HHC Health & Home Care Clinical Policy And

HHC HEALTH & HOME CARE Section: 6-6
Endocrine: Insulin Administration - Subcutaneous Injection __RN
PURPOSE: 8. Vials of insulin not in use should be refrigerated.
To introduce a prescribed dose of insulin into the
subcutaneous tissue.
CONSIDERATIONS:
1. Insulin may be injected into the subcutaneous tissue
of the upper arm, the anterior and lateral aspects of
the thigh, the buttocks, and the abdomen (with the
exception of a circle with a 2-inch radius of the
navel).
2. Rotation of the injection site is important to prevent
lipohypertrophy or lipoatrophy. Rotating within one
area is recommended (e.g., rotating injections
systematically within the abdomen) rather than
rotating to a different area with each injection. This
practice may decrease variability in absorption from
day to day.
3. Site selection should take into consideration the
variable absorption between sites. The abdomen
has the fastest rate of absorption, followed by the
arms, thighs and buttocks. (Insulin glargine does not
exhibit different absorption rates at different sites.)
4. Exercise increases the rate of absorption from
injection sites, probably by increasing the rate of
blood flow through the tissue around the site.
5. Avoid injecting insulin into areas of hypertrophy or
atrophy. This condition interferes with absorption
and can scar or desensitize the area.
6. Syringes may be discarded in an impervious bleach
or liquid soap bottle, tightly sealed, and disposed
with regular trash.
7. Insulin administration is an appropriate procedure to
teach to patients and families.
Extreme temperatures (86 o F, 30 o
C) and excess agitation should be avoided to
prevent loss of potency, clumping, frosting, or
precipitation.
9. Insulin in use may be kept at room temperature for
30 days after opening. An opened vial of insulin
may be kept in the refrigerator until the date of
expiration.
EQUIPMENT:
Insulin syringe with 24-30 gauge needle, 5/16 to 1/2 inch
long filled with prescribed dose of insulin
Alcohol wipe
Gloves
Puncture-proof container
Impervious trash bag
PROCEDURE:
1. Adhere to Universal Precautions.
2. Explain procedure to patient.
3. Select an appropriate injection site.
4. Clean the injection site by wiping an alcohol wipe in
a circular motion starting at the center and moving
outward.
5. Pinch up a large area of skin and insert the needle
into the skin at a 90 o angle.
6. Release the skin and depress the plunger all the
way down the barrel.
7. Hold an alcohol wipe over the site and pull the
needle straight out. Do not massage the area.
8. Discard soiled supplies in appropriate containers.
AFTER CARE:
1. Document in patient's record:
a. Medication, dosage, and site of administration.
b. Patient's response to procedure.
c. Instructions given to patient/caregiver.
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