Policy Manual sample

MDT Home Health Care Agency, Inc. 66 INTRAMUSCULAR INJECTIONS PURPOSE: Intramuscular injections are used to deposit medication deep into muscle tissue for absorption and systemic effect. All intramuscular injections are given in accordance with specific physician's orders regarding medication, dosage and frequency. All instruction to patients or caregivers regarding self-administration is in accordance with the physician's plan of care. One cc is the maximum volume for the pediatric patient, and 0.5 cc is the maximum volume for the infant. No more than 3.0 ml of a solution may be injected in one site for an adult. Sterile technique is always used. The first dose medication administration policy should be implemented. RESPONSIBLE PERSONNEL: RN, LPN EQUIPMENT: Prescribed medication, 3-5 ml. sterile disposable syringe with 20-25 gauge 1-2 inch sterile needle, alcohol sponges, needle box SPECIAL CONSIDERATIONS: The label of the bottle from which the medication is drawn should be read as the bottle is selected, as the medication is being drawn up, after the medication has been drawn up to ensure it is the correct medication. Always ask if the patient has any known allergies either to alcohol or to the medication. In adults, injection sites include dorsogluteal, ventrogluteal, vastus lateralis and deltoid. In infants, injection site is the vastus lateralis. The site should be inspected prior to giving the injection. Inflamed, irritated, edematous sites are inappropriate, as are areas containing moles, scarred tissue or birthmarks. Care should be taken in frail, elderly or emaciated patients or patients receiving frequent injections. Some medications require special solutions as solvents. Care to mix these thoroughly is indicated to ensure accurate dosage of medication. When muscles are tense, injections hurt more. Try to get the patient to relax. Ice held on the site prior to cleansing can produce a numbing effect. Orders should include medication, dose, route and frequency. Remaining contents of vials should be stored according to package inserts. If there is any question, the dispensing pharmacy should be contacted. PROCEDURE: 1. Wash your hands. 2. Inspect the medication and wipe the top of the vial with an alcohol swab. 3. Draw up the medication; double check dosage. 4. Ensure patient identity. 5. Explain the procedure to the patient and provide privacy. 6. Select a site. Establish a plan for rotation of sites if repeated dosages are indicated. 7. Position the patient. Expose the area into which the injection will be made and inspect the site.