• CDC: Selected Outbreaks and Patient Notification Events in Outpatient Settings (2010-2014)
  Table: A CDC-compiled list of example outbreaks and situations in which patients were notified of possible disease transmission due to unsafe injection practices.
• CDC Public Health Grand Rounds: The Impact of Unsafe Medical Injections in the U.S.
  Webcast: Description of the individual and societal impact of disease transmissions that result from unsafe injection practices.
• CDC Patient Notification Toolkit
  Toolkit: In the event of an infection safety breach, the CDC provides steps and tools for health facilities and health departments to address media communication, patient notification, and decision-making throughout the process.
• MMWR: Investigation of Hepatitis C Virus Transmission Associated with Injection Therapy for Chronic Pain - California, 2015
  Report: A patient receiving prolotherapy injections spread. 400 patients of a clinic offering prolotherapy were contacted for potential exposure to HCV, HBV, and HIV due to insufficient safe injection and aseptic technique practices.
• Outbreak of Tsukamurella Species Bloodstream Infection among Patients at an Oncology Clinic, West Virginia, 2001-2012
  Peer-Reviewed Journal Article: Infection Control and Hospital Epidemiology reports the outbreak of a bloodstream infection among oncology patients due to the use of a saline bag as a common source for saline flushes on multiple patients.
• Guh AY, Thompson, ND, Schaefer MK, Patel PR, Perz JF. Patient Notification for Blood borne Pathogen Testing due to Unsafe Injection Practices in the US Health Care Settings, 2001-2011
  Peer-Reviewed Journal Article: A 10-year summary of events in which patients were notified of potential bloodborne pathogen transmission due to unsafe injection practices.

Specialty-Specific Resources

Acupuncture

• Council of Colleges of Acupuncture and Oriental Medicine's Clean Needle Technique (CNT) Review Course: Acupuncture Safety
  Guidelines: A CEU review course for clean needle technique.
• Council of Colleges of Acupuncture and Oriental Medicine's Clean Needle Technique Manual: Best Practices for Acupuncture Needle Safety and Related Procedures, 7th Edition (2017)
  Guidelines: A thorough resource that addresses safe needle use, aseptic environment protocol, and disposal for a wide variety of oriental medicine practices, such as acupuncture, wet cupping, micro-needling, and electroacupuncture.

Blood Draw/Phlebotomy

• WHO Guidelines on Drawing Blood: Best Practices in Phlebotomy
  Book: Online access with section links provide a toolkit-style resource for safe needle use during blood draws.
• WHO Best Practice in Phlebotomy and Blood Collection
  Guidelines: General guidelines for phlebotomy, including the maintenance of a clean environment and safe tube and stopper management.

Dentistry

• CDC: Infection Prevention Checklist for Dental Settings
  Checklist: Dentistry-specific checklist to assess facility adherence to CDC-recommended safe injection guidelines.
• CDC: Summary of Infection Prevention Practices in Dental Settings
  Guidelines: Dentistry-specific tool for ensuring injection safety recommendations are followed through administrative design, education, and an included risk assessment tool.
• MMWR/CDC: Guidelines for Infection Control in Dental Health-Care Settings --- 2003
  Report: Guidelines for infection control, safe injection practices, aseptic technique and environmental standards, and more.

Dialysis

• CDC: Put Together the Pieces to Prevent Infections in Dialysis Patients
  Poster: Encourages safe injection practices, aseptic technique, and catheter care.
• American Society of Nephrology (ASN): Managing Infections in an Outpatient Dialysis Facility
  Online Learning Module: Interactive 90-minute training module that presents core infection and safety concept in a case-based format. This training was developed in partnership with CDC and includes video, audio files and text to present core concepts.
• ASN Compendium of Infection Control and Prevention Resources
  Informational Webpage. This page offers a resource library of compiled infection control and prevention resources related to dialysis settings. The resources are categorized for easy accessibility and include categories such as bloodstream infections related to vascular access, emergency management in dialysis, and staff and patient education. 
• CDC Making Dialysis Safer for Patients Coalition Resource Center
  

  Informational Webpage: This is a landing page to access all of CDC’s resources from the Making Dialysis Safer for Patients Coalition. CDC has developed posters, checklists, fact sheets, and videos that can be used in dialysis clinics, provider’s offices, training sessions and work areas.

  
  

Immunization

• CDC: Vaccine storage areas (pdf)
  Checklist: Vaccine storage area observation checklist
• ISMP: Safe Practice Guidelines for Adult IV Push Medications
  Guidelines: This compilation of recommendations addresses mixing (termed "admixture"), compounding, reconstituting and IV medication administration.

Point of Care Testing Involving Finger-stick

• CDC: Point of care testing (pdf)
  Checklist: Point of care area observation categories
• CDC: Infection Prevention During Blood Glucose Monitoring and Insulin Administration
  Informational Webpage: CDC recommendations for finger stick device use and handling.
• CDC: Frequently Asked Questions Regarding Assisted Blood Glucose Monitoring and Insulin Administration
  FAQs: CDC question and answer page for safe use of devices for blood glucose monitoring and insulin administration.
• CDC and CMS: Nursing Home Infection Preventionist Training, Module 10D - Point of Care Blood Testing (relevant to a broad audience)
  Online Training Module: Discusses point-of-care blood testing, including recommended infection prevention and control practices and consequences of failure to follow them. This module is organized in to two lessons and will take approximately 30 minutes to complete. 

Surgery

• CDC: Infection Prevention in Outpatient Surgery Centers
  PowerPoint Presentation: A 2012 presentation given by Dr. Melissa Schaefer (CDC) on the impact of best practice breaches, as well as a summary of guidelines for injection safety and ensuring aseptic technique is followed.

Micro Needling/Dermal Needling

• NCBI: Micro needling with Dermaroller
  Peer-Reviewed Journal Article: "Medical dermarollers are for single use only" (Doddaballapur, 2009)
• See Acupuncture (Clean Needle Technique Manual, 7th Edition, 2017)

Orthopedic and Pain Management

• CDC's Guide to Infection Prevention in Orthopedic and Pain Management Settings (Pocket Guide Version)
  This 96-page document includes content on safe injections and medication handling/storage (p. 21-29) as well as scenarios, checklists, and resources lists on the topic of injection safety.

Podiatry

• CDC's Guide to Infection Prevention for Outpatient Podiatry Settings (Pocket Guide Version)
  This 89-page document includes content on safe injections and medication handling/storage (p.19-23) as well as scenarios, checklists, and resource lists on the topic of injection safety.

Prolotherapy

• "No formal practice guidelines have been established for prolotherapy treatment, and no formal training is required to deliver this service" (Foster et al, 2015 p.547) (Investigation of Hepatitis C Virus Transmission Associated with Injection Therapy for Chronic Pain - California, 2015)

Wet Cupping

• See Acupuncture (Clean Needle Technique Manual, 7th Edition, 2017)

More Resources for Health Professionals

• Oregon Health Alert Network
  Web System: Oregon Health Authority provides a regional network that allows for sharing of health data among health professionals, public safety professionals, and public health partners.

  For more information, contact Roza Tammer at roza.p.tammer@dhsoha.state.or.us or call 971-673-1074.

References

Dolan SA, Arias KM, Felizardo G, Barnes S, Kraska S, Patrick M, Bumsted A. APIC position paper: Safe injection, infusion, and medication vial practices in health care. American Journal of Infection Control 2016; 44(7):750-757. https://www.sciencedirect.com/science/article/pii/S0196655316002832