1.

IN THE MEDICATION ROOM

a. Wash hands
b. Verify prescribers orders to the MAR
c. Pull vials, needle and syringe from drawers
i. Select appropriate medications
1. if necessary, check meds other name on phone
ii. Select appropriate needle/gauge
1. For sub Q: 27 needle on far left
a. 3/8-5/8
b. 25-27
2. For IM: 23 1 needle, 3rd drawer (these are just the
needles Ive picked; others are okay as long as they fit
guidelines)
a. 1-1/2
b. 21-25
iii. Select appropriate syringe
1. insulin
a. in units, in far right of drawer. Has needle attached.
b. ORANGE TOP
2. anything else
a. in mL, in other cubicles, 1-10 mL
b. quickly do the math in your head to figure out the
one you need so if youre giving 3 mL, youll
need to get the 5 mL syringe
iv. Check meds to the MAR again
v. Grab necessary supplies
1. black tray
2. alcohol preps
3. pencil and paper
4. chosen meds/supplies
5. the notebook c MAR in it
2. AT THE TABLE
a. Sit down and check meds to MAR
b. Do calculations of how much you need
i.
ii. For insulin NPH, it should tell you units
iii. For insulin R, consult the sliding scale in the notebook
c. Prepare each one
i. Clean the top of the vials c alcohol
ii. Make sure you roll insulins
iii. Aspirate before you inject
iv. making sure there are no bubbles
1. if bubbles, tap syringe
2. turn syringe upside down to make sure there are no bubbles
d. Write on syringe wrappers after preparing each
i. Medication name

ii. Route
iii. Amt ordered
e. Go ahead and open your alcohol preps for Pt room
f. Submit your meds for review
3. IN THE PT ROOM
a. Handwash
b. Check meds to MAR
c. Introduce yourself to Pt
d. Check ID band and two Pt identifiers (Name, DOB)
e. Explain procedure
i. Tell pts medications names
ii. Tell pt the purpose of each one
iii. Tell pt what you are going to inject where
4. PT POSITIONING
a. Put on gloves
b. Ask Instructor which medication they want administered first.
i. SUBQ
1. ABDOMEN
a. Im going to go below the costal margin
b. between the iliac crest
c. Im putting my fist on the umbilicus
d. And Im going to inject in the fatty part below the
umbilicus and above the pubic symphysis
ii. IM
1. VASTUS LATERALIS
a. Could you help me position the patient on their
side, please?
b. Im placing my hand on the greater trochanter
c. Im placing my other hand below the knee
d. Im going to inject in between
2. VENTRAL GLUTEAL
a. Palm on greater trochanter
b. Thumb towards the groin
c. Middle finger on top of iliac crest
d. Other three on iliac crest
e. Inject in V between index and middle finger
5. Injection
a. SUBQ
i. Into the blob
ii. Pinch the corner of it
iii. Go in at 45 degrees (easier)
iv. Apply alcohol
1. Inject the needle
2. stabilize the needle
3. Inject meds
4. pull out

5. gauze
6. sharps disposal
b. IM
i. VASTUS LATERALIS/ VENTRAL GLUTEAL
1. into the manikin
2. follow appropriate placement procedures above
3. z track
4. clean area
5. INSERT NEEDLE
6. ASPIRATE- 5
7. INJECT MEDS-10
8. HOLD -10
9. REMOVE NEEDLE
10. APPLY alc prep
11. DISPOSE OF SHARPS
6. FOLLOW-UP
a. Now Im going to position the pt for their comfort Im lowering the
bed, putting up the side rails, elevating the HOB, and making sure the call
button is within reach
b. REASSESS PT
i. Im going to come back thirty minutes to check on you and see
how your ________ and ___________ is.
c. DOCUMENTATION
i. Lastly Im going to document the procedure in the MAR
1. medication
2. route
3. loc
4. pt response