First injection mistake

carti, BSN, RN · Nov 6, 2018

nope nothing is gonna happen. If you forgot to clean their skin before an injection, make sure you do it again next time.

if it makes you feel better, I see nurses that I shadow at clinical forget to clean the hub of the vial before they get the medication out.

em96 · Nov 7, 2018

I think you're okay, no need to say anything. One nurse I followed never swabbed the skin before insulin injections because she said diabetics never do that when they're at home. I don't know if that's true or not, but the risk of harm from not cleaning the skin with alcohol before injection is pretty low. On the bright side, mistakes like these are learning experiences and you'll remember it every time you give an injection- so it probably won't happen again :)

akulahawkRN, ADN, RN, EMT-P · Nov 7, 2018

While this technically is an error, it's not the end of the world. Many diabetics don't swab themselves before giving injections and most of the time they have no problems whatsoever. This is because they're not introducing new flora to the skin nor into it. However some people don't have good hygiene so... it's those people that are going to have problems. Of course those people are the same ones that will easily develop skin abscesses from pretty much any scratch anyway.

Don't forget that if you're not letting the alcohol dry before you do the injection, you're effectively doing an injection without proper cleaning anyway. If you're going to be swabbing, you must swab and let the alcohol dry every time you swab something.

rnhopeful82, ASN, RN · Nov 7, 2018

Honestly, the only reason I use an alcohol swab before I change my pump site is to help the tape stick better. I never use them on my finger sticks on myself and I smile when they use alcohol and then gauze after when I go to the doctors. I laugh when they ask if I want a bandaid. I wouldn't have any fingers left to use if I used a bandaid every time I checked my sugar! I do use alcohol swabs on patients, who probably smile a little inside, too. It's safe practice and required, but I don't think you need to stress too hard on this. I'm sure the patient has done worse and will continue to do worse in the future. Just make sure you do it going forward :)

203bravo, MSN, APRN · Nov 7, 2018

none of my preceptors were around so no one saw me.

May I add that of your post - this is the statement that bothers me the most.

TheDudeWithTheBigDog, ADN, RN · Nov 8, 2018

Hey everyone,
i just recently learned to give injections and I signed up for a clinic to get more practice. I was so nervous I completely forgot to use an alcohol swab on their skin. I feel so bad, but none of my preceptors were around so no one saw me. Obviously I'll know better for next time but should I do anything about it? I just feel really guilty and can't believe it slipped my mind.

This is a problem with how our country works, and you'd think teaching an understanding of this stuff would be something we're taught early being in school for healthcare.

In normal conditions, it's very hard to get an infection from a clean needle. That bacteria that's on your skin, your body is going to kill it, that's what your immune system is for. But there's tons of other factors that can increase that risk, like other wounds, immune system problems... But it's still very hard to get an infection from that needle. He's not going to get an infection because you forgot to clean his skin one time. But it lowers the chance when you do remember to clean it. It's low enough of a chance that he might never get infected from a single needle stick his entire life, but again, that's under normal conditions. Some people are going to have problems that give them a noticeably higher chance. But there's also a chance that they'll also never get a single infection. It all comes down to "is this the unlucky injection?"

The whole point is odds. If 1 in 1,000 injections cause an infection, any injection could be that 1. But it's way more likely that injection will be that one than if it was 1 in 100,000. The point of cleaning first is to lower the chance that the injection that patient is getting is the one that leads to infection, and to lower the chance that the injection you're giving is the one that leads to infection. If you're taking insulin 3 times a day for 30 years, you have a high chance of getting an infection at some point. And if you're giving 20 insulin injections a day, 3 days a week, for 10 years, it's a high chance you're going to cause an infection at some point. All you're doing is creating a bigger time frame for where that unlucky situation might come up.

Spadeforce · Nov 9, 2018

op will prob never forget again, they will be fine, unless they got chronic granulomatous disease, jobs, or LAD which im sure they dont because nobody really does lol

KelRN215, BSN, RN · Nov 9, 2018

May I add that of your post - this is the statement that bothers me the most.

The statement you quoted bothered me too but I also have to wonder why a student is giving injections independently without any kind of supervision.

kiwinurse18 · Nov 12, 2018

In response to a few of the above comment. You shouldn't be using alcohol swabs before insulin anyway as it can affect the reading.

To the poster, there's many injections that don't require you to swab before injecting. It's not life and death, but if your preceptor had been there (like they should have been if you are a student giving medications) they could have clarified this with you.