Effects of thickness of muscle and subcutaneous fat on efficacy of gluteal intramuscular injection sites. More than 12 billion im injections are administered. Sep 24, 2014 read intramuscular injection technique. Intramuscular injections require a thorough and meticulous approach to patient assessment and injection technique. Helfer skin tap technique on pain during intramuscular injection revealed that the intramuscular injection of medication is a procedure commonly performed by nurses and are associated with discomfort, pain and trauma to the injected tissue. Injection, intramuscular injection technique, medication, medicines. Aspirating during the intramuscular injection procedure. These guidelines provide an evidence based approach and support best practice for the administration of intramuscular im and subcutaneous sc injections. Evidence calls for practice change in intramuscular injection techniques pamela k. The article by chung et al, however, provides compelling evidence that manual pressure applied to the injection site does reduce pain.
New evidencebased insulin delivery recommendations are available, and awareness of them should lead to more effective use of insulin therapy, improved clinical outcomes, and considerable cost savings. This article describes the practical, stepbystep approach for administering im injections, which will assist. Parenteral medications have a quicker onset of therapeutic effects. Keywords practical procedures injection technique this. Lee, et al intramuscular injection of diclofenac sodium in pediatric patients the number of patients included was 116 with an average age of 41 27 months and an average body weight of 15. May 27, 2014 nurses should also take an active approach to patient assessment before injecting medicines. Best practice technique in intramuscular injection. Commentary bmj evidencebased medicine bmj evidencebased.
Pdf are techniques used for intramuscular injection. Even though it can cause tissue, musculoskeletal and neurological complications such as. The first uk injection technique recommendations, 2nd edition. An evidencebased approach to subcutaneous injection technique. Ogstontuck, sherri 2014 subcutaneous injection technique.
Nurses should also take an active approach to patient assessment before injecting medicines. Isaacdockery a capstone project submitted to the faculty of gardnerwebb university hunt school of nursing. Single intramuscular injection of diclofenac sodium in. Are techniques used for intramuscular injection based on. Recognizing the evidence and changing practice on injection. The aim of this article was to indicate a safe and effective im i. A subsequent article will discuss good practice in intramuscular injection technique.
Sep 17, 2014 read subcutaneous injection technique. The technique for delivering intramuscular injection remains rooted in custom and practice. Guidelines on the administration of intramuscular and subcutaneous injections version number v3 date of issue february 2017. The hip is a good place to give an injection to adults and children older than 7 months. In each issue, the paramedic education team at edge hill university focuses on the clinical skills carried out by paramedics on the frontlines, highlighting the importance of these skills and how t. Use of this guideline can assist the clinician to maximize the therapeutic effects of administered medication while minimizing or eliminating patient injury and discomfort associated with im injections. The intramuscular route allows the rapid absorption of drugs into the circulation. Best practice technique in intramuscular injection mag online library. Injection technique author eileen shepherd is clinical editor at nursing times. An evidencebased approach to intramuscular injection technique this learning module has been accredited by the royal college of nursing and was last updated in 2016. A framework for safe practice is included, identifying important points for safe technique, patient care and clinical. Issn 00296570 full text not available from this repository. Best practice technique in intramuscular injection journal. Injection sites should be rotated systematically to prevent lipohypertrophy, which also substantially affects insulin uptake and action.
To consider to what extent intramuscular injection technique can be described to remain entrenched in ritualistic practice and how evidence. The authors of this article present the current evidence on the dorsogluteal and ventrogluteal intramuscular injection sites in an attempt to assist nurse decisionmaking and guarantee the integration of evidence based knowledge in order to improve patient care. Intramuscular injections im are a common yet complex technique used to deliver medication deep into the large muscles of the body. An evidencebased approach to intramuscular injection technique. An evidencebased approach to intramuscular injection. Describe essential steps for safely administering im injectionse. Each article explains the principles nurses should consider and reinforce with caregivers and is accompanied by a. Evidence calls for practice change in intramuscular. Efficacy and safety in intramuscular injection techniques. The result is a variation in this procedure not always consistent with an evidencebased approach. From basic nursing processes to advanced clinical capabilities, taylors clinical nursing skills. The result is a variation in this procedure not always consistent with an evidence.
