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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. 

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