For this reflection I will be using the Gibbs cycle of Reflection. (Jasper Pg. 77) During a home visit to a service user (SU) I was required to administer a Depot medication by injection. Depot medication is administered by injection and is slowly released into the body over a number of weeks. (RCP 2007) Firstly I gained informed consent from the service user in accordance with the NMC Code (NMC 2008). After consent was given, I then referred to the SU record card to check this was the right drug, being given to the right patient by the right route and at the right time.
(Kozier Pg. 52), I checked the medication was the correct and in date and checked with my mentor. Then as documented on the SU card checked to see which buttock left or right was injected previously. After putting on latex gloves, I then prepared the drug for administration, there are two parts to this particular medication Consta Riperidon, (BNF) which is powder and liquid and needs to be mixed, so followed the instructional leaflet which states step by step the procedure for mixing and preparation whilst being supervised by my mentor. (mentalhealthnurse 2005)
I had the sharps container close to me so I can dispose of the used syringe safely, gauze to use when I had finished the injection in case of any bleeding, and a plaster partially unwrapped and half stuck to my glove, so it will be ready to place on the site where the needle had pierced the skin. I wiped the Dorsgluteal site, upper outer quadrant of the buttock (NHS) with a sanitising wipe and waited for it to dry, (Timby Pg 806) I was then ready to administer the drug and checked the SU was happy for me to go ahead, which she was so let the SU know that they would experience a sharp scratch.
Using the z track technique which is a technique which reduces pain and leakage from the injection site, and at 90 Degrees (Timby Pg. 806) I inserted the needle all the way into the buttock. (UEA Pg. 5) Before administering the contents of the syringe, I attempted to aspirate to check there was no blood and had not pierced a capillary, however I found this difficult, my mentor was happy for me to continue, so administered the contents of the syringe at a slow and steady pace (UEA Pg.5) whilst making sure the SU was ok and comfortable.
I then withdrew the needle, covered the site and pressed down with the gauze, at the same time as I had my sharps container to hand, disposed of the syringe. I then checked for any visible bleeding which there was slight evidence and asked the SU know if it would be ok to apply a small plaster to the area making sure there were no allergies known to plasters. I then let the SU know I was finished and that they were able to adjust their clothing.
I then updated the SU drug record card which my mentor countersigned, then on arrival back to the office documented on the SU notes stating a home visit and administration of medication had taken place then asked my mentor again to check and countersign. This is to adhere to the Nursing and Midwifery Council 2008 (NMC) guidelines stating, “You must keep clear and accurate records of the discussions you have, the assessments you make, the treatment and medicines you give, and how effective these have been” (NMC Pg6).
Feelings I was apprehensive about giving my first injection with regards to how it would feel and how resistant the skin may be. I felt I needed to remain confident so as not to worry the SU, however the SU did know it was my first time giving an injection and was very relaxed and reassuring which put me at ease. I spent a lot of time checking I had the right medication and was mixing it for the right amount of time and checked with my mentor that I had done this correctly.
Evaluation
I did wonder if the SU should be told that this was my first injection, as this could perhaps cause the SU to be nervous, but I had previously met this SU on my taster placement and reassured me that they were very happy for me to do this for the first time. This gave me confidence to go ahead. I had made all the correct checks with regards to the medication and expiry date. Analysis The procedure I felt went well, I did feel very nervous and worried I would be clumsy with having to mix the powder and liquid. I think it is best to try and appear relaxed and confident throughout, this looks professional and the SU will feel reassured.
It is also important to maintain communication throughout, by asking if they are happy to go ahead, and what position they find most comfortable and warning them that you are about to proceed, this will relax the SU and help establish a therapeutic relationship. Conclusion It was difficult to judge with regards to the skins resistance and at what pace you should expel the contents of the syringe which is, according to Critical Skills Ltd approximately one millilitre per one ten seconds however I was talked through the procedure by my mentor. (UEA Pg. 5) Learning Outcomes Achieved.
1, 2, 4, 5, 7, 8, 9, 11, 12, 14 Word Count 898 References Jasper, M. (2003) Beginning Reflective Practice Foundations in Nursing Health. UK: Nelson Thornes. Timby B,K. (2009) Fundamental Nursing Skills and Concepts 9th Edition. Philadelphia: Lippincott Williams and Wilkins Kozier, B. (2008) Fundamentals of Nursing – Concepts, Process and Practice. Essex: Pearson Education The British National Formulary Risperidone.
Retrieved March 23rd 2011 from http://bnf. org/bnf/bnf/current/119713. htm? q=consta&t=search&ss=text&p=1#_119713 RCP. Depot Medication. Retrieved March 23rd 2011 from http://www. rcpsych. ac.uk/mentalhealthinfoforall/problems/schizophrenia/depotmedication. aspx Janssen-Cilag Ltd Consta Risperidone. Retrieved March 20th 2011from http://www. mentalhealthnurse. co. uk/images/Psychopharmacology/Risperdal%20Consta%20PIL. pdf.
The Nursing and Midwifery Council. The Code. Retrieved March 20th 2011from http://www. nmc-uk. org/Documents/Standards/The-code-A4-20100406. pdf University of East Anglia. Injection Administration. Retrieved March 20th 2011from https://portal. uea. ac. uk/webapps/portal/frameset. jsp? tab_id=_2_1&url=%2fwebapps%2fblackboard%2fexecute%2flauncher%3ftype%3dCourse%26id%3d_85962_1%26url%3d.