Medication Administration - Insulin Injection Policy

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• Determine the correct amount of insulin to be withdrawn.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.