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Administering Subcutaneous Injection (102.072)

Administering Subcutaneous Injection (102.072) - Policies, Clinical, UWMF Clinical, UWMF-wide, Clinical Policies and Procedures, Medication Administration, Route of

102.072

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UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE

TITLE: ADMINISTERING A SUBCUTANEOUS INJECTION

Effective Date: February, 2002 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education

Reviewed October, 2003 March, 2005 Feb 2008 October 2011


PURPOSE: To provide guidelines for the administration of subcutaneous injection at UWMF Clinics.

POLICY: Clinical staff will utilize the following guidelines to administer a subcutaneous injection to UWMF
patients. The preparation and administration of a medication should be completed by the same person.

DEFINITION: Subcutaneous (SQ) medications are injected into the adipose (fatty) tissue beneath the skin. SQ
administration allows for slower, more sustained drug administration than intramuscular (IM) administration. It
also has lower risk of tissue trauma and carries little risk of striking large blood vessels and nerves. Small doses
of water-soluble, nonirritating medications should be given by this route.
NOTE: Maximum quantity that can be injected into one site is 1ml, unless manufacturer notes otherwise.

SUPPLIES: 1-3 ml syringe with 1/2 to 7/8 inch needle (25, 26, or 27 gauge needle), Small gauze pads,
Alcohol pad, Gloves, Bandage, Provider’s order, Medication record, Medication

PROCEDURE:

1. Check medication against provider’s order and clarify any inconsistencies in the dose against the provider’s
order.

2. Identify the patient: include date of birth and verify allergies.

3. Know medication’s actions, special considerations, safe-dose ranges, purpose of administration, and
adverse effects.

4. Wash hands and assemble equipment.

5. Prepare medication, adhering to the five rights of drug administration.
Right – drug, dose, time, route, patient
Check the expiration date of the medication

6. Provide good light and privacy by closing curtains or door.

7. Provide patient education:
Explain medication(s), reason(s) for the medication(s), and administration technique to patient
Explain sensations to expect during administration (pain/discomfort during injection, burning/stinging at
site, etc.).

8. Put on disposable gloves.



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9. Have patient assume a position appropriate for the most commonly used sites (see diagram).
a. Outer aspect of upper arm - Patient's arm should be relaxed and at side of body.
b. Abdomen - Patient may lie in a semi-recumbent position.
c. Anterior thighs - Patient may sit or lie with leg relaxed.

10. Locate site of choice. Ensure that area is not tender and is free of lumps or nodules. If patient is receiving
multiple injections, make sure to alternate sites.

11. Clean area around injection site with an alcohol swab. Use a firm, circular motion while moving outward
from the injection site. Allow antiseptic to dry. Leave alcohol swab in a clean area for reuse when
withdrawing the needle or use a new gauze pad.

12. Grasp and bunch area surrounding injection site or spread skin at site.

13. Hold syringe in dominant hand between thumb and fore-finger. Insert needle quickly at a 45-90 degree
angle to the skin surface, depending upon length of needle and amount of subcutaneous tissue at the site.

14. After needle is in place, use your non-dominant hand to pull back the plunger slightly to check for blood
return. If none appears, begin injecting drug slowly. If blood appears on aspiration, withdraw needle,
prepare another syringe, and repeat the procedure at new site.
Note: It is not necessary to aspirate when giving insulin, heparin, or vaccinations.

15. After injection, remove the needle gently but quickly at the same angle used for insertion.

16. Cover the site with the alcohol pad and massage gently to distribute the drug and facilitate absorption.
(Do not massage a subcutaneous heparin or insulin injection site.)

17. Discard needle and syringe in sharps receptacle.

18. Assist patient to a position of comfort.

19. Remove gloves, dispose of them properly and wash hands.

20. Documentation (HealthLink)
 IMM/INJ
Manufacture, Lot #, Expiration date (as indicated)
NDC#
VIS# (if applicable)
Name, dosage, route of medication, site of injection, and time given
 Progress Notes utilizing SmartPhrases: .npinjectstart and .npinjectend
Assessment and laboratory results relevant to purpose of the medication
Effects of the medication on patient
Teaching about the drug or injection technique

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How patient tolerated procedure, i.e., desired effect, adverse reactions

21. Evaluate patient response to medication within an appropriate time frame.

22. Assess site. Observe closely for adverse reactions to the medication.

REVISED BY: Carol Decker, RN, MSN, Clinical Staff Education

REVIEWED BY: LaVay Morrison, RN, BSN, Clinical Staff Education

WRITTEN BY: Ronnie Peterson, R.N., M.S., Manager of Clinical Support

REFERENCES:
Kowalak, J. P. (Ed.). (2009). Lippincott’s nursing procedures (5th ed.). Ambler, PA: Lippincott Williams & Wilkins.

Perry, A.G. & Potter, P.A. (2002). Clinical nursing skills & techniques. (5th ed.). St. Louis, MO: Mosby.

Perry, A.G. & Potter, P.A. (2009). Fundamentals of nursing. (7th ed.). Hall, A. & Stockert, P.A. (Eds.). St. Louis, MO: Mosby
Elsevier.


AUTHORIZATION:



Medical Director Date