The World Health Organization and Centers for Disease Control and Prevention no longer recommend aspiration during intramuscular (IM) injections. The purpose of this study was to investigate the technique registered nurses (RNs) use during IM injections and incidence of blood aspiration. This descriptive study surveyed 164 RNs. Results noted that 74% of the sample continue to aspirate at least 90% of the time. Of the participants who continue to aspirate, only 3% aspirate for the recommended 5 to 10 s. Forty percent reported having aspirated blood at least once, whereas 6 RNs (4%) noted blood aspiration ≥13 times. Blood aspiration occurred most frequently in the dorsal gluteal (15%) and deltoid (12%). Based on the findings, it is recommended that RNs use a decision-making process to select the safest technique for IM injections. If a parental medication has different administration rates, dose, viscosity, or other concerns when given IM versus intravenously (IV), aspiration during IM administration should be implemented.
The intramuscular (IM) injection has been part of nursing practice since the 1960s. Over the past 60 years, the practice of aspiration during IM injection has been controversial and understudied. In 2016, a study by Thomas et al identified that blood aspiration does occur during injection. This article introduces a clinical practice guideline for safe and effective aspiration during IM injection, as a follow-up to the findings of that study. The proposed guideline acknowledges the correct practice of aspiration and identifies considerations that may make aspiration unnecessary. These practices and considerations are presented to the reader using a visual clinical pathway and a narrative clinical practice guideline.
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