5.1.7 Subcutaneous Injections

Subcutaneous Injections

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5.1.7 Subcutaneous Injections Contents Preamble ............................................................................................................................. 3 Details .................................................................................................................................. 3 Plan Development ............................................................................................................ 4 Medication ........................................................................................................................ 4 Policies and Procedures................................................................................................... 4 Support Worker Training .................................................................................................. 4 Procedure ............................................................................................................................ 5 Summary ............................................................................................................................. 6 Supporting Documents ........................................................................................................ 7 Policies ............................................................................................................................. 7 Forms ............................................................................................................................... 7 Information Sheets ........................................................................................................... 7 NGO Training ................................................................................................................... 7 Legislation ........................................................................................................................ 7 NDIS Practice Standards and Quality Indicators ................................................................. 8 5.1 High Intensity Daily Personal Activities .......................................................................... 8 5.1.7 Subcutaneous Injections ......................................................................................... 8 Human Services Quality Standards ..................................................................................... 9 3 Responding to Individual Need ..................................................................................... 9 6 Human Resources......................................................................................................... 9 Delegation of Authority......................................................................................................... 9 Version Details ................................................................................................................... 10

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Preamble BigDog Support Services Pty Ltd (BigDog) ensures that each client requiring subcutaneous

injections receives appropriate support relevant and proportionate to their individual needs and specific subcutaneous injections and medication administered.

BigDog considers it imperative to involve our clients in all aspects of their service delivery and the direction of their services to their ability. The dignity of risk is an essential part of this choice and control.

Details A subcutaneous injection is given into the subcutaneous fat under the skin. The skin is made up of different layers. Underneath the epidermis and dermis, which contain sweat glands and hair follicles, is a layer of fat. This is the area into which subcutaneous injections are given.

In this type of injection, a short needle is used to inject a drug into the tissue layer between the skin and the muscle. Medication given this way is usually absorbed more slowly than if injected into a vein, sometimes over a period of 24 hours.

The subcutaneous layer has fewer nerve endings compared to the muscle tissue, making the injections less uncomfortable for the client.

Advancements in needle and syringe technology have contributed to making subcutaneous injections even more convenient and user-friendly.

This type of injection is used when other methods of administration might be less effective.

For example, some medications can’t be given by mouth because acid and enzymes in the stomach would destroy them.

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Plan Development Each client is involved in the assessment and development of the plan for their subcutaneous injections which includes dosage measurement and calculation. With their consent, each participant’s health status is subject to regular and timely review by an appropriately qualified health practitioner. The plan identifies how risks, incidents and emergencies will be managed, including required actions and escalation to ensure participant wellbeing.

Medication There are documented written or phone orders by the health practitioner prescribing the medication that trained workers may administer by subcutaneous injection.

Policies and Procedures BigDog has appropriate policies and procedures in place, including a training plan for workers, that relate to the support provided to clients requiring subcutaneous injections and related medication.

Support Worker Training BigDog will ensure that each worker has completed training, relating specifically to the client’s injection and medication needs and high intensity support skills descriptor for subcutaneous injections, delivered by an appropriately qualified health practitioner or person that meets the high intensity support skills descriptor for subcutaneous injections. Workers must also have a basic understanding of the client’s related health condition.

Subcutaneous Injections In this NGO course, workers will learn about the use of subcutaneous injections to administer a range of medications. They will understand what a subcutaneous injection is, and the different types of medications administered using this method. Discussions on responsibilities and requirements when administering medication via subcutaneous injection and outline the recommended procedure to follow. Lastly, workers will learn about side effects and adverse reactions and their role in recognising and responding to these events to ensure the safety and wellbeing of the client.

After this lesson workers will be able to: 1. Identify what a subcutaneous injection is and what it is used for.

2. Understand the requirements for workers associated with administering medication via subcutaneous injections.

3. Follow the recommended procedures to administer a subcutaneous injection.

4. Recognise the worker role in identifying and responding to incidents and emergencies associated with subcutaneous injections.

Course duration: 30 minutes Any other client specific training will be delivered by an appropriately qualified RTO. 5.1.7 Subcutaneous Injections

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Procedure The location of injection is important for subcutaneous injections. The drug needs to be injected into the fatty tissue just below the skin. Some areas of the body have a more easily accessible layer of tissue, where a needle injected under the skin will not hit muscle, bone, or blood vessels.

Support Worker Preparation Understand the support plan (and medication management plan), confirms it is the correct and current plan for the client, and checks the client’s specific support requirements for example, type of medication, injection requirements, and individual preferences.

Check with the client on their expectations, capacity and preferences for being involved in the delivery of support.

Check with the client on their preferences for communication, including the use of aids, devices and/or method.

Communicate with the client using client-specific communication strategies, communication aids, devices, or resources, including resources in the client’s preferred language.

Prepare for hygiene and infection control.

Check required injecting equipment medication, and related consumables are available and ready for use.

Subcutaneous Injection Follow hygiene and infection control procedures.

Deliver support in ways that are least intrusive or restrictive and fit into the client’s daily routines and preferences.

Make sure the client is ready to receive support and helps them to position themselves to ensure the injection site location is accessible.

Observe the client before, during and after the injection and immediately informs an appropriate health practitioner in response to any signs of an adverse reaction or infection.

Safely handle and dispose of sharps and other consumables.

Monitor and record information required by the support plan.

Work collaboratively with others to ensure continuity and effective delivery of support.

