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  Last modified July 8, 2004  

Teaching injections to UCPs

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Q

I work in the community. Recently, I was asked to teach school employees to administer epinephrine injections. I understand that administering an injection is a controlled act. Can nurses teach a person how to administer epinephrine injections?

A

Yes, nurses can teach unregulated care providers (UCPs), such as school employees, to administer injections that are considered routine activities of living.

The RHPA provides several exceptions that allow persons who are not authorized as members of a regulated health profession to perform controlled acts. One of these exceptions is when that person is providing first aid or temporary assistance in an emergency. In this case, epinephrine injections do not require delegation when they are administered to students and employees who are carrying their own epinephrine injection pen.

In determining whether to assume this as part of your role, you need to consider the following questions.

  1. Are you competent to administer substances by injection?
  2. Do you have the competencies to make the decision to teach epi pen injections?
  3. Do you have the necessary competencies to teach epi pen injections?
  4. Have you assessed the client, risks and environmental supports?
  5. Do you have a plan to determine the competence of the learners?
  6. Is there a plan to ensure that the learners maintain their competence, once instructed?
  7. Is there a plan for regular review of the learners' competence?
  8. Does your employer support this activity as part of your nursing role? There may be liability considerations for the employer.

If you can answer yes to all of the above questions, and your employer agrees this is part of your role, then as a nurse you are accountable for both the decision to teach and for the teaching. The document Utilization of Unregulated Care Providers (UCPs): A Guide to Making Decisions lists factors that the nurse needs to weigh in deciding to teach certain activities to UCPs.

It is important for the nurse to ensure learners are clear about the following:

  • the conditions for performing the injection;
  • the indicators for seeking assistance; and
  • any reporting parameters (what, when and who to report to).

Documentation of the teaching process needs to be kept on file with the employer and community agency. To ensure client safety, there should be a periodic review of the competence of the school employees and of the clients, risks and supports available.

 

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