Barriers of Nurses’ about ‘Z-Track Method’ Which is Used in Intramuskuler Injections Applications

Öz

Aim: This research was to determine the opinions of nurses regarding the Z-track method of intramuscular injection and the factors preventing its use. This is a qualitative research using a phenomenological approach. Method: The sample consisted of 38 nurses who worked for a minimum of one year in a university hospital. Data were collected using semi-structured in-depth individual face-to-face interviews. Data were analyzed using content analysis and coded using the NVIVO 11 software. Findings: As a result of the content analysis, seven themes and nine subthemes emerged: (a) opinions about personal experiences: method of application, positive personal experiences, and negative personal experiences; (b) factors affecting usage: positive/encouraging factors and negative/discouraging factors; (c) opinions about colleagues; (d) frequency of application; (e) diseases for which the Z-track method is applied; (f) drugs given by the Z-track method; and (g) suggestions for dissemination: suggestions for training, suggestions for patients, suggestions for institutions and suggestions for healthcare professionals. Conclussion: Obstacles against the use of the Z-track method mostly result from lack of training and role models. However, it has been determined that there is a need for regulations regarding the determination, development and dissemination of standards for the application of the Z-track method.

Anahtar Kelimeler

• injection
• intramuscular injection
• Z-track method
• nurses
• qualitative study

İntramüsküler Enjeksiyon Uygulamalarında Kullanılan 'Z Tekniği' Konusunda Hemşirelerin Engelleri

Öz

Amaç: Bu araştırma, hemşirelerin intramüsküler enjeksiyon uygulamalarından Z-tekniğine ilişkin görüşlerini ve kullanımını engelleyen faktörleri belirlemek amacıyla yapılmıştır. Bu nitel araştırmada fenomenolojik yaklaşım kullanılmıştır. Yöntem: Örneklemi bir üniversite hastanesinde en az bir yıl çalışan 38 hemşire oluşturmuştur. Veriler, yarı yapılandırılmış derinlemesine bireysel yüz yüze görüşmelerle toplanmıştır. Veriler içerik analizi kullanılarak analiz edilmiş ve NVIVO 11 yazılımı kullanılarak kodlanmıştır. Bulgular: İçerik analizi sonucunda yedi tema ve dokuz alt tema ortaya çıkmıştır: (a) kişisel deneyimlere ilişkin görüşler: uygulama yöntemi, olumlu kişisel deneyimler ve olumsuz kişisel deneyimler; (b) kullanımı etkileyen faktörler: olumlu/teşvik edici faktörler ve olumsuz/kullanımı engelleyici faktörler; (c) meslektaşlar hakkındaki görüşler; (d) uygulama sıklığı; (e) Z-tekniğinin uygulandığı hastalıklar; (f) Z-tekniğiyle verilen ilaçlar; ve (g) yaygınlaştırma önerileri: eğitim önerileri, hastalar için öneriler, kurumlar için öneriler ve sağlık profesyonelleri için öneriler. Sonuç: Z-tekniğinin kullanılmasının önündeki engeller çoğunlukla eğitim ve rol model eksikliğinden kaynaklanmaktadır. Ancak Z tekniğinin uygulanmasına yönelik standartların belirlenmesi, geliştirilmesi ve yaygınlaştırılmasına yönelik düzenlemelere ihtiyaç olduğu tespit edilmiştir.

Anahtar Kelimeler

• Enjeksiyon
• intramüsküler enjeksiyon
• nitel çalışma
• Z-tekniği yöntemi

Kaynakça

1. 1. Chung J W, NG W.M.Y, Wong T. K. An experimental study on the use of manual pressure to reduce pain in intramuscular injections. Journal of Clinical Nursing. 2002; 11(4): 457-461.
2. 2. Nicoll L. H, Hesby A. Intramuscular injection: an integrative research review and guideline for evidence-based practice. Applied Nursing Research.2002; 16(2): 149-162.
3. 3. Potter, P. A., Perry, A. G., Stockert, P., & Hall, A.. Fundamentals of nursing: medication administration. 9th ed. Elsevier Health Sciences, USA; 2017.
4. 4. Uslusoy E. Ç, Duran E. T, Korkmaz M. Safe injection practices. Journal of Hacettepe University Faculty of Nursing. 2016; 3(20): 50-57.
5. 5. Engstrom J. L, Giglio N. N, Takacs S. M, Cherwenka D. I. Procedures used to prepare and administer intramuscular injections: a study of infertility nurses. Journal of Obstetric Gynecologic and Neonatal Nursing. 2000; 29(2):159–168.
6. 6. Altıok M, Kuyurtar F, Gökçe H, Taşdelen B. Primary care midwives and nurses’ knowledge about intramuscular injections. Journal of Fırat Health Services. 2007; 4(2): 69-84.
7. 7. Güneş Ü. Y, Zaybak A, Biçici B, Çevik K. The Examination of the Procedures Regarding to Intramuscular Injection Used by the Nurses. Journal of Atatürk University Nursing School. 2009; 12(4): 84-90.
8. 8. Kara D. Investigation of the Effect on Pain of Internal Rotation and Z Way Technique in Intramuscular Injection Administrations [dissertation]. İzmir: Ege University;2011.