Pre-filled Injection Set up pre-filled pens and pumps and any related equipment to administer medication.

Follow procedures to document medication administered.

Check with the client to discuss any changes needed to the subcutaneous injection support they are receiving.

Support the client to provide feedback and request changes to their support plan and other relevant plan as required.

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Summary Any client who requires a subcutaneous injection must be prescribed by a qualified health professional.

A worker’s knowledge includes: A basic understanding of the purpose of the medication and related storage requirements.

A knowledge of the impact of variables that affect take up of medication for example, injection site location, rotation and timing.

An understanding of the indicators and action required for common problems including signs of infection at the site of injection such as change in skin colour, swelling, itchiness or pain, signs of withdrawal and/or side effects from medication, and reactions to incorrect medication dose.

Understand the procedures and responsibilities for reporting and documentation, including, handover, recording observations and incident reporting.

Understand the procedures and responsibilities for requesting review of subcutaneous injection support.

The purpose and methods of hygiene and infection control.

When and how to involve or get advice from the appropriate health practitioner.

For administration of insulin injections, there are additional skills and knowledge that are required – these are listed in the Diabetes Management Checklist.

Any high intensity daily personal activity and management forms part of the formal training program and must be signed off by a Registered Training Organisation (RTO).

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Supporting Documents Policies 1.1 Person-Centred Supports 1.3 Privacy and Dignity 2.3 Quality Management 3.4 Responsive Support 5.1 High Intensity Daily Personal Activities

Forms Audit Checklist Subcutaneous Injections Client Profile Kit NGO Course Report NGO User Report Training Attendance Sheet

Information Sheets Subcutaneous Injections

NGO Training Subcutaneous Injections

Legislation Disability Discrimination Act 1992 (Cwth) Disability Services and Inclusion Act 2023 (Cwth) Disability Services Act 2006 (QLD) Health Act 1937 (QLD) Health Regulation Act 1996 (QLD) National Disability Insurance Scheme Act 2013 NDIS (Provider Registration and Practice Standards) Amendment Rules 2021 Queensland Guardianship and Administration Act 2000 (QLD) Queensland Human Rights Act 2019 (QLD) Queensland Mental Health Act 2016 (QLD)

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NDIS Practice Standards and Quality Indicators BigDog Support Services Pty Ltd (BigDog) is a registered NDIS provider and is required to apply the scheme’s practice standard and quality indicators.

The standards have been developed to create an important benchmark to assess provider performance and ensure that high quality and safe supports and services are provided to NDIS clients.

The four core modules are: 1.0 Rights and Responsibilities; 2.0 Governance and Operational Management; 3.0 The Provision of Supports; and 4.0 The Support Provision Environment.

The supplementary modules cover: 5.0 Specialist Support 5.1 High intensity daily personal activities 5.2 Implementing behaviour support plans.

5.1 High Intensity Daily Personal Activities These NDIS Practice Standards set out the responsibilities of BigDog when providing supports and services to clients that require the following.

5.1.1 Complex Bowel Care 5.1.2 PEG Feeding and Management 5.1.3 Severe Dysphagia Management 5.1.4 Tracheostomy Management 5.1.5 Urinary Catheter Management 5.1.6 Ventilator Management 5.1.7 Subcutaneous Injections 5.1.8 Complex Wound Management

5.1.7 Subcutaneous Injections Each client requiring subcutaneous injections receives appropriate support relevant and proportionate to their individual needs and specific subcutaneous injections and medication administered.

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Human Services Quality Standards The Standards set a benchmark for the quality of service provision. Each Standard is supported by a set of performance indicators which outline what BigDog is required to demonstrate to meet that standard.

3 Responding to Individual Need The assessed needs of the individual are being appropriately addressed and responded to within resource capacity.

3.3 BigDog ensures that services to the individual/s are delivered, monitored, reviewed and reassessed in a timely manner.

6 Human Resources Effective human resource management systems, including recruitment, induction and supervisory processes, result in quality service provision.

6.3 BigDog provides people working in BigDog with induction, training and development opportunities relevant to their roles.

Delegation of Authority Name

Position

Details

Steven Paull

Director

Authorise review and implementation

Courtney Carroll

Director

Authorise review and implementation

David Burrett

Operations Manager

Ensure information dissemination

Monique Paull

HR Manager Lawyer

Ensure compliance by employees

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Version Details This policy will be reviewed every twelve (12) months unless circumstances deem it necessary to review earlier. The review process will involve an analysis of the usefulness of the policy and to note any changes which are required to improve the policy.

If minor changes are made in wording or to clarify the intent, the version number will indicate this by adding a ‘point’ i.e. Version 1.0 indicates the original version and 1.1 with the first round of minor changes made. A significant change or intent of the policy will be indicated by a whole new number i.e. Version 2.0.

The following rules also apply in interpreting this policy: • Headings are for convenience only and do not affect interpretation.

• A singular word includes the plural and vice versa.

• A word that suggests one gender includes the other genders.

Date

V

November 2021

5.0 New Policy

January 2022

5.1 Updated Responsible Offices details and NDIS (Provider Registration and Practice Standards) Amendment Rules 2021

January 2023

6.0 Included Human Services Quality Framework (HSQF) and Child Protection Act and the term “Client” is returned to “Client” to allow for policies to cover NDIS and HSQF.

March 2024

6.1 Disability Services Act 1986 replaced with Disability Services and Inclusion Act 2023 and policy review process included.

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Details

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