SCIG (SC)

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Pharmacy specific orders / instructions always supersede the Agency guidance provided below. If in doubt, do not guess, call our office, or tag @TeamHelp-CareCoordination(Best Tag) and ask for Clinical Support.

ALWAYS make sure you have everything you need to complete infusion before you begin

ALWAYS confirm your medication dose against the medication label and orders

ALWAYS reach out to us first (not the Pharmacy) with any questions

NEVER tell a Pt you have not given a particular medication before

NOTE: This may be a TEACH or may be a RN infusion.

MIXING

Obtain a clear/clean space to prepare the SCIG
Be sure all the necessary supplies are available to complete infusion from beginning to end. You will need subcutaneous needle set, solution container (Bag or syringe), Tegaderm, pump tubing, pump, transfer device, syringe(s), alcohol, gauze, tape, sharps container, infusion log and other supplies as needed.
Use a transfer device (i.e., syringe and mini-dispensing pin or needle) to draw up the ordered dose
Prepare the infusion pump following the manufacturer’s instructions, including attaching any necessary adapters
Prime (fill) the infusion tubing. To prime the tubing, connect the syringe filled with SCIG to the infusion tubing and gently push on the syringe plunger to fill the tubing
- Stop priming before fluid reaches the needle.
Insert syringe into the infusion pump.
Select access area for the infusion
- Clean the skin at each site with an antiseptic skin prep. Let the skin dry.
- Using two fingers, pinch together the skin around the infusion site. With a quick dart-like motion, insert the needle straight into the skin.
- Secure with Tegaderm
Recommended infusion sites include subcutaneous tissue in the abdomen (most common) thighs, upper arms, and the side of upper leg/hip. Site considerations:
- Up to eight sites may be used at the same time. Four or fewer is most common.
- Sites should be rotated to minimize irritation.
- If more than one site is being used, be sure the sites are at least 2 inches apart and avoid the 2-inch circumference of the umbilicus.
- DO NOT use sites that are scarred, bruised, broken, or inflamed.
- The number of infusion sites and needle size will be dictated by the MD/Pharmacy order.
- Rotate sites with every infusion

ADMINISTRATION

Take baseline vitals and document basic assessment
Follow the manufacturer’s instructions to turn on the infusion pump
Monitor patient for any adverse reactions.
Record vitals every 15 minutes after infusion start, AND 5-10 minutes post infusion
Record lot numbers and expiration dates for vials used.
When completed, turn off the pump, disconnect patient and remove SC needles
- Place gauze or Band Aid at sites
Instruct patient to record infusion in an infusion diary, sent by pharmacy
- Brand of SCIG
- Batch number/sticker
- Date and time of infusion
- Length of infusion
- Any reactions to infusion
Clean and dispose of used supplies.

RN TEACHING PATIENT/CAREGIVER TO ADMINISTER

If teaching the patient/caregiver to administer the medication independently the same steps above are applicable. In addition, the Agency nurse shall:

Assess the client’s learning readiness and ability to pay attention and perform the required tasks
Explain the purpose of the medication, why this route is preferred, and why site rotation is important
Instruct the client regarding the potential side effects of the medication, including delayed hypersensitivity and anaphylaxis, which can potentially occur after the patient has received several doses of the medication. Ensure patient knows when to reach out to EMS.
Explain that the medication should be taken as prescribed until the MD/provider directs otherwise.
Allow the patient/caregiver to discuss any unresolved questions or concerns about the medication
Proceed to teach the patient/caregiver the techniques for administration
Observe and document when the client has successfully verbalized and/or demonstrated independence with medication administration and related therapy education elements including the importance of hand hygiene, storage, and handling of medication, supplies and pumps, preparation of medication using aseptic technique, subcutaneous site selection, cleansing, insertion and removal pump preparation, discontinuing treatment, and waste disposal.
When teaching the patient to self-administer, each clinical note must include the patient/caregiver’s progress toward the goal of independence. The narrative note should specify what steps/goals the client has accomplished and what additional teaching / education elements they still need to achieve. If any concerns exist regarding their ability to perform any tasks and/or become independent, it should be documented in the note and reported to the Agency