Contraceptive Implants Session VI Infection Prevention Session VI

Contraceptive Implants Session VI: Infection Prevention Session VI, Slide #1

Preparing for Insertion • Have the client wash her entire arm (one she uses less often). • Cover the procedure table and arm support with a clean cloth. • Ask client to lie on her back so that implant arm is turned outwards and bent at the elbow and is well supported. • Prepare clean instrument tray, open sterile instrument pack. • For Jadelle and Sino-Implant (II), carefully open sterile pouch containing implants by pulling apart, without touching the rods, allowing them to fall into a sterile cup or bowl. • For Implanon, remove the sterile applicator with the preloaded implant by allowing it to fall on the sterile tray. Session VI, Slide #2

Before Insertion • Wash hands with antiseptic soap and water, dry with clean towel or air-dry. • Put sterile or high-level disinfected (HLD) gloves on both hands before procedure. • Clean insertion site with a cotton soaked in antiseptic solution and held in a sterile or HLD forceps. • Use sterile surgical drape with a hole to cover arm. Hole should be large enough to expose entire area where implants will lie. • When giving local anesthetic, use a new disposable syringe and needle, if available, an autodisable syringe is preferable. Session VI, Slide #3

During Insertion: Jadelle and Sino-Implant • To minimize risk of infection and/or expulsion, make sure ends of rods nearest to the incision are not too close (not less than 5 mm) to incision. If tip of rod is too close to the incision, it should be carefully removed and reinserted. To enable easy removal of both rods from a single incision, it is important that ends of rods closest to the incision are not farther apart, than the width (not length) of one implant. • While inserting implants, try not to remove trocar from incision. Keeping trocar in place minimizes tissue trauma, decreases chances of infection, and minimizes insertion time. Session VI, Slide #4

During Insertion: Implanon • After confirming rod is in applicator, remove needle shield. • Without needle shield, implant can fall out, so keep applicator in upright position until insertion. • If it falls out or if contamination occurs, use a new package. Session VI, Slide #5

After Insertion • Clean around insertion site with antiseptic. • Cover insertion site with bandage and cover with gauze. • Dispose of applicator, syringe and needle in sharps container. Burn or bury when ¾ full. • Decontaminate non-disposable instruments in 0. 5% chlorine for 10 minutes. • Dispose of contaminated items like gauze, cotton, etc. in leak-proof container or plastic bag. Session VI, Slide #6