Best Practices in Parenteral Drug Administration

This aims to explain the basics of drug administration using the different routes. It aids the learners to evaluate and understand the principles and guidelines of administering medication while considering the safety of the patient.

1. Administration of Injections: Best Practices and Techniques

2. Welcome and Introduction Welcome to our session on injection administration! Today, we'll cover preparation of injections and the techniques for intradermal, subcutaneous, and intramuscular injections. These are essential skills for your nursing practice and exams.

3. Preparing Injections from Ampules Use a gauze pad to wrap the neck of the ampule. Break the ampule away from the body. Draw up medication using a filter needle. Remember, do not inject air into the ampule. What might be the reason for not injecting air into an ampule?

4. Preparing Injections from Vials Scrub the top of the vial for 15 seconds with an alcohol swab. Inject air equal to the medication dose into the vial. Draw up the medication with the vial upside down. Why is it important to inject air into a vial before drawing up medication?

5. Intradermal Injections Use a 26- to 29-gauge needle, 3/8 to 1/2 inch in size. Inject a small volume (max of 0.1 milliliters). Hold skin taut, insert needle at a 10- to 15-degree angle. Form a small wheal under the skin. Do not massage the site after injection.

6. Subcutaneous Injections Use a 25- to 27-gauge needle, 3/8 to 5/8 inch in size. Inject volume between 0.5 and 2 milliliters. Choose a fatty area like the abdomen or upper lateral arm. Rotate injection sites to prevent tissue damage. Insert at a 45- to 90-degree angle.

7. Insulin Injections Use an insulin syringe marked with units. Short-acting insulin should be clear. Gently rotate insulin suspension vials; do not shake. Rotate insulin injection sites. How would you ensure the correct technique when administering insulin?

8. Mixing Insulins Remember "clear before cloudy" – short-acting before longer-acting. Inject air into the longer-acting (cloudy) insulin first. Inject air into the short-acting (clear) insulin, then draw it up. Draw up longer-acting insulin last. Why is the order of drawing up insulins important?

9. Intramuscular Injections Use a 20- to 23-gauge needle, 1 to 1 1/2 inches in size. Insert at a 90-degree angle. Choose the correct site: vastus lateralis for infants, deltoid or ventrogluteal for adults. Avoid dorsogluteal site to prevent nerve damage.

10. IM Injection Sites for Infants Use the vastus lateralis muscle for infants. Avoid deltoid and ventrogluteal sites for this age group. Why is the vastus lateralis the preferred site for infants?

11. Z-track Method for IM Injections Used for medications that can stain tissue, like iron dextran. Displace skin and tissue to the side with the nondominant hand. Inject the needle, administer medication, and withdraw. Allow the skin to return to its place. How does the Z-track method prevent tissue staining?

12. Injection Safety and Hygiene Always practice hand hygiene before preparing injections. Use gloves when administering injections. Dispose of needles and syringes in a sharps container. Never recap a used needle. What are some potential consequences of poor injection hygiene?

13. Injection Complications Be aware of potential complications like infection, bleeding, or allergic reactions. Monitor the injection site for redness, swelling, or pain. Report any adverse reactions immediately. How can you minimize the risk of complications?

14. Documentation of Injections Record the medication, dose, route, site, and time of administration. Note any patient reactions or side effects. Ensure documentation is clear and accurate for continuity of care. Why is proper documentation crucial in patient care?

15. Patient Education and Consent Explain the purpose and procedure of the injection to the patient. Obtain informed consent before administering the injection. Provide post-injection care instructions. How can effective patient education improve injection outcomes?

16. Review of Injection Techniques Intradermal: small volume, shallow angle. Subcutaneous: fatty tissue, moderate volume. Intramuscular: deep tissue, larger volume. Practice these techniques to build confidence and skill.

17. Injection Practice and Simulation Engage in simulation exercises to practice injection techniques. Use injection pads or mannequins for hands-on experience. Seek feedback from instructors and peers. What are some ways you can practice injection techniques outside of lab?

18. NCLEX and Exam Preparation Understand the principles behind each injection technique. Study with NCLEX-style questions and scenarios. Review best practices and safety protocols. How will mastering injection techniques benefit you in your exams and future practice?

19. Common Medications Administered via Injection Insulin for diabetes management. Vaccines for immunization. Antibiotics for infections. Pain medications for analgesia. What are some considerations when administering these common medications?

20. Handling Injection Anxiety Recognize that some patients may have a fear of needles. Use distraction techniques and provide reassurance. Employ pain-reducing strategies like topical anesthetics. How can you support a patient who is anxious about injections?

21. Conclusion and Q&A We've covered the key points of injection preparation and administration. Practice is essential to becoming proficient in these skills. Do you have any questions or need clarification on any topics discussed today?