![]() This does not alter our adherence to PLOS ONE policies on sharing data and materials. OA and RSH declare no competing interests. He is an officer of the International Union against Sexually Transmitted Infections (treasurer), and a charity trustee of the Sexually Transmitted Infections Research Foundation. He is an NIHR Journals Editor and associate editor of Sexually Transmitted Infections journal. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the paper and its Supporting Information files.įunding: The authors received no specific funding for this work.Ĭompeting interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: JDCR reports personal fees from GSK Pharma, Hologic Diagnostics, Mycovia and Janssen Pharma as well as ownership of shares in GSK Pharma and AstraZeneca Pharma and is author of the UK and European Guidelines on Pelvic Inflammatory Disease is a Member of the European Sexually Transmitted Infections Guidelines Editorial Board is a Member of the National Institute for Health Research Funding Committee (Health Technology Assessment programme) was previously a Member of the National Institute for Health Research HTA Primary Care, Community and Preventative Interventions Panel (2013-2016). Received: AugAccepted: ApPublished: May 3, 2021Ĭopyright: © 2021 Ayinde et al. ![]() ![]() PLoS ONE 16(5):Įditor: Mª Ángeles Peña Fernández, University of Alcalá, SPAIN Limitations included considerable heterogeneity, poor reporting of randomisation, and possible bias in outcome measures from unblinding of assessors or participants.Ĭitation: Ayinde O, Hayward RS, Ross JDC (2021) The effect of intramuscular injection technique on injection associated pain a systematic review and meta-analysis. The effect of changing the needle after drawing up the injectate on injection pain was conflicting and warming the injectate did not reduce pain. There was insufficient evidence on the benefits of the ‘Z track technique’ (2 studies, SMD = -0.20) and the cold needle technique (2 studies, SMD = -0.73) on injection pain. Acupressure techniques which mostly involved applying sustained pressure followed by intermittent pressure (tapping) to acupressure points local to the injection site reduced pain (4 studies: SMD = -1.62), as did injections to the ventrogluteal site compared to the dorsogluteal site (2 studies, SMD = -0.43). Of these, applying manual pressure (4 studies, SMD = -0.85) and Helfer (rhythmic) tapping (3 studies, SMD = -2.95) to the injection site reduced injection pain, whereas the use of a plastic device to apply local pressure to the skin (ShotBlocker) did not significantly reduce pain (2 studies, SMD = -0.51). ![]() 10 studies applied local pressure to the injection site. Evidence-based nursing practice is pivotal in ensuring patient safety, and regular updates, monitoring, and intervention mapping strategies may help improve practitioners' adherence to clinical recommendations.29 studies were included in the systematic review and 20 studies in the meta-analysis. Some of the current nursing practices pertaining to IM injections seem to evolve more like a tradition passing from one generation to the next and based upon Schön’s and Benner's learning concepts. Vial breakage by neck wrapping with a cotton ball from an outward direction results in low glass particles than the entire ampoule neck wrapping with a gauze pad from an inward direction method. The risk increases with larger bore, unfiltered needles (safe with 23G). However, economic constraints, time consumption, and workforce shortages are significant hindrances to its routine practice. The syringe filters significantly minimize the risk of glass particle contamination. Aspiration is unnecessary and is now reserved only for dorsogluteal site injections. The World Health Organization and Centers for Disease Control and Prevention do not recommend it. Blood aspiration is observed mainly in the dorsal gluteal (15%) and deltoid (12%) injections. Though nurses continue practicing aspirations, most do it for a short duration than the recommended time of 5 to 10 seconds. The Practice of Aspiration Prior to Drug Administration However, there is still ongoing debate over this point. ![]() Ultrasound guidance and proper needle length are key factors in ensuring true IM injections among patients with increased body mass index. Female sex, obesity, subcutaneous fat thickness, and injection site play significant roles in governing the same. True intramuscular injections are observed only in 32 to 52%, with the incidence even falling to 8% among females. Nursing, Allied Health, and Interprofessional Team Monitoring ![]()
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