9. 9. Şanlıalp A. Assessing Effectiveness of Education About Knowledge and Frequency of Dorsogluteal and Ventrogluteal Site Selection and Z Technique on Nurses’ IM Injection Practices[dissertation]. Denizli: Pamukkale University; 2013.
10. 10. Şimşek H, Yıldırım A. Qualitative Research methods in social sciences (9th ed.). Ankara: Seçkin Yayıncılık; 2016.
11. 11. Creswell, J. W. (2009). Research design: Qualitative, quantitative and mixed method approaches (3rd ed.). Sage Publications.
12. 12. Carter H, Mccoy T. T. Are we on the same page?: A comparison of intramuscular injection explanations in nursing fundamental texts. Medsurg Nursing. 2008; 4(17): 237-240.
13. 13. Cocoman A, Murray J. Intramuscular injections: A review of best practice for mental health nurses. Journal of Psychiatric and Mental Health Nursing. 2008; 15(5): 424-434.
14. 14. Malkin B. Are techniques used for intramuscular injection based on research evidence?. Nursing Times. 2008;104(50-51): 48-51.
15. 15. Kocaman G. Evidence based practice in nursing. Journal of Dokuz Eylul University Nursing Research and Development. 2003; 5(2): 61-69.
16. 16. Çopur E. Ö, Kuru N, Seyman Ç. S. Overview of the evidence based practices in nursing. Journal of Health and Nursing Management. 2015; 1(2):51-55.
17. 17. Taylor C, Lillis C, Lemone P, Lynn P. Fundamentals of Nursing: The Art and Science of Person- Centered Nursing Care (8th ed.). Wolters Kluwer; 2014.
18. 18. Gray, T., & Miller, H. (2008). Injection technique. The Foundation Years, 6(4), 252- 255.
19. 19. Hunter J. Intramuscular injection techniques. Nursing Standard. 2008; 22(24): 35-40.
20. 20. Craven R. F, Hirnle C. Jensen S. Fundamentals of nursing: human health and function (Transl. Ed. N. Uysal and E. Çakırcalı). Ankara: Palme Press;2015.
21. 21. Tambunan E. H, Wulandari I. S. Utilizing z-track air lock technique to reduce pain in intramuscular injections. Jurnal Ners. 2015; 10(1): 112–117.
22. 22. Kağıtçıbaşı Ç. New Human And Humans: An Introduction To Social Psychology (10th ed).İstanbul: Sistem Matbaacılık; 2015. 23. Özpulat F. Determination of opinions of health personnel working at ministry of health Ankara Dışkapı training and research hospital regarding in-service training program, Journal of Nursing Science and Art of Maltepe University, 2010; 283-292.
23. 24. Atak H. The Turkish adaptation of the ten-item personality inventory. Archives of Neuropsychiatry. 2013;50(4): 312-319.
24. 25. Şenses M, Yıldızoğlu İ. Traditional maternity and childcare practices of mother-in-laws and brides in eight different cities. Child Forum. 2002;5(2): 44-48.
25. 26. Merdan E. Research the relationship between five factor personality theory’ and business values: a research in banking. Journal of Gümüşhane University Social Sciences Electronics. 2013;4(7): 140-159.
26. 27. Dil S, Bulantekin Ö. Determination of the Relationship Between Family Functionality and Locus of Control and Levels of Academic Success Among Nursing Students. Çankırı Karatekin University School of Health, Journal of Psychiatric Nursing. 2011;2(1): 17-24.
27. 28. Delialioğlu O, Yıldırım Z. Students’ perceptions on effective dimensions of interactive learning in a blended learning environment. Educational Technology & Society. 2007;10(2): 133-146.
28. 29. Sönmez, B., & Yıldırım, A. (2014). Determination of nurses’ innovative behaviour and their views about the factors affecting their innovative behaviour: a qualitative study in a university hospital. Journal of Health and Nursing Management, 2(1), 49-59.
29. 30. Selimoğlu E, Yılmaz H. B. Effects of in-service training on institutions and employees. Paradoks, Economics, Sociology and Policy Journal. 2009; 5(1): 1-12.
30. 31. Bandura, A. A. (2001). Cognitive theory: An agentic perspective. Annual Review of Psychology. 2001; 52(1): 1-26.