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

Year 2019, Volume: 5 Issue: 3, 134 - 140, 06.09.2019
https://doi.org/10.30934/kusbed.533530

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.

Supporting Institution

Istanbul University Scientific Research Projects (IUBAP) Unit

Project Number

BEK- 2016-21708

Thanks

Istanbul University Scientific Research Projects (IUBAP) Unit

References

  • Kaya N, Palloş A. Parenteral drug management. In: Atabek Aştı T, Karadağ A, editors. Nursing Science and Art, Istanbul, TR: Akademi Basın ve Yayıncılık; 2012:761-809.
  • Kaya N, Salmaslıoğlu A, Terzi B, Turan N, Acunaş B. The reliability of site determination methods in ventrogluteal area injection: A cross-sectional study. Int J Nurs Stud. 2015;52(1):355-360. doi:10.1016/j.ijnurstu.2014.07.002.
  • Kaya N, Turan N, Özdemir Aydın G. Intramuscular injection to ventrogluteal site: A systematic review. International Journal of Caring Sciences. 2016;9(3):1168-1176. doi:10.7748/ns2004.03.18.25.39.c3560.
  • Potter PA, Perry AG, Stockert P, Hall A. Fundamentals of Nursing. 9th ed. Philadelphia, PA: Elsevier Health Sciences; 2016; p. 647-652.
  • Yıldız D, Kızıler E, Fidancı BE, Suluhan D. Çocuklara intramusküler enjeksiyon uygulamasında doğrular nelerdir? J Nurs Sci. 2017;9(2):144-152. doi:10.5336/nurses.2016-51005.
  • Kim HJ, Park SH. Sciatic nerve injection injury. J Int Med Res. 2014;42(4):887-897. doi:10.1177/0300060514531924.
  • Boyd AE, DeFord LL, Mares JE, et al. Improving the Success Rate of Gluteal Intramuscular Injections. Pancreas. 2013;42:878-882. doi:10.1097/MPA.0b013e318279d552.
  • Sarı D, Şahin M, Yaşar E, Taşkıran N, Telli S. Investigation of Turkish nurses frequency and knowledge of administration of intramuscular injections to the ventrogluteal site: Results from questionnaires. Nurse Educ Today. 2017;56(9):47-51. doi:10.1016/j.nedt.2017.06.005.
  • Coskun H, Kilic C, Senture C. The evaluation of dorsogluteal and ventrogluteal injection sites: a cadaver study. Journal of Clinical Nursing. 2016;25:1112-1119. doi:10.1111/jocn.13171.
  • Larkin TA, Ashcroft E, Elgellaieb A, Hickey BA. Ventrogluteal versus dorsogluteal site selection: A cross-sectional study of muscle and subcutaneous fat thicknesses and an algorithm incorporating demographic and anthropometric data to predict injection outcome. Int J Nurs Stud. 2017;71:1-7. doi:10.1016/j.ijnurstu.2017.02.017.
  • Bağış S, Adam M, Leblebici ÜB, Karataş M, Güven AZ, Çeliker AR. Sciatic nerve injury due to intramuscular injection: electrophysiological findings and one-year follow-up. Turk J Med Sci. 2012;42(5):913-7.
  • Craven RF, Hirnle CJ. Fundamentals of Nursing: Human Health and Function. 8th ed. Philadelphia, PA: Lippincott Williams&Wilkins; 2016, p. 529-530.
  • Taylor C, Lillis C, LeMone P, Lynn P. Fundamentals of Nursing the Art and Science of Nursing Care. 7th ed. China: Wolters Kluwer, Lippincott Williams&Wilkins; 2011, p. 797- 2842.
  • Min HJ, Kim YJ. Analysis of gluteal subcutaneous and muscle thickness in infants and children for application to intramuscular injection, autologous fat grafting, and gluteal artery perforator flaps. Arch Plast Surg. 2018;45(6):550-556. https://doi.org/10.5999/aps.2017.01760.
  • Greenway K. Rituals in nursing: intramuscular injections. J Clin Nurs. 2014;23:3583-3588. doi:10.1111/jocn.12627.
  • Masuda S, Yasuhara Y, Tanioka T, et al. Comparison of gluteal muscle intramuscular injection sites of Japanese healthy subjects: considerations for optimal insertion of injection needle length. Open Journal of Psychiatry. 2016;6(2):203-212. doi:10.4236/ojpsych.2016.62025.
  • Cocoman A, Murray J. Recognizing the evidence and changing practice on injection site. Br J Nurs. 2010;19(18):1170-1174. doi:10.12968/bjon.2010.19.18.79050.
  • Berman A, Snyder S, Frandsen G. Kozier&Erb's Fundamentals of Nursing: Concepts, Process, and Practice. 10th ed. New Jersey, NJ: Pearson; 2015; p. 797-803.
  • Smith SF, Duell D, Martin BC, et al. Clinical Nursing Skills: Basic to Advanced Skills. 9th ed. Upper Saddle River, NJ: Pearson Prentice Hall; 2016.
  • Kaya N, Turan N, Palloş AÖ. Dorsogluteal bölge intramusküler enjeksiyon uygulamak amacıyla kullanılmamalı mı? İ.Ü.F.N. Hem. Derg. 2012;20(2):146-53.
  • Sherri, Ogston-Sherri. Intramuscular injection technique: an evidence-based approach. Nursing Standard. 2014;29(4):52-63. doi:10.7748/ns.29.4.52.e9183.
  • Doğu, Ö. The invisible tip of the iceberg; How often is the ventrogluteal area used? Journal of Education and Research in Nursing. 2016;13(1):7-10.
  • Walsh L, Brophy K. Staff nurses’ sites of choice for administering intramuscular injections toadult patients in the acute care setting. J Adv Nurs. 2010;67(5):1034-1040. doi:10.1111/j.13652648.2010.05527.x.
  • Wynaden D, Tohotoa J, Omari OA, et al. Administering intramuscular injections: How does research translate into practice over time in the mental health setting? Nurse Educ Today. 2015;35:620-624. doi:10.1016/j.nedt.2014.12.008.
  • Strohfus PK, Paugh O, Tindell C, Molina-Shaver P. Evidence calls for practice change in intramuscular injection techniques. J Nurs Educ Pract. 2018;8(2):83-92. doi:10.5430/jnep.v8n2p83.
  • Larkin TA, Elgellaie A, Ashcroft E. Comparison of the G and V methods for ventrogluteal site identification: Muscle and subcutaneous fat thicknesses and considerations for successful intramuscular injection. Int J Ment Health Nurs. 2018;27:631-641. doi:10.1111/inm.12346.
  • Cook IF. Best vaccination practice and medically attended injection site events following deltoid intramuscular injection. Hum Vaccines Immunother. 2015;11(5):1184-91. doi:10.1080/21645515.2015.1017694.
  • Hensel D, Springmyer J. Do perinatal nurses still check for blood return when administering the hepatitis B vaccine? J Obstet Gynecol Neonatal Nurs. 2011;40(5):589-594. doi:10.1111/j.1552-6909.2011.01277.x.
  • Mclaws ML, Palenik CJ, Askarian M. Assessment of injection practice in primary health care facilities of Shiraz, Iran. Am J Infect Control. 2014;42:300-304. doi:10.1016/j.ajic.2013.09.006.

