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

Session VI, Slide #2 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 #3 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 #4 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 #5 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 #6 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.