Medication Administration - Subcutaneous Medication Policy

Medication Administration - Subcutaneous Medication Policy 

Purpose: To ensure safe and effective administration of subcutaneous medications to residents in compliance with CMS guidelines and the State Operations Manual (SOM) for long-term care facilities. 

Procedure: 

I. Preparation: 

• Prepare the medication. If the medication is a suspension, mix well before withdrawing. Check with the pharmacy if there is any question about the appearance of the drug. 

• Calculate the correct amount of medication. 

• Prepare the syringe and needle. 

• Swab the rubber cap with an alcohol sponge. 

• Pull back the plunger to draw a volume of air into the syringe equal to the volume of medication to be given. Inject the air into the vial. 

• Withdraw the correct amount of medication. 

• Do not recap the needle. 

• Obtain an alcohol sponge for skin preparation. 

II. Documentation: 

• Document medication administration. Rotate sites. Document the injection on the MAR along with the site used, as follows: 

• Left Arm (LA) 

• Right Arm (RA) 

• Left Thigh (LT) 

• Right Thigh (RT) 

• Left Abdomen (LS) 

• Right Abdomen (RS) 

• Left Buttock (LB) 

• Right Buttock (RB) 

III. Site Selection and Preparation: 

• Select an appropriate site for injection. Be sure to give medication in subcutaneous tissue as opposed to muscle. 

• Adjust the resident’s position. 

• Cleanse the skin with an alcohol sponge using a circular motion from the center of the chosen site until an area about 3 inches in diameter has been prepared. 

IV. Injection: 

• Grasp, pinch, and swab a cushion of flesh. 

• Hold the needle with the bevel side up and insert at a 45-degree angle. 

• Insert the needle quickly. 

• Pull back on the plunger to see if the needle is in a blood vessel. If so, withdraw the needle, secure new equipment and medication, and repeat the procedure. 

• Inject the medication slowly. 

• Remove the needle quickly. 

• Wipe the area with an alcohol sponge. Apply pressure over the injection site. Do not rub. 

V. Disposal: 

• Discard the syringe and needle in the designated area. 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.