Hemşirelerin İntramusküler Enjeksiyon Bölgesi Seçimini Etkileyen Faktörler: Kesitsel Bir Çalışma

Year 2019, Volume: 5 Issue: 3, 134 - 140, 06.09.2019
https://doi.org/10.30934/kusbed.533530

Abstract

Amaç: 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. 

Project Number

BEK- 2016-21708

References

  • Kaya N, Palloş A. Parenteral drug management. In: Atabek Aştı T, Karadağ A, editors. Nursing Science and Art, Istanbul, TR: Akademi Basın ve Yayıncılık; 2012:761-809.
  • Kaya N, Salmaslıoğlu A, Terzi B, Turan N, Acunaş B. The reliability of site determination methods in ventrogluteal area injection: A cross-sectional study. Int J Nurs Stud. 2015;52(1):355-360. doi:10.1016/j.ijnurstu.2014.07.002.
  • Kaya N, Turan N, Özdemir Aydın G. Intramuscular injection to ventrogluteal site: A systematic review. International Journal of Caring Sciences. 2016;9(3):1168-1176. doi:10.7748/ns2004.03.18.25.39.c3560.
  • Potter PA, Perry AG, Stockert P, Hall A. Fundamentals of Nursing. 9th ed. Philadelphia, PA: Elsevier Health Sciences; 2016; p. 647-652.
  • Yıldız D, Kızıler E, Fidancı BE, Suluhan D. Çocuklara intramusküler enjeksiyon uygulamasında doğrular nelerdir? J Nurs Sci. 2017;9(2):144-152. doi:10.5336/nurses.2016-51005.
  • Kim HJ, Park SH. Sciatic nerve injection injury. J Int Med Res. 2014;42(4):887-897. doi:10.1177/0300060514531924.
  • Boyd AE, DeFord LL, Mares JE, et al. Improving the Success Rate of Gluteal Intramuscular Injections. Pancreas. 2013;42:878-882. doi:10.1097/MPA.0b013e318279d552.
  • Sarı D, Şahin M, Yaşar E, Taşkıran N, Telli S. Investigation of Turkish nurses frequency and knowledge of administration of intramuscular injections to the ventrogluteal site: Results from questionnaires. Nurse Educ Today. 2017;56(9):47-51. doi:10.1016/j.nedt.2017.06.005.
  • Coskun H, Kilic C, Senture C. The evaluation of dorsogluteal and ventrogluteal injection sites: a cadaver study. Journal of Clinical Nursing. 2016;25:1112-1119. doi:10.1111/jocn.13171.
  • Larkin TA, Ashcroft E, Elgellaieb A, Hickey BA. Ventrogluteal versus dorsogluteal site selection: A cross-sectional study of muscle and subcutaneous fat thicknesses and an algorithm incorporating demographic and anthropometric data to predict injection outcome. Int J Nurs Stud. 2017;71:1-7. doi:10.1016/j.ijnurstu.2017.02.017.
  • Bağış S, Adam M, Leblebici ÜB, Karataş M, Güven AZ, Çeliker AR. Sciatic nerve injury due to intramuscular injection: electrophysiological findings and one-year follow-up. Turk J Med Sci. 2012;42(5):913-7.
  • Craven RF, Hirnle CJ. Fundamentals of Nursing: Human Health and Function. 8th ed. Philadelphia, PA: Lippincott Williams&Wilkins; 2016, p. 529-530.
  • Taylor C, Lillis C, LeMone P, Lynn P. Fundamentals of Nursing the Art and Science of Nursing Care. 7th ed. China: Wolters Kluwer, Lippincott Williams&Wilkins; 2011, p. 797- 2842.
  • Min HJ, Kim YJ. Analysis of gluteal subcutaneous and muscle thickness in infants and children for application to intramuscular injection, autologous fat grafting, and gluteal artery perforator flaps. Arch Plast Surg. 2018;45(6):550-556. https://doi.org/10.5999/aps.2017.01760.
