Minimising the risk of needlestick injuries in vaccination

A few tips to help minimise the risk of needlestick injuries, we have written these for Pharmacists who do not vaccinate regularly or who maybe have become complacent – it’s all too easy to sustain a needlestick injury so we hope these help:

  • Remove the sheath just before you intend to administer the vaccine.
  • Never resheath the needle
  • Place the sharps bin no more than one arms distance away from the client and ensure it is open and ready to use
  • Place the needle and syringe straight into the sharps bin before placing cotton wool on the client’s arm
  • Some vaccine sheaths are tight to get off so point the needle and syringe down and away from you to gently release the sheath.

How to administer an Intramuscular Injection

Hold the syringe between thumb and forefinger as if holding a pen or dart. Stretch the skin from above with your non-dominant hand to displace the subcutaneous layer and to reduce the sensitivity of the nerve endings. Insert the needle quickly in a controlled manner into the skin at a 90-degree angle. Depress the plunger at approximately 1 second for each 0.1ml then in a controlled manner, remove the needle.

Once the needle has been withdrawn, immediately dispose in the sharps container. Ask the patient to apply gentle pressure to the site afterwards with the cotton wool 

The difference for subcutaneous injections

Subcutaneous injections (SC) are given beneath the epidermis into the layer of fat (adipose) and connective tissue 6.  For individuals with a bleeding disorder, vaccines normally given by an IM route should be given by deep subcutaneous injection to reduce the risk of bleeding – this subcutaneous layer is not richly supplied with blood vessels

Guidance regarding flu vaccines states that most patients on stable anticoagulant therapy can receive influenza vaccine by intramuscular injection, for example, individuals on warfarin who are up to-date with their scheduled INR testing where their latest INR was in the therapeutic range

For a subcutaneous injection the skin is bunched between the thumb and forefinger, in order to lift adipose tissue from underlying muscle. Holding the syringe between thumb and forefinger insert the needle at a 45-degree angle and inject the vaccine slowly. Once the needle has been withdrawn, immediately dispose in the sharps container. Ask the patient to apply gentle pressure to the site afterwards with the cotton wool

 Taken from our vaccine hand-out 10th April 2017