Guidelines for supporting clients subcutaneous injectable medications
Overview
Introduction
While injectable medication has many healthcare benefits to clients, there are complexities associated with prescribing, preparing and administering this form of medication.
This means there are greater risks than for other routes of administration. Safe systems of work are required to minimise the risks to ensure clients receive safe effective care.
This policy aims to ensure the safe administration of injectable drugs via the subcutaneous route.
Subcutaneous injections
The subcutaneous route is used for slow, sustained absorption of the medication. Up to 1-2 ml of drug/fluid is injected, slowly, into the subcutaneous tissue inserting the needle at a 45-degree angle into a raised skin fold in order to lift adipose tissue from the underlying muscle. Aspiration following needle insertion is not required as the risk of puncturing blood vessels is negligible.
The subcutaneous route is suitable for administering small doses of non-irritating water-soluble medication such as insulin or heparin.
Injection site
The recommended sites to administer medication by subcutaneous are:
the abdomen in the umbilical region
the lateral or posterior aspect of the lower part of the upper arm
the thighs (under the greater trochanter rather than the mid-thigh)
buttocks.
If the medicine is given frequently to the client via the subcutaneous route, rotate injection sites to decrease the likelihood of irritation and ensure improved absorption.
The injection site should be assessed before and after medication administration for signs and symptoms of possible difficulties including:
pain/tenderness,
inflammation,
bruising,
oedema,
hardness,
heat,
exudates/leaking,
discharge,
itching,
burning,
unresolved blanching and
necrosis.
Change the injection site immediately if any of these signs and symptoms are present.
A maximum volume of 2 ml is tolerable using this route for injection. Only highly soluble drugs should be administered to prevent irritation.
A 25G needle is usually used to administer medication via subcutaneous.
when clients are supported that require injectable medication via the subcutaneous route
to all employees, supervisors and key managers supporting clients that require subcutaneous injections
Related Items
NDIS (Quality Indicators) Guidelines 2018 (Cth)
Subcutaneous Injections Prima
Policy
Subcutaneous injection general guidelines As a guide:
ensure each client requiring subcutaneous injection receives relevant support proportionate to their individual needs and specific medication requirements
when using a syringe, a needle no longer than 8 mm is recommended
syringes and pen needles are single-use only
injections should not be administered through clothing
shorter length pen needs are recommended for adults and children.
Needle safety Never recap a used needle—recapping needles increases the risk of needle stick injury. Always dispose of used needles in a sharps approved container.
Carer responsibilities when supporting clients with subcutaneous injectable medications
Responsibilities of carers are to:
work within their scope of practice and qualifications
wear appropriate PPE—gloves are not necessary (they don’t protect from needle stick injury) but an apron is recommended to protect clothes
correctly identity of the person they are to administer medication to using the person’s medication chart
adhere to hand hygiene and injection control policies
choose an appropriate needle size and practice good administering techniques
report incidents via the incident management system.
Key manager responsibilities when supporting clients with subcutaneous injectable medications
Responsibilities of key managers are to:
ensure carers have current knowledge and a training plan to teach the standards of care for clients that require subcutaneous injectable medications
provide carers education to provide excellent confident care
regularly audit subcutaneous injection practices
ensure carers follow the Administer subcutaneous medication process