  • Greenway K. Rituals in nursing: intramuscular injections. J Clin Nurs. 2014;23:3583-3588. doi:10.1111/jocn.12627.
  • Masuda S, Yasuhara Y, Tanioka T, et al. Comparison of gluteal muscle intramuscular injection sites of Japanese healthy subjects: considerations for optimal insertion of injection needle length. Open Journal of Psychiatry. 2016;6(2):203-212. doi:10.4236/ojpsych.2016.62025.
  • Cocoman A, Murray J. Recognizing the evidence and changing practice on injection site. Br J Nurs. 2010;19(18):1170-1174. doi:10.12968/bjon.2010.19.18.79050.
  • Berman A, Snyder S, Frandsen G. Kozier&Erb's Fundamentals of Nursing: Concepts, Process, and Practice. 10th ed. New Jersey, NJ: Pearson; 2015; p. 797-803.
  • Smith SF, Duell D, Martin BC, et al. Clinical Nursing Skills: Basic to Advanced Skills. 9th ed. Upper Saddle River, NJ: Pearson Prentice Hall; 2016.
  • Kaya N, Turan N, Palloş AÖ. Dorsogluteal bölge intramusküler enjeksiyon uygulamak amacıyla kullanılmamalı mı? İ.Ü.F.N. Hem. Derg. 2012;20(2):146-53.
  • Sherri, Ogston-Sherri. Intramuscular injection technique: an evidence-based approach. Nursing Standard. 2014;29(4):52-63. doi:10.7748/ns.29.4.52.e9183.
  • Doğu, Ö. The invisible tip of the iceberg; How often is the ventrogluteal area used? Journal of Education and Research in Nursing. 2016;13(1):7-10.
  • Walsh L, Brophy K. Staff nurses’ sites of choice for administering intramuscular injections toadult patients in the acute care setting. J Adv Nurs. 2010;67(5):1034-1040. doi:10.1111/j.13652648.2010.05527.x.
  • Wynaden D, Tohotoa J, Omari OA, et al. Administering intramuscular injections: How does research translate into practice over time in the mental health setting? Nurse Educ Today. 2015;35:620-624. doi:10.1016/j.nedt.2014.12.008.
  • Strohfus PK, Paugh O, Tindell C, Molina-Shaver P. Evidence calls for practice change in intramuscular injection techniques. J Nurs Educ Pract. 2018;8(2):83-92. doi:10.5430/jnep.v8n2p83.
  • Larkin TA, Elgellaie A, Ashcroft E. Comparison of the G and V methods for ventrogluteal site identification: Muscle and subcutaneous fat thicknesses and considerations for successful intramuscular injection. Int J Ment Health Nurs. 2018;27:631-641. doi:10.1111/inm.12346.
  • Cook IF. Best vaccination practice and medically attended injection site events following deltoid intramuscular injection. Hum Vaccines Immunother. 2015;11(5):1184-91. doi:10.1080/21645515.2015.1017694.
  • Hensel D, Springmyer J. Do perinatal nurses still check for blood return when administering the hepatitis B vaccine? J Obstet Gynecol Neonatal Nurs. 2011;40(5):589-594. doi:10.1111/j.1552-6909.2011.01277.x.
  • Mclaws ML, Palenik CJ, Askarian M. Assessment of injection practice in primary health care facilities of Shiraz, Iran. Am J Infect Control. 2014;42:300-304. doi:10.1016/j.ajic.2013.09.006.
There are 29 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article | Midwifery & Nursing
Authors