Proper technique when administering intramuscular injections. The administration of intramuscular injections is a common nursing intervention in clinical practice. Best infection control practices for intradermal, subcutaneous, and intramuscular needle injections bull world health organ 2003 81 7 491500. Delivered by intramuscular im injections, long acting injections lai, offering comparatively long term medicinal effects from several weeks to several months, are gaining much attention. The average injected dose of diclofenac sodium was 29 12 mg. The aim of this article was to indicate a safe and effective im injection technique based on evidenced data derived from ultrasonographic data. After the brief presentation, the participants will be able to. Since 2000, there has been an increasing debate on what is best practice for the administration of intramuscular injections particularly in relation to site selection, needle size and technique. Pdf are techniques used for intramuscular injection based. Intramuscular injections, nursing education, patient safety, injection practices, evidence based practice 1. Administering an im injection is a common nursing procedure yet debate over the necessity to aspirate during the procedure is evident in the literature and reflected in practice.
In consideration of safety aspects for the im injection such as the prevention of nerve and blood vessel injury, and injection site reactions such as redness and swelling, 1 selection of appropriate im injection sites see section 2, 2 selection of appropriate im injection needles see section 3, 3 assessment of im injection site by. Be aware of the onset, peak, and duration of all parenteral medications. Implement evidence based practice in im injection 5. While appropriate im injection technique is important for optimum action of drugs and vaccines, im injections are per. The procedure for im injection has been dis cussed widely. Fiveyear cost analysis of intradetrusor injection of botulinum toxin type a and augmentation cystoplasty for refractory neurogenic. The thigh is a good place to give an injection to yourself or a child less than 3 years old.
Drawing up and administering intramuscular injections. Effectiveness of nursing interventions on pain associated. Dougherty l, lister s 2015 the royal marsden hospital manual of. Apr 14, 2015 the process of aspiration has been ingrained in the intramuscular injection procedure, and whilst many policies no longer recommend this practice, it often continues to be taught and practiced. The process of aspiration has been ingrained in the intramuscular injection procedure, and whilst many policies no longer recommend this practice, it often continues to be taught and practiced. Jul 23, 2018 the intramuscular route allows the rapid absorption of drugs into the circulation. Future studies level 1 and 2 are needed to further demonstrate the best evidence leading to safe and effective im injections. Between 2005 and 2008, eight claims for sciatic nerve injury following a dorsogluteal im injection were made to acc, six of which occurred in a general practice setting.
Implement evidencebased practice in im injection 5. Recognizing the evidence and changing practice on injection sites. This is part 1 of a twopart series on injection techniques. Know which medications are considered highalert medications and perform independent double checks to minimize errors.
Abstract the intramuscular route allows for rapid absorption of drugs into the circulation. How to minimise pain after an intramuscular injection quora. Oct 31, 2011 after the brief presentation, the participants will be able to. This is the second article in a twopart series on injection techniques. May 27, 2014 intramuscular injections require a thorough and meticulous approach to patient assessment and injection technique. The best injection sites for an intramuscular injection. Identify different sites used for intramuscular injectionsc. The aim of this article is to update the nurses knowledge and skills on injection techniques. Question lacks the critical detail of injection site since there are four major sites of im injection see below from 1, and each has specific. Guidance for professionals on how to use a harm reduction approach to.
Proper technique when administering intramuscular injections by ashley m. More than 12 billion intramuscular im injections are given annually throughout the world. Accurate anatomical knowledge is necessary in order to. These guidelines provide an evidencebased approach and support best practice for the administration of intramuscular im and subcutaneous sc injections. Aug 28, 2018 using the correct injection technique and selecting the correct site will minimise the risk of complications. Using the correct injection technique and selecting the correct site will minimise the risk of complications. Look at the thigh, and imagine it in 3 equal parts. Short answer pain a few days after an intramuscular im injection could mean it wasnt done properly.
Weight gain associated with second generation long acting antipsychotics influences the site and needle size for effective medication delivery. A nursing process approach, 5th edition, helps you hone your cognitive, technical, interpersonal, and ethicallegal capabilities and master patient interaction, clinical reasoning, and communication skills essential to safe and effective personcentered care. Good injection technique can mean the difference between less pain and injury. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family members medications. It is clear that more research is needed in this area in order to develop supporting im injection policies. Evidence based information on intramuscular injection technique from hundreds of trustworthy sources for health and social care.