Sample Nursing Paper on Teaching document on Giving Injections

Teaching document

Conducting an injection requires that a nurse have the right skills to do it in the right and safe way. It means that every nurse needs to learn about the proper techniques that they can use to conduct an injection. They need to use evidence based practice as a guideline on injecting people from children to adults in order to minimize complications or cause any form of discomforts on the person who is receiving the injection. The further requirement when conducting the exercise is good communication whereby the nurse explains to the parents of a child or an adult receiving the injection on what to do or not to do before and after the procedure is completed. The following are some of the procedures that nurses can use to conduct intradermal, subcutaneous and intramuscular injection in a safe way.

  1. Intramuscular injection

When conducting an intramuscular injection, a nurse has to understand that they are administering the drug on the human muscles. The practice is common when conducting immunizations in children. The preferred site to do the injection is the deltoid muscle because only a small amount of injections is administered. At the same time, vastus lateralis site should be preferred (GOSH, n.d). The following procedure should be followed for effective results to be achieved when conducting intramuscular injection:

The first step is identifying which is the right site to inject based on the child’s age. It is important to note that 2ml is the maximum medicine volume that is appropriate for intramuscular injection on the thigh (GOSH, n.d). On the other hand, the nurse should only inject 1ml volume of the medicine on the deltoid muscle. The second step involves preparing the site of injection with the main intention of disinfecting it. The third step is administering the injections whereby the nurse has to take caution not to contact the bone with the needle. However, deep penetration has to take place. The needle should be held and inserted while at the angle of 90 degree. The forth step involve aspirating but in the case of immunization this step is not necessary. The main reason for aspirating is to check any blood which might endanger the patient if injected. However, if there is no presence of blood, the drug is administered by pushing the needle plunger slowly and in a smooth way (GOSH, n.d).  When blood traces is identified, the nurse has to take out the needle using the syringe then conduct the procedure again.

There are different techniques to hold and insert the needle during injection. The stretch technique involves stretching the skin using the thumb and the forefinger while the other hand is used to hold and insert the needle on the skin. During this time, the syringe should be at the motion angle of 90 degrees. A plunger depression should be used whereby the medication is released within 10seconds for every 10ml (Doyle & McCutcheon, 2016). There is also the pinch up method where the nurse gets to pinch the skin where she wants to inject. The needle is then inserted but in a dart motion after which the pinch is released. Lastly, the z-track method involve both pushing and pulling the skin in the same direction before inserting the needle which is held in 90 degrees angle and dart motion observed. However, the technique is tedious thus not advisable to be used on small children though it is the best for minimizing pain after injection.

  1. Subcutaneous injection (SC)

The process involves administering the medication on the dermis and epidermis skin layers. The procedure is commonly used when administering heparin or insulin. The injection is conducted on the upper thigh, buttocks, the upper arm or on the abdomen depending on which medication is being administered.

The first step in conducting the injection involves identifying the right spot for administering the medicine. The second step is cleaning it using cotton inserted in a disinfection substance to disinfect area. The third step involves bunching up the skin gently as a way to avoid injection the other muscle layers. However, in this case aspiration is not required. The needle must be placed in a 90 degrees angle when inserting on the skin. Take note that if the child being injected has less subcutaneous tissue then the best needle length to use is one which is not longer than mm and it must be placed at an angle of 45 degrees (Doyle & McCutcheon, 2016). The injection process should be quick though the medication should be slowly released on the body. The process of withdrawing the needle also needs to be quick.

  1. Intradermal injection

The first step involves identifying the right spot which can be upper back or the forearm. Ensure that there are no hairs, rashes or lesions for safety purposes. Clean the spot and then use a needle which is of an appropriate size. The most recommended needle is 26G 10mm though the intradermal medication is always 1ml (GOSH, n.d). The child needs to be distracted before injection is conducted. The next step involves stretching the skin using the forefinger and thumb while the other hand is used for insertion purposes. The needle in this case should be placed at an angle of 10-15 degree. The needle should then be quickly but gently removed and disposed in a container for safety purposes. The nurse is then expected to remove their gloves and thoroughly wash their hands.

It is important to follow these steps while conducting injection for safety purposes. Locating the right place to inject is important to avoid swelling or administering the medicine on the wrong place. If a wrong spot is injected, there is a possibility of damaging the blood vessels or might even result in death of the patient (Doyle & McCutcheon, 2016). It is also important because there are some medications that cause a rapid effect if caution was not observed during injection. The other safety measure that should be taken involves administering the right dosage as a way to prevent the tissues from getting damaged. The best way to prevent the injected part from being infected or becoming septic is by cleaning the area and using needles that are properly sterilized.

 

 

References

Doyle, G.R. & McCutcheon, J.A. (2016). Parenteral medication administration. Retrieved from https://opentextbc.ca/clinicalskills/chapter/6-7-intradermal-subcutaneous-and-intramuscular-injections/

GOSH. (n.d). Administration of medication via intradermal, subcutaneous and intramuscular injections. Retrieved from http://www.gosh.nhs.uk/administration-medication-intradermal-subcutaneous-and-intramuscular-injections