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  • 1.  Sublocade injections

    Posted 11-18-2024 12:09

    I work for an FQHC that sees a large number of recovery patients.   Providers especially in our homeless shelter are asking if RN's in the clinic can administer Sublocade injections.  Are there any other clinics that are administering this medication and do they have policies or procedures around it ?



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    Dana Cassidy RN
    PCHC
    Bangor ME
    (207) 944-9908
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  • 2.  RE: Sublocade injections

    Posted 11-19-2024 10:10

    Hi there--

    we do sublocade in our clinics (another FQHC in CT). It falls under our basic policy around Long-Acting Injectable medications. We did specific trainings around sublocade as it has a specific injection technique--use the videos available from the manufacturer. We also created EHR templates to ensure the nurses could best track which abdominal quadrant they had done the prior injection in so that they could track the clockwise injection method with every new dose. Our nurses do a relapse prevention visit along with the medication injection to assist in between provider visits every 90 days--so they see the provider, then 2 visits with nursing, and then the next visit back with the provider and so on. We do not store the medication overnight--so, we have 2 models for med delivery: 1) the first is where the pharmacy delivers the doses to our clinic on 1 day per week, and all of the pts receiving it come in for a group (some participate in a BH group), and then our nurses only sign for the doses of the patients who show up for their appt, which with sublocade it is most of them; 2) we have some sites that have pharmacies in the building that are approved as specialty pharmacies and can dispense sublocade. For those sites, the nurse goes to the pharmacy and picks up the med and then will administer it to the pt from there. So, the pharmacy is stocking the controlled substance and not our site. As a part of the visit, the nurse prints out the pharmacy information and reviews it with the patient, and then schedules the next injection. 

    I am working on updating our policies for it now...but basically, we cover each LAI, and then have a standard process for documenting, educating, monitoring after the injection, coordinating follow-up, etc. 

    Hope that helps,

    Mary

    Mary Blankson, DNP, APRN, FNP-C, FAAN

    Chief Nursing Officer

    Community Health Center, Inc.

    675 Main Street,

    Middletown, CT, 06457

    Cell: (860)227-5432

    mary@chc1.com



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    Mary Blankson DNP APRN FNP-C FAAN
    Community Health Center, Inc.
    Middletown CT
    (860) 227-5432
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  • 3.  RE: Sublocade injections

    Posted 11-20-2024 16:23

    Thank you so much for your input and information.   Its so helpful as we start the RN model in our homeless shelter clinic.   The providers have been overwhelmed and we are seeing a huge impact of having RN's there already after a week. 

    Dana



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    Dana Cassidy RN
    PCHC
    Bangor ME
    (207) 944-9908
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  • 4.  RE: Sublocade injections

    Posted 11-19-2024 20:38
    Hi,
    I'm the nurse educator at an FQHC where we administer sublocade on our integrated family medicine/addictions team and our homeless outreach/medical respite program. We used to get the medication shipped from a specialty pharmacy and used controlled substance logs in those two med rooms to track each dose. Now we have an in-house pharmacy and the nurse picks the medication up there at the time of the patient's appointment, so we are not storing it on the floor.

    It's a pretty simple subcutaneous injection in the abdomen, rotating sites each month. Anyone who's given a heparin or insulin shot can learn to give sublocade. It can be pretty painful, especially the 300mg loading doses, but most patients tolerate it well enough to continue therapy. Patients sign a consent prior to the first injection.

    The Grayken Center for Addiction Training and Technical Assistance at Boston Medical Center has fantastic resources on a wide range of SUD topics. Here is their compilation of XR buprenorphine resources, including a start-up guide, policies and procedures, instructional videos, and more: https://www.addictiontraining.org/resources/?category=11. You can also put in a request for TTA on their website. They offer customized training and consultation at no cost to Federally Qualified Health Centers. All are welcome to attend their frequent live webinars, and they do one on XR buprenorphine on a regular basis. I cannot say enough good things about them!

    You're most welcome to email me at cbadler@lchcnet.org if I can be of any further assistance.

    Charlotte Badler, MSN, RN, NPD-BC
    Nurse Educator
    Lynn Community Health Center
    Lynn, MA





  • 5.  RE: Sublocade injections

    Posted 11-20-2024 16:21

    Thank you so much for the information!!  Do you use SQ lidocaine prior to the injection?

    Dana 



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    Dana Cassidy RN
    PCHC
    Bangor ME
    (207) 944-9908
    ------------------------------



  • 6.  RE: Sublocade injections

    Posted 11-21-2024 12:16

    Hello,

    RNs do give sublocade injections.  We are already trained on SQ inj and receive additional training on the Sublocade in general.  


    Heidi Spielmaker                                                               

    Pronouns: she/her

    Manager, Community Health Nursing

    Hspielmaker@tap360health.org

    Follow us at: www.tap360health.org

     

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