Selection of Site for Administration of Intramuscular Injection to Adult Patients by Nurses: A Cross-Sectional Study

Abstract

Objective:This study was carried out to determine the sites which are selected by nurses to use in the intramuscular medicine applications and the factors affecting the selection of the injection sites. Methods: The population of this descriptive and cross-sectional type of study was composed of 250 nurses working in two hospitals in Istanbul, the sample was composed of 171 nurses selected by stratified random sampling method. Data were collected with 'Structured Questionnaire Form'. Results: The average age of the nurses was found to be 26.27±7.46 years, it was determined that 40.4% of them applied injection very often and they preferred dorsogluteal site to apply injection with a ratio of 83.6%. When the knowledge level of nurses about the complications that may occur depending injection site, it was seen that some nurses did not consider complications such as pain, nerve, bone and vascular injury, infection, necrosis, tissue irritation, nodules or stiffness, abscess and hematoma in the deltoid site. On the other hand, it was learnt that they had a risk of developing sciatic nerve damage in the ventrogluteal site. The unit, which the nurses work and the experience period in that unit affects the site selection in injection application. As a result, nurses often prefer the dorsogluteal site in injection. Conclusion:The nurses' knowledge about the complications that may ocur in the sites chosen for injection by them is insufficient and there are factors affecting the selection of the site. ÖzAmaç: Bu çalışma hemşirelerin intramusküler ilaç uygulamalarında seçtiği enjeksiyon bölgeleri ile bölge seçimini etkileyen faktörleri belirlemek amacıyla yapıldı. Yöntem: Tanımlayıcı ve kesitsel türdeki bu araştırmanın evreni İstanbul'daki iki hastanede çalışan 250 hemşire; örneklemini ise tabakalı rastgele örnekleme yöntemi ile seçilen 171 hemşire oluşturdu. Veriler, 'Yapılandırılmış Soru Formu' ile toplandı. Bulgular: Hemşirelerin yaş ortalamasının 26,27±7,46 yıl olduğu, %40,4'ünün çok sık intramusküler enjeksiyon uyguladıkları, intramusküler enjeksiyon için %83,6 oranla öncelikli olarak dorsogluteal bölgeyi tercih ettikleri belirlendi. Hemşirelerin intramusküler enjeksiyon bölgesine göre gelişebilecek komplikasyonlar hakkında bilgi düzeyleri incelendiğinde; bazı hemşirelerin ağrı, deltoid bölgede sinir, kemik ve damar yaralanması, enfeksiyon, nekroz, doku tahrişi, nodül veya sertlik, apse ve hematom gibi komplikasyonları bir risk olarak görmedikleri öte yandan ventrogluteal bölgede siyatik sinir hasarı gelişme riskinin bulunduğunu ifade ettikleri görüldü. Hemşirelerin çalıştıkları ünite ve ünitedeki deneyim süresi intramusküler enjeksiyon uygulamasında bölge seçimini etkilemektedir. Sonuç olarak, hemşireler intramusküler enjeksiyon uygulamasında sıklıkla dorsogluteal bölgeyi tercih etmektedir. Sonuç: İntramusküler enjeksiyon için seçtikleri bölgelerde gelişebilecek komplikasyonlar konusundaki bilgileri yetersizdir ve bölge seçimini etkileyen faktörler bulunmaktadır. Anahtar Kelimeler: İntramusküler enjeksiyon, ventroglutea...

Knowledge and practices of nurses working in psychiatry clinics on ventrogluteal injection

“…Individuals with chronic mental disorders have physical problems such as obesity or metabolic syndrome due to long-term use of antipsychotic drugs (Acı & Kutlu, 2019). In IM injections administered to patients with obesity problems, the needle cannot reach the muscle layer due to the injection site and the depth of the individual's adipose tissue (Kaya et al, 2015(Kaya et al, , 2016Soliman et al, 2018;Turan et al, 2019). In such cases, delayed and low absorption may lead to an increase in dose due to the failure to obtain the expected treatment response (Seeman, 2017;Turan et al, 2019;Wynaden et al, 2015).…”

“…In IM injections administered to patients with obesity problems, the needle cannot reach the muscle layer due to the injection site and the depth of the individual's adipose tissue (Kaya et al, 2015(Kaya et al, , 2016Soliman et al, 2018;Turan et al, 2019). In such cases, delayed and low absorption may lead to an increase in dose due to the failure to obtain the expected treatment response (Seeman, 2017;Turan et al, 2019;Wynaden et al, 2015). Nurses working in psychiatry clinics should follow the current literature on the adequate absorption of drug doses and safe drug applications by IM injection (Kaya et al, 2016;Turan et al, 2019).…”

“…Along with the start of the use of LAIs, the importance of intramuscular (IM) injection, which is included in parenteral applications, in psychiatry clinics further increased (Wynaden et al, 2015). Nurses have important roles and responsibilities in the safe administration of drugs in IM injections, education of patients and their relatives, and monitoring patients' responses to drugs (Kaya et al, 2016; Turan et al, 2019). Individuals with chronic mental disorders have physical problems such as obesity or metabolic syndrome due to long‐term use of antipsychotic drugs (Acı & Kutlu, 2019).…”

“…In such cases, delayed and low absorption may lead to an increase in dose due to the failure to obtain the expected treatment response (Seeman, 2017; Turan et al, 2019; Wynaden et al, 2015). Nurses working in psychiatry clinics should follow the current literature on the adequate absorption of drug doses and safe drug applications by IM injection (Kaya et al, 2016; Turan et al, 2019).…”

“…Studies showed that there was less pain and bleeding in the injections administered into the VG site compared to those administered into the DG site (Kaya et al, 2012). In addition to them, the advantages of using the VG site include the ease of positioning the patient (Kaya et al, 2012; Turan et al, 2019) and lower contamination with stools and urine compared to the DG site (Sarı et al, 2017). Nevertheless, since it has been demonstrated in almost all textbooks published since 1960 that the DG site is an appropriate site for IM injections, and due to the small anatomical structure of the VG site, difficulty in locating, and the worry that the patient may be harmed (Coskun et al, 2016), the use of the VG site by nurses is limited (Gülnar & Özveren, 2016; Sarı et al, 2017).…”