sub cut injections

[K+MgSO4, BSN]

hi guys looking for some clarification.

i have been in my new job for about 2 months and have noticed that alot of the nurses that i work with use alco-wipes on a pt before giving a sub cut injection such as heparin or clexanne or insulin. The way i was taught and worked with was not to wipe for ub cut injections esp insulin as frequent use of alco wipes will cause harding of the skin. i have asked collegues who use alco wipe why they use them (i always do on IMs or IV or blood draws) but have been unable to get a definate answer.

I was alway taught that the liklyhood of a clean pt i.e. one not covered in physical dirt or faces etc getting an infection from a sub cut injection was minimal and the risks of swabbing were greater as discussed earlier. Please correct me if I am way off base.

BTW I trained and worked on a surgical ward in Ireland and am now working on a medical / surgical ED overflow ward in Australia. Maybe a cultural thing???

Thanks K

[Lindap126]

I just finished nursing school and throughout all of my clinicals I have always been taught to wipe with an alcohol swab before giving subcutaneous injections. What you're saying makes sense, but I've always been taught to wipe. Definitely could be a cultural thing since I am in the US.

[ohmeowzer RN, RN]

you mean sub q injections ? i use alcohol wipe i let it dry a few seconds before giving the injections. i have heard of nurses not using the alcohol wipes.. i don't hold it against them , i have heard the same thing you did.. but i have been doing it my way for the longest time ... i also have heard of nurses not using alcohol wipes before poking the skin for a accucheck , i do use alcohol swab and let it dry a minute and then i poke them... i'm sure alot of people will help you .. i'm not sure i was much help..lol.... old habits die hard...

[GilaRRT]

Looking at the evidence base, alcohol wipes do not appear to make much of a difference if any in some cases. The commonly recommended procedure (wipe for a full 30 seconds & dry for a full 30 seconds) is rarely even followed by many nurses. Therefore, I can see people advocating against using alcohol swabs. In fact, some hospitals mandate that their staff use a dedicated antimicrobial scrub instead of alcohol for injections and/or IV insertion.

I would say less of a cultural practice, and simply facilities implementing policy based on the interpretation of the current evidence base.

[ayla2004, ASN, RN]

uk trained and practising nurse i don't alco wipe s/c or i/m injections but would clean with soap and water if not socially clean and do so for blood sugars.

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[MirandAck!!!]

Interesting! I think there is always a risk of infection from these injections and that is hypothetically the reason for alchohol wipes!

[ayla2004, ASN, RN]

risk of infection yes but our venipuncture/canulation p&P is that wiping dows notingd for flora removal from the area and that a scubing method side to side and up/down using chlorehxine/isoproprly is required.

and yes i was taught alco wipes cause hardering to the skin espcially in diabetcs if due to increaed frequency.

if handwashing with soap and water is best for infection control why wouldn't it not be good for injections?

[Virgo_RN, BSN, RN]

Our P&P is to use an alcohol wipe for SQ injections.

[justiceforjoy]

We are taught to alcohol swab and allow to dry completely prior to all sub-q injections with the exception of insulin.

We use just soap and water for glucose testing and insulin injections.

[mcknis]

Interesting to see the differences in cultures and edges of the world!

[GilaRRT]

Again, not so much a cultural issue. Simply the interpretation of the current body of evidence. Unfortunately, we do many things that have little to no evidence to support efficacy.

[K+MgSO4, BSN]

Thanks guys for the opions am glad that I am not doing any harm to my pt by the sounds of it - and no one has brought up any current research for using alcowipes. Have to agree with GilaRN that is something that is being done because it has always been done that way (thats why i posed the question because the only answers i got were alongthe lines of because I have always done it or i think it is best for the pt). cheers :)