Establishing best practice guidelines for administration of intra muscular injections in the adult: A systematic review of the literature

Abstract

This article describes best practice guidelines for the administration of intramuscular injections developed after the identification of 300 abstracts and a review of 150 articles on the subject area. While the administration of medication via the intramuscular route is a daily occurrence for nurses working in both hospitals and community settings, several concerns and complications have been identified with the procedure. Routinely, nurses are required to make numerous decisions regarding factors such as needle size, length and the site to be used during the administration of medication into muscle tissue. Therefore, it is important that relevant up-to-date guidelines are available to assist nurses to make informed decisions about the technique to use. Techniques delivering medication to the correct site will facilitate efficacious outcomes for the client and ensure the delivery of quality nursing care in all health care settings.

Utilizing Z-track Air Lock Technique to Reduce Pain in Intramuscular Injections

“…Demikian juga perbedaan antar kelompok yang mendapatkan perlakuan ketiga teknik yang berbeda menunjukkan perbedaan yang tidak signifi kan. Walaupun demikian manfaat kedua teknik ini pada beberapa penelitian sebelumnya menunjukkan intensitas nyeri yang rendah dibandingkan teknik tradisional. Wynaden (2005), Ban, Li, dan Pillay (2006) menyimpulkan penggunaan teknik Air-lock dalam prosedur injeksi intramuskuler sebagai metode yang efektif dalam menurunkan intensitas nyeri saat penyuntikan. Hal ini berkaitan dengan adanya efek mengunci oleh tambahan udara 0,2 ml pada obat atau larutan yang disuntikkan, sehingga tidak terjadi perembesan ke lapisan sub kutaneus di mana terdapat saraf persepsi.…”

Randomized clinical trial to assess pain and bruising in medicines administered by means of subcutaneous and intramuscular needle injection: Is it necessary to have needles changed?

“…These recommendations are mentioned in different technical books and are based on established practices, but are not accompanied by scientific evidence (13)(14)(15) . Most drug administration manuals do not address the need to change needles in order to apply injections (16)(17) .…”

Aspirating during the intramuscular injection procedure: a systematic literature review

“…Systematic reviews have also reached different conclusions with some authors agreeing that aspiration should be a fundamental element of the IM injection procedure (Beyea & Nicoll , Nicoll & Hesby & Wynaden et al . , ) and others negating aspiration entirely (Taddio et al . ).…”

“…Previously, aspiration has been advocated by Rodger and King (2000) and Hunter (2008) but not recommended by Diggle (2007). Systematic reviews have also reached different conclusions with some authors agreeing that aspiration should be a fundamental element of the IM injection procedure (Beyea & Nicoll 1995, Nicoll & Hesby 2002& Wynaden et al 2005 and others negating aspiration entirely (Taddio et al 2009). Perhaps unsurprisingly then, experience of nursing in a variety of settings suggests that the practice of aspirating when administering IM injections differs.…”