Policy Manual sample

MDT Home Health Care Agency, Inc. 119 SUBCUTANEOUS INJECTIONS PURPOSE: Subcutaneous injections are used to inject medication into the adipose tissues beneath the skin for systematic absorption. All subcutaneous injections are administered in accordance with specific physician's order indicating medication, dosage and frequency. All instructions to patients or caregivers regarding self-administration is in accordance with the physician's Plan of Care. RESPONSIBLE PERSONNEL: RN, LPN EQUIPMENT: Prescribed medication, sterile disposable needle (25 gauge, 5/8 inch or less), sterile syringe, alcohol sponges, needle box SPECIAL CONSIDERATIONS: The most common sites for subcutaneous injections are in outer aspect of the upper arms and the anterior thigh. The abdomen and scapular areas can be used as well. The nurse should always assess for allergies regarding alcohol or the medication prior to giving the medication. Any area that appears red, inflamed, swollen or the site of a burn or a birthmark should not be chosen as an injection site. The label of the bottle from which the medication is drawn should be read as the bottle is selected, after the medication has been drawn and before injection in order to avoid medication errors. PROCEDURE: 1. Inspect the medication. 2. Wash hands. Wipe the top of the vial with antiseptic swab. 3. Draw up the medication into the syringe; double check dosage. 4. Ascertain 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 patient. Expose the area into which the injection will be made and inspect the site. 8. Wipe the injection site with an antiseptic swab. Using a circular motion, clean outward from injection site. 9. Allow the skin to dry before injecting the drug. Do not touch after cleaning. 10. Remove the needle sheath. 11. Position the needle and syringe bevel side up. 12. With the non-dominant hand, pinch or spread the skin around the injection site firmly. 13. Warn the patient regarding the stick. 14. Insert the needle at a 45 degree or 90 degree angle to the skin surface, depending upon the amount of SQ tissue present at the site and the needle length. 15. Release the patient's skin before injecting the medication. 16. Support syringe with non-dominant hand and inject the medication slowly and steadily into tissue. 17. Quickly remove the needle at the same angle as insertion. 18. Using the antiseptic sponge, blot the site. Remove the sponge. Assess the site. 19. Reposition and cover the patient. 20. Do not resheath the needle. Every nurse should carry a receptacle into which the entire syringe can be dropped.