Giving injections question....

Nurses General Nursing

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The other day when I got my flu vaccine I asked the nurse to please draw it up with a separate needle and she looked at me like I was crazy. The other 3 nurses sitting with us had never heard of it either. We were taught that if you draw up meds with a diff needle that you admin with- it keeps the needle sharper and less painful. In my 3 years as a nurse- I always do this. (except tuberculin and insulin needles- as there isn't an option)

So- thoughts? Do you change needles? Have you really never heard of this? I was told I was wasting resources. :confused:

Specializes in Critical Care.

I have heard of doing it too. I don't normally change my needle, but depending on the circumstances I sometimes do. Or I'll use a blunt needle to draw up my med, then switch to the sharp needle.

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Specializes in Med-Surg.

I have never heard of this.. even my Canadian Fundamentals of Nursing (Potter and Perry) does not say to change the needle.. unless using a filter needle when drawing from an ampule..... is it best practice to change needles after drawing your medication up when your using a vial?

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Specializes in Trauma Surgery, Nursing Management.

I always change the needle. Even when I was a vet tech in high school, I changed the needle.

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Specializes in Med/surg, rural CCU.
I have never heard of this.. even my Canadian Fundamentals of Nursing (Potter and Perry) does not say to change the needle.. unless using a filter needle when drawing from an ampule..... is it best practice to change needles after drawing your medication up when your using a vial?

I'm not sure, this is what I am wondering. I was taught to change needles in nursing school, but can't find anything to support this.

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Specializes in Med-Surg.
I'm not sure, this is what I am wondering. I was taught to change needles in nursing school, but can't find anything to support this

I just learned this last semester too... (i am now in 4th semester of my BSN)...

But i have never seen an RN do this.. nor have I ever been taught this. I mean i guess it makes sense, but I guess the rationale behind not changing it is that it's a waste of resources, and i dont think the rubber stopper

would make a difference on the sharpness of the needle. I just wonder if it is best practice why my textbook has NOTHING about it!!

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Specializes in Med/surg, rural CCU.
I just learned this last semester too... (i am now in 4th semester of my BSN)...

But i have never seen an RN do this.. nor have I ever been taught this. I mean i guess it makes sense, but I guess the rationale behind not changing it is that it's a waste of resources, and i dont think the rubber stopper

would make a difference on the sharpness of the needle. I just wonder if it is best practice why my textbook has NOTHING about it!!

I'm confused about your post. You said you just learned it, but have never been taught it?? :confused:

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Specializes in Med-Surg.

Sorry i should have been more clear. I learned how to give injections last semester. But I was only ever taught about changing the filter needle... I had never been taught about changing a needle because it could potentially get dull from the rubber stopper....

Even last week I did a heparin inj sc,... didnt change the needle... I did an ondanzetron IM last week.. never changed the needle.. (and this is under direct teacher supervision..)

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I just learned this last semester too... (i am now in 4th semester of my BSN)...

But i have never seen an RN do this.. nor have I ever been taught this. I mean i guess it makes sense, but I guess the rationale behind not changing it is that it's a waste of resources, and i dont think the rubber stopper

would make a difference on the sharpness of the needle. I just wonder if it is best practice why my textbook has NOTHING about it!!

Well there is no evidence that supports that a 1 time puncture of a rubber stopper has any measurable effect upon the type 305 stainless steel (that is also coated in a lubricant, usually silicone) so commonly used in needles.

I have found a couple studies, one I posted, that basically says there is no appreciable dulling or wearing from a one time puncture of a rubber stopper.

This might be one of those Nursing myths that are so common that are based on loose facts and half truths (like the "Using coke to declog a g-tube" myth)

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Specializes in Peds/outpatient FP,derm,allergy/private duty.
I have given 50 flu shots to employees this week. Never once changed a needle (never heard of doing this). At least 75% made a specific comment on how painless their injection was. All in the technique.

I agree! I'm always mindful that times change and the sheer number of times I've given injections aren't a scientific study, but I don't believe it. I was also skeptical of the idea that if you didn't use a filter needle to draw from a glass ampule you would be injecting glass fragments into the patient, so I looked far and wide for evidence that had ever happened for naught. My thought was that if it were true, there would have been at least one case out of literally millions to prove the point. So it's based on conjecture. If anyone knows of studies on this issue I'd love to see!

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I agree! I'm always mindful that times change and the sheer number of times I've given injections aren't a scientific study, but I don't believe it. I was also skeptical of the idea that if you didn't use a filter needle to draw from a glass ampule you would be injecting glass fragments into the patient, so I looked far and wide for evidence that had ever happened for naught. My thought was that if it were true, there would have been at least one case out of literally millions to prove the point. So it's based on conjecture. If anyone knows of studies on this issue I'd love to see!

Found this although it does not actually give numbers of poor outcomes rather lists a lot of "potentials"

http://classic.aacn.org/aacn/practice.nsf/a40dd285cb9efd8e8825669e00031e21/69d2c30ba9fa866c88256754006d7cde?OpenDocument

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Specializes in Nursing Professional Development.

It sounds like a good topic for a research project to me. Is the cost of switching needles worth it?

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I really think that 90% of the time people just THINK IM injections are going to be painful... I don't necessarily think it's technique or needle-related, I think it's just that IM injections aren't nearly as painful as people are fearful of needles and think they are going to be severely painful.

Just my observation from my weekend at a flu clinic. (BTW I didn't change needles between drawing and giving, although we were supplied with additional needles that I'm assuming were for that purpose... they just didn't fit on the syringe, oops.)

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