More than 12 billion intramuscular im injections are given annually throughout the world. This is part 1 of a twopart series on injection techniques. Best practice technique in intramuscular injection. Effectiveness of nursing interventions on pain associated. This article describes the practical, stepbystep approach for administering im injections, which will assist. The average injected dose of diclofenac sodium was 29 12 mg. The result is a variation in this procedure not always consistent with an evidencebased approach. More than 12 billion im injections are administered. Injection sites should be rotated systematically to prevent lipohypertrophy, which also substantially affects insulin uptake and action.
How to minimise pain after an intramuscular injection quora. These guidelines provide an evidence based approach and support best practice for the administration of intramuscular im and subcutaneous sc injections. Aspirating during the intramuscular injection procedure. Know which medications are considered highalert medications and perform independent double checks to minimize errors. An evidencebased approach to intramuscular injection technique. Guidelines on the administration of intramuscular and subcutaneous injections version number v3 date of issue february 2017. Weight gain associated with second generation long acting antipsychotics influences the site and needle size for effective medication delivery. Are techniques used for intramuscular injection based on. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family members medications. Effects of thickness of muscle and subcutaneous fat on efficacy of gluteal intramuscular injection sites. Future studies level 1 and 2 are needed to further demonstrate the best evidence leading to safe and effective im injections. Even though it can cause tissue, musculoskeletal and neurological complications such as. Guidance for professionals on how to use a harm reduction approach to.
Recognizing the evidence and changing practice on injection sites. The procedure for im injection has been dis cussed widely. 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. 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. An evidencebased approach to subcutaneous injection technique. Recognizing the evidence and changing practice on injection. 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. This is the second article in a twopart series on injection techniques. 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. Proper technique when administering intramuscular injections. The result is a variation in this procedure not always consistent with an evidence.
Evidencebased practice requires the integration of the best available evidence in conjunction with. Intramuscular injections im are a common yet complex technique used to deliver medication deep into the large muscles of the body. The article by chung et al, however, provides compelling evidence that manual pressure applied to the injection site does reduce pain. 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 require a thorough and meticulous approach to patient assessment and injection technique. Parenteral medications have a quicker onset of therapeutic effects. Best practice technique in intramuscular injection mag online library. Identify different sites used for intramuscular injectionsc. A framework for safe practice is included, identifying important points for safe technique, patient care and clinical. It is clear that more research is needed in this area in order to develop supporting im injection policies. A subsequent article will discuss good practice in intramuscular injection technique. Keywords practical procedures injection technique this. Good injection technique can mean the difference between less pain and injury.
Be aware of the onset, peak, and duration of all parenteral medications. 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. Evidence calls for practice change in intramuscular. Isaacdockery a capstone project submitted to the faculty of gardnerwebb university hunt school of nursing. The thigh is a good place to give an injection to yourself or a child less than 3 years old. 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. May 27, 2014 intramuscular injections require a thorough and meticulous approach to patient assessment and injection technique. After the brief presentation, the participants will be able to. These guidelines provide an evidencebased approach and support best practice for the administration of intramuscular im and subcutaneous sc injections. Injection technique author eileen shepherd is clinical editor at nursing times. Evidencebased information on intramuscular injection technique from hundreds of trustworthy sources for health and social care. The procedure for im injection has been discussed widely in the literature. Proper technique when administering intramuscular injections by ashley m.
The intramuscular route allows the rapid absorption of drugs into the circulation. Look at the thigh, and imagine it in 3 equal parts. May 27, 2014 nurses should also take an active approach to patient assessment before injecting medicines. The aim of this article was to indicate a safe and effective im i. Implement evidence based practice in im injection 5. The first uk injection technique recommendations, 2nd edition. Implement evidencebased practice in im injection 5. Nurses should also take an active approach to patient assessment before injecting medicines. Each article explains the principles nurses should consider and reinforce with caregivers and is accompanied by a. Short answer pain a few days after an intramuscular im injection could mean it wasnt done properly. Issn 00296570 full text not available from this repository. An evidencebased approach to intramuscular injection. Evidence calls for practice change in intramuscular injection. The hip is a good place to give an injection to adults and children older than 7 months.
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. 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. Injection, intramuscular injection technique, medication, medicines. Describe essential steps for safely administering im injectionse. Best infection control practices for intradermal, subcutaneous, and intramuscular needle injections bull world health organ 2003 81 7 491500. Best practice technique in intramuscular injection journal. Pdf are techniques used for intramuscular injection based. Sep 17, 2014 read subcutaneous injection technique. Intramuscular injections, nursing education, patient safety, injection practices, evidence based practice 1.
Accurate anatomical knowledge is necessary in order to. While appropriate im injection technique is important for optimum action of drugs and vaccines, im injections are per. 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. Fiveyear cost analysis of intradetrusor injection of botulinum toxin type a and augmentation cystoplasty for refractory neurogenic. Drawing up and administering intramuscular injections. 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. Evidence calls for practice change in intramuscular injection techniques pamela k. 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. Although there is significant research, spanning 8 decades, on the procedure. The aim of this article is to update the nurses knowledge and skills on injection techniques.
Aug 28, 2018 using the correct injection technique and selecting the correct site will minimise the risk of complications. The administration of intramuscular injections is a common nursing intervention in clinical practice. The aim of this article was to indicate a safe and effective im injection technique based on evidenced data derived from ultrasonographic data. The best injection sites for an intramuscular injection. 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. Sep 24, 2014 read intramuscular injection technique. Abstract the intramuscular route allows for rapid absorption of drugs into the circulation. Pdf are techniques used for intramuscular injection. The technique for delivering intramuscular injection remains rooted in custom and practice. Oct 31, 2011 after the brief presentation, the participants will be able to. Commentary bmj evidencebased medicine bmj evidencebased. Ogstontuck, sherri 2014 subcutaneous injection technique.
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