Common Injection Errors and How to Avoid Them

Common Injection Errors and How to Avoid Them

Administering injections is one of the most routine procedures in healthcare settings across Nigeria, from tertiary hospitals in Lagos to primary health centres in rural communities. Yet, despite how common this practice is, common injection errors and how to avoid them remain a critical topic in patient safety discussions.

Injection errors can lead to serious complications such as infections, nerve damage, medication wastage, cross-contamination, and even life-threatening conditions. According to the World Health Organization (WHO), unsafe injection practices contribute significantly to the transmission of bloodborne pathogens globally, including hepatitis B, hepatitis C, and HIV.

For healthcare professionals, hospital administrators, and policymakers in Nigeria, understanding common injection errors and how to avoid them is not optional; it is essential to safeguard patients and protect healthcare workers.

This comprehensive guide explores:

  • The most frequent injection mistakes
  • Why they happen
  • The risks involved
  • Practical strategies to prevent them
  • Best practices for safe injection procedures

Why Injection Safety Matters in Nigeria

Nigeria administers millions of injections yearly for immunizations, antibiotics, insulin therapy, and emergency medications. In many communities, injections are often perceived as “stronger” or more effective than oral medications.

However, with high injection frequency comes a higher risk. Unsafe injection practices can result in:

  • Needle-stick injuries among healthcare workers
  • Transmission of infectious diseases
  • Increased healthcare costs due to complications
  • Loss of public trust in health facilities

Improving injection safety starts with recognizing common injection errors and how to avoid them through proper training, high-quality consumables, and adherence to infection prevention protocols.

Most Common Injection Errors in Healthcare Settings

1. Using the Wrong Syringe or Needle Size

One of the most frequent injection errors is selecting the incorrect syringe or needle size for the procedure.

Why This Happens:

  • Lack of training
  • Inadequate supply of varied syringe sizes
  • Rushed clinical environment

Risks:

  • Inadequate drug delivery
  • Increased patient pain
  • Tissue trauma
  • Medication wastage

How to Avoid It:

  • Understand gauge (needle thickness) and length requirements for IM, IV, SC, and intradermal injections.
  • Ensure your facility stocks a range of sterile, high-quality syringes.
  • Always match syringe capacity with the prescribed dosage.

For example, insulin administration requires fine-gauge needles, while intramuscular injections may require longer needles depending on the patient’s body mass.

2. Incorrect Injection Site Selection

Improper site selection can cause severe complications such as nerve injury or abscess formation.

Common Mistakes:

  • Injecting too close to the sciatic nerve
  • Using inflamed or infected skin areas
  • Repeated injections in the same location

Risks:

  • Nerve damage
  • Pain and swelling
  • Reduced drug absorption

How to Avoid It:

  • Follow anatomical landmarks strictly.
  • Rotate injection sites, especially for insulin and repeated IM injections.
  • Assess the site before injection for redness, swelling, or lesions.

3. Poor Hand Hygiene and Infection Control

Skipping handwashing or using contaminated gloves is a major contributor to healthcare-associated infections (HAIs).

Why It Happens:

  • Time pressure
  • Limited access to running water
  • Complacency

Risks:

  • Cross-contamination
  • Bloodstream infections
  • Outbreaks in healthcare facilities

How to Avoid It:

  • Follow WHO’s “5 Moments for Hand Hygiene.”
  • Use alcohol-based hand rubs when water is unavailable.
  • Always use new sterile syringes and needles for each patient.

4. Reusing Syringes or Needles

This is one of the most dangerous injection errors and remains a global public health issue.

According to the WHO, reuse of injection equipment without sterilization has been linked to millions of hepatitis infections worldwide.

Risks:

  • Transmission of HIV
  • Hepatitis B and C
  • Sepsis

How to Avoid It:

  • Adopt a strict single-use policy.
  • Use auto-disable syringes where appropriate (e.g., immunization programs).
  • Dispose of sharps immediately after use in puncture-proof containers.

5. Incorrect Dosage Administration

Administering too much or too little medication can have severe consequences.

Causes:

  • Misreading prescription
  • Miscalculations
  • Using the wrong syringe calibration

Risks:

  • Overdose
  • Treatment failure
  • Adverse drug reactions

How to Avoid It:

  • Double-check medication orders.
  • Use clearly marked, high-quality syringes.
  • Implement a “two-person verification” system for high-risk drugs.

6. Failure to Remove Air Bubbles

Air embolism is rare but potentially fatal when air enters the bloodstream during IV injections.

