Saint Paul University Philippines
Tuguegarao City, Cagayan 3500
School of Nursing and Allied Health Sciences
COLLEGE OF NURSING
ADMINISTERING INTRADERMAL INJECTION
LEARNING OBJECTIVES:
• Identify guidelines for safe medication administration
• Discuss indication for the subcutaneous route
• Identify properly locations/sites for subcutaneous injection
• Demonstrate proper subcutaneous injection technique
EQUIPMENT NEEDED:
• Tuberculin syringe
• Client’s Medication Administration Record (MAR)
• Vial or ampule of medication
• Alcohol swabs or cotton balls with alcohol
• 2×2 sterile gauze square (optional)
• Clean gloves
• Pen with blue or black ink
NOTE:
Since you are doing this return demonstration in your homes without physical supervision from
your clinical instructors, you will not be allowed to do the skill on an actual patient. Please
prepare an alternative object were you can do the injection technique. You may opt to use an
orange/citrus fruit, a foam, a small pillow or a stuff toy in replacement for a human patient.
Please also prepare your own disposal bin for your syringes such as an empty plastic bottle with
cap (preferably a Zonrox bottle).
SCENARIO:
Prior to beginning antibiotic therapy to a patient who has scarlet fever, you were asked to
conduct skin testing for penicillin on the said patient in the inner surface of his forearm.
EVIDENCE TO BE PRODUCED RATIONALE
1. Check the Medication Administration To avoid medication errors
Record (MAR) or doctor’s order.
• Check the label on the medication carefully
against the MAR to make sure that the correct
medication is being prepared. Also check for the
dose, route of administration, time and frequency.
2. Gather and organize the equipment. To ensure that all supplies needed
are available and accessible for the
nurse to use
3. Perform hand hygiene and observe appropriate To prevent transfer of
infection control procedures microorganism
4. Greet and introduce self then verify the clients To recognize the correct patient
identity using two (2) patient identifiers
5. Explain the procedure to the patient. Provide To enhance patient’s cooperation
information to the patient of what drug he/she
would be taking. Explain that the medication will
produce a small wheal called bleb and that it may
produce redness and induration (hardening), which
will need to be interpreted at a particular time.
6. Assess the client’s ability or willingness to
cooperate.
7. Provide privacy.
8. Ensure adequate lighting.
9. Lock and raise the bed to a working height.
10. Keep the equipment or supplies within reach.
11. Position the patient in a comfortable position
(may sit or lie down)
12. Locate and clean the site.
• Locate the area for injection (inner surface of the
forearm)
• Check and make sure that the site is not tender,
inflamed, or swollen and that it does not have any
lesions.
• Apply gloves as indicated by agency policy.
• Cleanse the skin at the site using a firm circular
motion starting at the center and widening the
circle outward. Allow the area to dry thoroughly
13. Prepare the syringe for the injection.
• Remove the needle cap while waiting for the
antiseptic to dry.
• Expel any air bubbles from the syringe. Small
bubbles that adhere to the plunger are of no
consequence.
• Grasp the syringe in your dominant hand, close to
the hub, holding it between thumb and forefinger.
Hold the needle almost parallel to the skin surface,
with the bevel of the needle up.
14. Inject the fluid.
• With the nondominant hand, pull the skin at the To facilitate easier entry of the
site until it is taut. (Grasp the client’s dorsal forearm needle and provide less discomfort
and gently pull it to tighten the ventral skin or pull for the client.
the skin gently using the thumb and forefinger of
the non-dominant hand)
• Insert the tip of the needle far enough to place This verifies that the medication
the bevel through the epidermis into the dermis. entered the dermis
The outline of the bevel should be visible under the
skin surface.
• Stabilize the syringe and needle. Inject the
medication carefully and slowly so that it produces
a small wheal on the skin.
15. Withdraw the needle quickly at the same angle
at which it was inserted.
• Do not massage the area. Massage can disperse the
medication into the tissue or out
through the needle insertion site
16. Circle area with pen, write the name of the To facilitate relocation of the area
drug injected and the particular time when you will during rechecking of site for
recheck the site (after 15 to 30 minutes). Instruct reaction.
patient not to wash off nor scratch the site.
17. Position the client in comfortable position.
18. Remove gloves and wash hands.
19. Document all relevant information.
20. As part of the follow-up care, return to the
patient following the indicated time written on the
injection site and check for any skin reaction.
