Giving injections question....

[AprilRNurse]

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.

[kesr]

Injecting insulin is the exception. Studies have found decreased accuracy of delivered insulin doses with syringes that had detachable needles compared with non-detachable needles."

That make sense, those doses are such small volume that the amount in the needle dead space make matter.

Interesting thread!

[MissJulie]

We've been taught that you always change the needle, except with insulin of course, even with TB (the syringes we use have detachable needles). The biggest reason is that once the needle has been used to draw up the medication, it is no longer sterile. Also, when drawing up the medication, especially after expelling any air and possibly having a drop of medication on the needle, it is no longer sterile.

I think the biggest thing here is the observance of proper aseptic technique, not the use of resources. Of course, every nurse does things differently (or so I am told) and policy differences could affect this as well.

The basic thing I took away from our lab was this: If in doubt, change the needle.

[HamsterRN, ADN, RN]

Can you cite any case studies or examples of what you described happening or is this a personal theory?

I can say that there is a RISK of introducing foreign matter or infection by changing needles. As we know the more times a sterile delivery mechanism is manipulated the greater the chance of contamination.

I was also taught that the main concern is coring when entering the vial, which is the advantage to blunt, "non-coring" needles when accessing a vial. Accessing a vial using a regular needle the switching to another regular needle doesn't solve this problem.

How to Enter a Medication Vial Without Coring â€" A A

[cookziedough]

Can you cite any case studies or examples of what you described happening or is this a personal theory?

I can say that there is a RISK of introducing foreign matter or infection by changing needles. As we know the more times a sterile delivery mechanism is manipulated the greater the chance of contamination.

I haven't really noticed much articles about this topic but there probably were studies for it already that led to articles such as below:

http://www.gethealthyharlem.org/articles/did-you-know...-using-same-needle-more-once-can-hurt-your-veins

Over the years, I have personally had experienced seeing particles inside a vial AFTER puncturing the rubber stopper with the needle. This usually happened with a larger lumen needle. As I've said, it is all about SAFETY for our patients as the FIRST priority that nurses ought to think of. Yes, resources need to be properly handled these days, too, so we won't be wasting any, but I believe it doesn't really count in situations where you need to have to use items only once.

I am aware of TB and Insulin syringes, though, which have attached needles. I'm not really sure about it, maybe related to needle size still... ?

Just my opinion...:)

Be Blessed Always!

[AprilRNurse]

Thank you so much for your answers! I'm still not sure what is truly "best practice" but at least I know I'm not odd and wasteful for changing the needle. Maybe I'll e-mail my manager and see what we're supposed to be doing.

[leslie :-D]

Thank you so much for your answers! I'm still not sure what is truly "best practice" but at least I know I'm not odd and wasteful for changing the needle. Maybe I'll e-mail my manager and see what we're supposed to be doing.

i thought my link (post #46) from lippincott's nursingcenter, pretty much answered your question?

it is a very reputable source...

but great idea about going to mgr.

if not already, have him/her make it a part of your p&p manual.

leslie

[HamsterRN, ADN, RN]

i thought my link (post #46) from lippincott's nursingcenter, pretty much answered your question?

it is a very reputable source...

but great idea about going to mgr.

if not already, have him/her make it a part of your p&p manual.

leslie

I'd avoid Lippincott whenever possible, Moseby's Nurse consult, or for that matter any person off the street is a better source of nursing information than Lippincott.

[CorpsmanRN, BSN, RN]

I switch needles (it's what I was taught in Corpsman school). I don't recall what they taught us in nursing school though.

Usually what I notice that causes discomfort is the medication being injected (& maybe how fast the person injected it).