med error..

I am assuming the nurses use the right deltoid out of habit. It reminds me of bringing my dog to the vet for shots...the vet always uses the same location for specific shots so if there is a localized reaction they will know which drug caused it. Is it wrong to put give it on the left side? No. Is it wrong to give it some place other than the deltoid? No. I bet it is just out of habit/routine. Will it cause problems for the patient? No. Can you get sued? No. Relax, you did fine.

Yeah there is no difference in the right or left deltoid except one is on the left and the other is on the right. Either one is fine. You did no harm.

on the medex it said to administer pneumovax 0.5cc IM to deltoid. Not specifying WHICH deltoid it is. So I just gave it to one of the deltoids. My mom works at this SNF as a LPN too. I told her I gave pneumovax and when she asked where i put it, i told her "LA deltoid" and she told me that pneumovax always goes in the RA deltoid. Like I said, no specification on the medex as to WHICH deltoid it was supposed to be given, which I told her. I'm a new nurse at this SNF and no one had told me that pneumovax is always given to the RA deltoid. I'm wondering if this is a major error? I'm freaking out and I don't want to lose my license or get sued for something like this, I dont feel like it's a "big" deal since it still went into the deltoid. I would just like to know your opinions on my situation?

I've never seen that in a policy before but check your policy and procedure manuals.-It probably is nursing preference...You'll document which arm you gave it in on the MAR and in any other records the facility uses-it is NOT a med error...

We often give our vacs early in the shift and most of the residents are still in bed so we'll use which ever side is up.

Yeah, I wouldn't worry, either. I had a similar incident happen as a vaccination nurse administering flu and pneumococcal vaccinations. The literature stated pneumonia right and flu left. I forgot and did it the other way around. Then, I thought about it...what if the right side is contraindicated? Discussed it, found out it didn't make a difference. It does make it easier to follow in case you forget, though. I make it a habit to use pneumonia on the right deltoid, so, in case I have to chart later than I intended, I will automatically know (especially, if I gave more than one injection), that pneumonia was administered on right. We have the same for PPD...most people place it on the left forearm, but some nurses do place it on the right.

I asked my charge nurse today about the situation and she also said it doesn't matter and that it used to be a protocol, but since some residents have a dialysis site in the RA, you'd have to use the left and so that's why they changed it. Thanks a lot you gals/guys! I'm definitely going to look into taking a nursing and the law course. I was just freaking out but you all have made me more at ease. Thanks again!

If it's not specified on the transcribed order, it's not your fault. Just like the PPD is 'usually' giving where I come from in the left forearm, it's a general 'rule.' Dont worry.

I give most of my injections on the L delt. Why? because the chair next to my desk is on my LEFT. It matters not. Your mom is messin' with ya.

I asked my charge nurse today about the situation and she also said it doesn't matter and that it used to be a protocol, but since some residents have a dialysis site in the RA, you'd have to use the left and so that's why they changed it. Thanks a lot you gals/guys! I'm definitely going to look into taking a nursing and the law course. I was just freaking out but you all have made me more at ease. Thanks again!

Most dialysis grafts I've worked with have been in the forearm, no where near the deltoid.

LOL, I agree, mom is messing with you. I was told at one time (when I did emplyee health vac's) that you give it in the left because most people are right handed and you did not want to make them call off work because arm was sore LOL (yep, they were messing with me then too!!!) :)

I've never seen a protocol written for a particular site for a subQ or IM injection. Generally just follwed what I was taught in nursing school. (Deep glut or siggsted deltoid etc,etc,). More importantly if the patient is lucid and genrally healthy, I ask them which arm would you prefer to have your "flu shot" given in? It's there body and of course I woulndn't give an inj with the chance of danger to a site . That is why I observe the site first. I had a guy who had polio when he was younger and it effected the left arm, he choose the left arem, but I told him the blood flow may be better in his dominant arm and I gave it with his permission in the right.

It's like knocking on the door, asking a patient if you can come in. Utilize their rights. I agree with the above posters, nursing and law ethics is a very informed areana to help you know of your nursing rights. You're mom probably did the Right arm out of habit and thinks that that should stand for all inj. I disagree with that, she's not getting the injection.

You did fine. Chin Up!!!!

.....AND FURTHER MORE.... the Dr's order should simply say "drug", 0.5 ml, one time only, IM. As long as it's IM,it's the nurse's and/or pt's choice as to which area.(butt or delt).