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

Larkin, Theresa A; Ashcroft, Elfriede; Elgellaie, Asmahan; Hickey, Blake Anthony

doi:10.1016/j.ijnurstu.2017.02.017

Cited by 22 publications

(50 citation statements)

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“…The sciatic nerve is the most commonly hit nerve, especially in children, older patients and thin patients. Also, the absorption of medicine is much slower after DG application, because of the thicker layers of fatty tissue [10,14].…”

Section: Discussionmentioning

confidence: 99%

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Frequency of application and level of nurses’ knowledge on administering intramuscular injections into the ventrogluteal site

et al. 2018

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Introduction. The most recent literature data and studies have recommended the middle gluteal muscle or the ventrogluteal side as the site for the application of intramuscular injection. Although it has been recommended for many years because of its many advantages it is rarely used in the clinical practice. The aim of this study was to evaluate the frequency of application of intramuscular injection and the level of nurses' of knowledge on how to give injections at the ventrogluteal site. Material and Methods. This study was conducted as an observational, analytical cross-sectional study at two healthcare institutions of different medical care levels on a sample of 96 nurses. The Questionnaire on the level of knowledge concerning the Ventrogluteal Site for Intramuscular Injection was used as a research instrument. Results. A quarter (28.1%) of the nurses knew that the ventrogluteal site or the middle gluteal muscle was the recommended site for intramuscular injection, while in their clinical practice only 20.8% of the nurses used it. The average score on the Questionnaire on the level of knowledge concerning the Ventrogluteal Site for Intramuscular Injection was 8.8 ± 4.1 (SD), the maximum score being 22. Conclusion. The results of the study show that the ventrogluteal site for administering intramuscular injections is rarely used, and the level of knowledge which the nurses from the study sample have shown about the procedure and the advantages of using the ventrogluteal site for intramuscular injections is rather low. SažetakUvod. Prema najnovijoj literaturi i istraživanjima preporučeno mesto za davanje intramuskularnih injekcija je srednji glutealni mišić odnosno njegova ventroglutealna strana. Iako se već dugi niz godina preporučuje, zbog svih prednosti koje ima, u kliničkoj praksi se retko koristi. Cilj ove studije bio je da se proceni učestalost korišćenja ventroglutealnog mesta i nivo informisanosti medicinskih sestara o intramuskularnoj injekciji u ventroglutealno mesto. Materijal i metode. Istraživanje je sprovedeno kao opservativna, analitička studija preseka u dve zdravstvene ustanove različitog nivoa zdravstvene zaštite na uzorku od 96 medicinskih sestara. Kao instrumenti istraživanja korišćen je upitnik za procenu znanja o ventroglutealnom mestu za davanje intramuskularne injekcije. Rezultati. Da je ventroglutealno mesto, odnosno srednji glutealni mišić mesto izbora za intramuskularnu injekciju znalo je četvrtina (28,1%) medicinskih sestara, a u kliničkoj praksi ga koristi samo 20,8% medicinskih sestara. Prosečan skor na upitniku znanja medicinskih sestara o ventroglutealnom mestu za intramuskularnu injekciju bio je 8,8 ± 4,1 (SD) od maksimalno mogućeg skora 22. Zaključak. Rezultati sprovedene studije su pokazali da se ventroglutealno mesto za davanje intramuskularnih injekcija retko koristi, kao i da je nivo znanja medicinskih sestara o proceduri i prednostima intramuskularne injekcije u ventroglutealno mesto ograničeno. Ključne

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Section: Discussionmentioning

confidence: 99%

“…The results of conducted studies show that injections into the ventrogluteal site are the least painful and there is almost no bleeding. Compared to the dorsogluteal site, the positioning of the patient is easier, and the risk of contamination with feces and urine is lower [2,10].…”

Section: Introductionmentioning

confidence: 99%

Frequency of application and level of nurses’ knowledge on administering intramuscular injections into the ventrogluteal site

et al. 2018

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“…Even with these precautions, some patients feel the pain during the IM injections. Many physical-procedural interventions can be used to prevent pain (Cocoman & Murray, 2008;Kara et al, 2015;Kara & Yapucu Güneş, 2016;Kaya, Salmaslioğlu, Terzi, Turan, & Acunaş, 2015;Larkin, Ashcroft, Elgellaie, & Hickey, 2017). Some of these interventions include acupressure, manual pressure, postinjection massage, the ShotBlocker, the Z-technique, the air-lock technique, and altered injection speed.…”

Section: Introductionmentioning

confidence: 99%

Systematic review and meta‐analysis: Physical‐procedural interventions used to reduce pain during intramuscular injections in adults

Zeyrek

Takmak

Kurban

et al. 2019

Journal of Advanced Nursing

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Aims To assess the effectiveness of physical‐procedural interventions in reducing pain during intramuscular injections. Design Systematic review and meta‐analysis. Method English keywords were used to search databases [MEDLINE (OVID, Ebsco), SCOPUS, Science Direct, COCHRANE and the reference lists from retrieved articles] from their inception to November 2017 and randomized and quasi‐experimental trials were selected based on inclusion and exclusion criteria. The standardized mean difference and random effects model were used. Results From 2,318 articles, 15 articles (1996–2017) met the criteria for the meta‐analysis. Physical‐procedural interventions described in the articles were included in this systematic review. The overall standardized mean difference was 0.595 (95% confidence interval (CI) = 0.417–0.773), indicating a moderate effect on pain levels. Generally, these interventions (two‐needle technique, acupressure, manual pressure, ShotBlocker, Z‐technique, air‐lock technique, injection site postinjection massage, and speed of injection) have been found to moderately reduce pain. Conclusion It seems difficult to conclude that a single intervention reduces pain in adults. However, we can state that the most effective interventions for reducing pain during intramuscular injections in adults involve the ventrogluteal site, the Z‐technique, and manual pressure. Impact The systematic review will provide guidance to clinicians, staff, and educator nurses and future studies. The systematic review will help nurses and educators apply techniques based on evidence in any setting. The systematic review will guide well‐designed and well‐reported studies to contribute to the accumulation of evidence in nursing research.

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“…Complications that might occur include abscess, necrosis, infection, tissue damage, hematoma, chronic pain, injuries to nerve, bone, and vein, periostitis, and contracture. 3,4,[7][8][9][10] The most important complication, however, is sciatic nerve damage and it takes place particularly due to injections delivered to dorsogluteal (DG) site. 1,2,11 The sciatic nerve is the most frequently affected nerve, particularly in children, the elderly, and underweight patients 6 .…”

Section: Introductionmentioning

confidence: 99%

“…In addition, studies show that although administration of IM injections is one the most common responsibility of nurses, their knowledge of IM injection, administration sites, and methods is insufficient and it is not evidence-based. 4,9,10,17 Study questions: 1. To what extent are the nurses familiar with the complications that might occur at the sites of IM injections?…”

Section: Introductionmentioning

confidence: 99%

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

Turan

Aydın

Kaya

2019

Kocaeli Üniversitesi Sağlık Bilimleri Dergisi

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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...

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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

Cited by 22 publications

References 30 publications

Frequency of application and level of nurses’ knowledge on administering intramuscular injections into the ventrogluteal site

Frequency of application and level of nurses’ knowledge on administering intramuscular injections into the ventrogluteal site

Systematic review and meta‐analysis: Physical‐procedural interventions used to reduce pain during intramuscular injections in adults

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

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