Evidence-based practice: to promote ventrogluteal site as the first choice of intramuscular injection

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Abstract Description
Abstract ID :
HAC5835
Submission Type
Authors (including presenting author) :
Wong SY (1)
Affiliation :
(1) Accident and Emergency Department, Yan Chai Hospital
Introduction :
Ventrogluteal injection site is suggested as the safest intramuscular injection site by recent studies. The Medical Council of Hong Kong (2016) indicates that dorsogluteal site risks damaging the sciatic nerve, so ventrogluteal site is more preferable.

Although the Basic Nursing Standards for Patient Care- Medication Administration published by Hosptial Authority (2017) supports above mentioned recommendation, majority of nurses in my department prefer dorsogluteal site for intramuscular injection.

In order to understand the best practice on intramuscular injection site selection, literature search was performed and 17 journals were reviewed by Johns Hopkins Nursing Evidence-Based Practice Research Evidence Appraisal Tool. The findings reflected that ventrogluteal site(VG) was better than dorsogluteal site (DG) with following advantages: VG is less painful as well as thinner subcutaneous fat and more importantly VG site can free from sciatic nerve injury as it is anatomically far away from sciatic nerve and superior gluteal artery. The findings supported the suggestion from Medical Council of Hong Kong (2016). Based on the evidence based practice was established, training sessions were provided to nurses in my department and this project was conducted to determine the outcome of training about the practice of nursing staff on intramuscular injection site selection.
Objectives :
To enhance nurse's knowledge on intramuscular injection site selection by evidence-based practice through providing training session.

To promote ventrogluteal site as the first choice of intramuscular injection.
Methodology :
A simple pre-test, post-test design was adopted. 21 nurses from Accident and Emergency Department, Yan Chai Hospital, were recruited for training on the use of ventrogluteal site for intramuscular injection. Questionnaires were used by means of data collection after training.
Result & Outcome :
15 participants opted for dorsogluteal site as first choice for intramuscular injection. 14 participants expressed their willingness to change the practice or continue to decide ventrogluteal site as their first choice for intramuscular injection. The rest of them (n=7) did not want to change their practice because of difficulty in changing habit (n=3) and difficulty in locating the ventrogluteal site (n=4).

Although the training would enhance nurse's intramuscular injection with evidence-based knowledge that ventrogluteal site was the safest intramuscular injection site, it was habitual challenge to change nurse's practice. More theoretical training with injection workshop might help to reinforce the injection technique, thus further promoted best practice among nurses. The finding of this project was similiar to the study of Arslan and Ozden (2018).

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