Subcutaneous Injection Procedure

Pre-Administration Preparation

• Hand Hygiene: Perform hand hygiene before starting the procedure.
• Medication Preparation:
  • Use aseptic technique while preparing the medication.
  • Check the medication label twice against the Medication Administration Record (MAR).
• Timing:
  • Administer medication to the patient at the correct time according to agency policy.
  • Time-critical medications such as stat and now doses should be given at the exact time specified.

Patient Interaction

• Introduction & Identification:
  • Introduce yourself to the patient.
  • Identify the patient using two identifiers (e.g., name and birth date).
• Allergy Check:
  • Ask about allergies to medications.

Administration Preparation

• Electronic MAR Access:
  • Access the electronic MAR at the bedside.
  • Compare the medication label with the MAR.
• Medication Explanation:
  • Discuss the purpose, action, and possible adverse effects of the medication with the patient.
  • Allow the patient to ask questions.

Injection Site Selection

• Previous Injection Site:
  • Check the MAR or ask the patient about the last injection site.
• Site Inspection:
  • Inspect for bruising, inflammation, or edema.
  • Use a different site if the area shows signs of infection.
• Preferred Injection Sites:
  • Outer aspect of the upper arm.
  • Abdomen (below the costal margin to the iliac crest).
  • Anterior aspect of the thigh.
  • For insulin or heparin, prefer abdominal sites; low molecular weight heparin should be injected 2 inches from the umbilicus.
• Needle Size:
  • Grasp a skin fold and measure; the needle should be half as long as the fold.

Injection Procedure

• Patient Positioning:
  • Help the patient find a comfortable position and ask them to relax the area.
• Site Cleaning:
  • Wear clean gloves.
  • Clean the site with an antiseptic swab in a circular motion, starting from the center.
• Needle Insertion:
  • Remove needle cap.
  • Hold syringe like a dart in the dominant hand.
  • Insert needle at a 45 to 90-degree angle; for obese patients, use a 90-degree angle.
• Medication Injection:
  • Slowly inject medication over several seconds.
  • Withdraw the needle quickly and apply gentle pressure with a swab or gauze.

Post-Procedure

• Needle Disposal:
  • Activate needle safety.
  • Dispose of the needle and syringe in a puncture-proof container.
• Hand Hygiene:
  • Remove gloves, discard them, and perform hand hygiene.
• Documentation:
  • Document the medication name, dose, and injection site in the MAR.
• Follow-Up Care:
  • Stay with the patient for several minutes for signs of allergic reaction.
  • Check back in 15-30 minutes for any acute pain, tingling, burning, or numbness at the site.