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Joint Injection (102.092)

Joint Injection (102.092) - Policies, Clinical, UWMF Clinical, UWMF-wide, Clinical Policies and Procedures, Orthopedics and Movement

102.092

1
UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE

TITLE: JOINT INJECTION

Effective Date: April, 2004 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education

Reviewed November 2007 June 2009 October 2011


PURPOSE: To provide guidelines for assisting with steroid injections into a joint of a patient at UWMF
Clinics.

DEFINITION: Injection of an anti-inflammatory medication (corticosteroid) into a joint to help reduce
swelling and to ease pain.

POLICY: The clinical staff will utilize the following guidelines to properly assist with the injection of steroids
into the joint of a UWMF patient.

SUPPLIES: Chlorhexidine cleansing solution, clean gauze pads, alcohol prep sticks (3), 70% isopropyl
alcohol, fLidocaine 1%, prescribed medication (generally-corticosteroid)
1 (3cc) & 1 (6-cc) syringe, Band-Aid, sterile field, 2x2 sterile gauze
Sterile needles: 18-gauge (1½ inch) 20-gauge (1½ in), 25-gauge (5/8 in)
2 sterile gloves, Pen, Provider’s order, Patient’s record

PROCEDURE:

1. Check provider’s order and clarify any inconsistencies.

2. Wash hands and gather equipment.

3. Review history with provider for contraindications to the procedure.

4. Introduce yourself and identify the patient. Include date of birth and verify allergies.

5. Explain procedure to the patient and answer any questions.

6. Assist patient onto exam table and apply drape to injection site.

7. Wash hands and gather equipment and set up sterile field.

8. Put on sterile gloves.

9. Prepare area(s) to be injected with chlorhexidine solution and alcohol prep sticks:
clean with chlorhexidine solution (x3) in circular motion from center of site to outside.
clean in the same method and pattern (x3) with the alcohol prep sticks.

10. Assist provider as needed with the injection.


2
11. Provide patient with support.

12. After the injection, cleanse area with 70% isopropyl alcohol.

13. Apply gently pressure with 2x2 sterile gauze.

14. Apply Band-Aid to site.

15. Remove gloves and wash hands.

16. Assist patient in scheduling follow-up appointment (as needed).

17. Documentation (in IMM/INJ and Progress Notes in HealthLink)
 IMM/INJ
Manufacture, Lot #, Expiration date (as indicated)
NDC#
Name, dosage, route of medication, site of injection, and time given
 Progress Notes
Assessment and laboratory results relevant to purpose of the medication
Effects of the medication on patient
Teaching about the drug or injection technique
How the patient tolerated the procedure
Discharge instructions and follow-up

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

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

REVIEWED BY: Lynn Posick, NP, Ortho/Rehab - Foot/Ankle

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