Administering Subcutaneous Injections

Equipment:

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• Appropriate size syringe and needle that is based on patients age and site of administration
• Alcohol swab
• Small gauze pad
• Vial or ampule of medication
• Clean gloves
• Medication administration record or computer printout
• Sharps container

Steps:

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1. Check accuracy and completeness of each MAR with provider’s written order including the patient’s name, medication name and dosage, route of administration and time of administration.
2. Educate patient on medications including action and possible side effects. Allow patient to ask questions.
3. Close room curtain or door.
4. Perform hand hygiene.
5. Utilizing aseptic technique, prepare medications for only one patient at a time and deliver medications to patient at correct time. Check label of medication carefully with MAR or computer printout.
6. WIIAPA:
   1. Wash hands & apply gloves
   2. Introduce self
   3. Identify patient (use 2 identifiers and compare to patient’s MAR)
   4. Allergies – don’t forget food allergies
   5. Plan of care
   6. Assess patient
7. Place patient in a comfortable position and select appropriate site.
   1. Ensure needle is appropriate size—one-half length of skinfold when grasping between thumb and forefinger at site.
8. Clean site with antiseptic swab beginning at the center of site and rotating outward in circular direction for about 5 cm or 2 inches.
9. Remove needle cap by pulling it straight off.
10. Hold syringe as a dart between thumb and forefinger of dominant hand.
11. Administer injection.
    1. For an average-sized patient hold skin across injection site or pinch skin with nondominant hand.
    2. Inject needle quickly and firmly at 45 to 90 degree angle.
    3. Release skin if pinched. Option: When using injection pen or administering heparin, continue to pinch skin while injecting medicine.
    4. For obese patient, pinch skin at site and inject needle at 90 degree angle below tissue fold.
12. After needle enters site, grasp lower end of syringe barrel with nondominant hand to stabilize it. Move dominant hand to end of plunger and slowly inject medication over several seconds.
13. Withdraw needle quickly while placing antiseptic swab or gauze gently over site.
14. Apply gentle pressure to site but do not massage.
15. Discard uncapped needle and attached syringe into sharps container.
16. Help patient to comfortable position, place call bell within reach, lower bed and raise side rails as appropriate.
17. Remove gloves and perform hand hygiene.
18. Stay with patient for several minutes and observe for any allergic reactions.
19. Document.