Nuray Turan

Gülsün Özdemir Aydın This is me 0000-0003-0550-3195

Nurten Kaya 0000-0003-0414-3589

Project Number BEK- 2016-21708
Publication Date September 6, 2019
Submission Date February 28, 2019
Acceptance Date July 16, 2019
Published in Issue Year 2019 Volume: 5 Issue: 3

Cite

APA Turan, N., Özdemir Aydın, G., & Kaya, N. (2019). Selection of Site for Administration of Intramuscular Injection to Adult Patients by Nurses: A Cross-Sectional Study. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi, 5(3), 134-140. https://doi.org/10.30934/kusbed.533530
AMA Turan N, Özdemir Aydın G, Kaya N. Selection of Site for Administration of Intramuscular Injection to Adult Patients by Nurses: A Cross-Sectional Study. KOU Sag Bil Derg. September 2019;5(3):134-140. doi:10.30934/kusbed.533530
Chicago Turan, Nuray, Gülsün Özdemir Aydın, and Nurten Kaya. “Selection of Site for Administration of Intramuscular Injection to Adult Patients by Nurses: A Cross-Sectional Study”. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi 5, no. 3 (September 2019): 134-40. https://doi.org/10.30934/kusbed.533530.
EndNote Turan N, Özdemir Aydın G, Kaya N (September 1, 2019) Selection of Site for Administration of Intramuscular Injection to Adult Patients by Nurses: A Cross-Sectional Study. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi 5 3 134–140.
IEEE N. Turan, G. Özdemir Aydın, and N. Kaya, “Selection of Site for Administration of Intramuscular Injection to Adult Patients by Nurses: A Cross-Sectional Study”, KOU Sag Bil Derg, vol. 5, no. 3, pp. 134–140, 2019, doi: 10.30934/kusbed.533530.
ISNAD Turan, Nuray et al. “Selection of Site for Administration of Intramuscular Injection to Adult Patients by Nurses: A Cross-Sectional Study”. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi 5/3 (September 2019), 134-140. https://doi.org/10.30934/kusbed.533530.
JAMA Turan N, Özdemir Aydın G, Kaya N. Selection of Site for Administration of Intramuscular Injection to Adult Patients by Nurses: A Cross-Sectional Study. KOU Sag Bil Derg. 2019;5:134–140.
MLA Turan, Nuray et al. “Selection of Site for Administration of Intramuscular Injection to Adult Patients by Nurses: A Cross-Sectional Study”. Kocaeli Üniversitesi Sağlık Bilimleri Dergisi, vol. 5, no. 3, 2019, pp. 134-40, doi:10.30934/kusbed.533530.
Vancouver Turan N, Özdemir Aydın G, Kaya N. Selection of Site for Administration of Intramuscular Injection to Adult Patients by Nurses: A Cross-Sectional Study. KOU Sag Bil Derg. 2019;5(3):134-40.