Mary Shortreed

Mary Shortreed

Youngstown State University, USA

Title: Intramuscular injection best practices: What does the literature say?


Mary Shortreed is a National League for Nursing (NLN) Certifi ed Nurse Educator. She is an instructor at the Youngstown State University. She is currently pursuing a Doctor of Nursing Practice (DNP) at Case Western Reserve University, Cleveland, Ohio.


Administering intramuscular injections is a skill which is frequently performed by nurses and nursing students. However, the literature about the proper technique for administering an intramuscular injection presents confl icting information. Further, selected nursing textbooks are not in agreement about this procedure. Four fundamentals of nursing textbooks and current literature, including literature reviews, were reviewed to compare recommendations for the use of the dorsogluteal site, Z-track method, aspiration and bunching and fl attening when administering an intramuscular injection. Th is presentation discusses the results of this review of the literature and texts about performing an intramuscular injection. None of the textbooks reviewed recommended using the dorsogluteal site for an intramuscular injection. Th e literature was inconclusive about the use of the site. All nursing textbooks reviewed recommended the use of the Z-track technique for all intramuscular injections. All four nursing textbooks recommended the use of aspiration with intramuscular injections. None of the literature supported aspiration for intramuscular injections. Several national and international health organizations suggested that aspiration is not necessary for immunizations. Th e literature is not defi nitive on the use of either bunching or fl attening when giving an intramuscular injection. However the length of the needle should be considered when using either technique. Due to a lack of a strong evidence-base, further research is needed to determine best practices about proper technique for administering intramuscular injections.

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