Prevention:

  • Tap syringe gently to dislodge air bubbles.
  • Expel air before administering injection.
  • Inspect syringe carefully under good lighting.

7. Improper Disposal of Used Syringes

Improper disposal exposes healthcare workers, cleaners, and waste handlers to needle-stick injuries.

Risks:

  • Occupational infections
  • Community exposure from scavenging

Prevention:

  • Use sharps containers immediately after injection.
  • Do not recap needles.
  • Train all staff on medical waste management protocols.

Systemic Causes of Injection Errors

Understanding common injection errors and how to avoid them also requires examining systemic challenges.

1. Inadequate Training

Many primary healthcare workers lack continuous professional development opportunities.

2. Poor Supply Chain Management

Stock-outs may force facilities to improvise with inappropriate equipment.

3. High Patient Load

Overworked staff are more likely to make errors.

4. Substandard Medical Consumables

Low-quality syringes can:

  • Have unclear markings
  • Leak
  • Break easily

Using certified, quality-tested syringes significantly reduces risk.

Best Practices for Safe Injection Procedures

1. Follow Standard Injection Protocols

Every facility should have clear written guidelines aligned with:

  • WHO Injection Safety Guidelines
  • Nigeria Centre for Disease Control (NCDC) infection prevention standards

2. Continuous Training and Competency Assessment

Healthcare workers should undergo:

  • Regular refresher courses
  • Supervised practice sessions
  • Periodic skill assessments

3. Use High-Quality, Sterile Syringes

Reliable syringes must:

  • Be individually packed
  • Have clear, accurate calibrations
  • Be made from medical-grade materials
  • Ensure smooth plunger movement

High manufacturing standards reduce mechanical failure and contamination risk.

4. Maintain Proper Documentation

Accurate records help:

  • Track adverse reactions
  • Identify error patterns
  • Improve clinical audits

5. Encourage a Culture of Safety

Healthcare facilities should:

  • Encourage error reporting without punishment
  • Conduct regular safety audits
  • Reward adherence to safety standards

Case Study – Preventing Injection Errors in a Nigerian Primary Health Centre

A rural health centre in Northern Nigeria experienced repeated post-injection abscess cases during immunization campaigns.

Investigation Revealed:

  • Reuse of needles due to supply shortages
  • Poor hand hygiene
  • Inadequate waste disposal

Intervention:

  • Supply of single-use auto-disable syringes
  • Staff retraining
  • Introduction of sharps disposal bins

Outcome:

Within six months, post-injection complications reduced significantly, and community trust improved.

This example highlights how addressing common injection errors and how to avoid them requires both quality supplies and proper training.

Role of Policymakers in Reducing Injection Errors

Policymakers can:

  • Enforce strict procurement standards
  • Support local manufacturing of quality medical consumables
  • Fund infection prevention programs
  • Strengthen regulatory oversight

Improving injection safety at the national level reduces long-term healthcare costs and protects public health.

How Patients Can Protect Themselves

Even patients can contribute to safer injections by:

  • Ensuring a new syringe is opened in front of them
  • Asking healthcare workers about hygiene practices
  • Reporting unsafe practices

Patient awareness strengthens accountability.

Conclusion: Prioritizing Injection Safety in Nigeria

Understanding common injection errors and how to avoid them is fundamental to improving healthcare quality and patient outcomes in Nigeria.

From choosing the correct syringe size to preventing cross-contamination, every step matters. Safe injection practices:

  • Protect patients
  • Safeguard healthcare workers
  • Reduce healthcare costs
  • Strengthen public trust

Healthcare facilities must invest in training, enforce infection control standards, and procure reliable medical consumables.

For high-quality, sterile, and reliable medical syringes that support safe injection practices, contact O-care today. Together, we can build a safer healthcare system.

FAQs: Common Injection Errors and How to Avoid Them

1. What are the most common injection errors in hospitals?

Common injection errors include wrong needle size selection, incorrect injection site, dosage miscalculation, poor hygiene, and reuse of syringes.

2. How can healthcare workers prevent injection-related infections?

By practicing proper hand hygiene, using sterile single-use syringes, and disposing of sharps correctly.

3. Why is syringe quality important in preventing injection errors?

High-quality syringes ensure accurate dosage measurement, reduce leakage, and prevent mechanical failure during administration.

4. What happens if the wrong injection site is used?

It can cause nerve damage, pain, abscess formation, or poor medication absorption.

5. How can Nigerian hospitals improve injection safety?

Through continuous staff training, procurement of quality syringes, adherence to WHO guidelines, and strict infection control policies.