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Medication Administration - Insulin Injection Policy

Nursing Policy & Procedure Manual

Medication Administration - Insulin Injection Policy 

Purpose: 

To ensure safe and effective administration of insulin injections to residents, adhering to CMS guidelines and maintaining proper insulin storage and administration practices. 

Procedure: 

I. Preparation: 

  • Obtain insulin from the refrigerator and allow it to warm to room temperature. All insulin must be stored in a cool place. If stored on the medication cart, state the date of opening on the label. Insulin is effective for 30 days. 

  • Rotate the vial of insulin gently between hands – do not shake the vial. 

  • Determine the correct amount of insulin to be withdrawn. 

  • Prepare the syringe and needle. 

  • Swab the rubber cap with an alcohol sponge. 

II. Drawing Insulin: 

  • Hold the insulin syringe with the correct calibration in view and withdraw the ordered dosage of insulin. 

  • If the prescriber has ordered two types of insulin to be given, draw up the regular or clear insulin first, then the NPH or any of the cloudy insulins. 

  • Pull back on the plunger to admit a bubble of air to prevent the loss of insulin. 

  • Place a protector on the needle. 

III. Site Identification and Documentation: 

  • Identify the appropriate site for injection: 

  • Left Arm: LA 

  • Right Arm: RA 

  • Left Thigh: LT 

  • Right Thigh: RT 

  • Left Abdomen: LS 

  • Right Abdomen: RS 

  • Document administration in the Medication Administration Record (MAR). Include the site of administration to ensure rotation and the dosage given if using a sliding scale. 

IV. Administration: 

  • Cleanse the injection site with an alcohol wipe. 

  • Expel air from the syringe slowly with the needle pointed upward. 

  • Insert the needle quickly at a 45-degree angle. 

  • Pull the plunger back slightly to check if the needle is in a blood vessel. If blood is aspirated, remove the needle and prepare a new dosage. 

  • Inject insulin slowly. 

  • Remove the needle and apply firm pressure over the site. Do not rub the area. 

  • Discard the syringe and needle in the appropriate syringe disposal container. Do not recap the needle. 

References: 

  • Centers for Medicare & Medicaid Services (CMS), Requirements of Participation for Long-Term Care Facilities. 

  • State Operations Manual (SOM), CMS. 

Tags
Medication Administration - Insulin Injection Policy
Insulin Injection
Resident Care
Medication Administration
CMS compliance
State Operations Manual
Long-Term Care Facility
insulin storage
Diabetes Management
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