Invasive procedures (e.g., Indwelling catheter insertion, NG tube insertion, subcut/intramuscular injections) Aseptic technique (e.g., Central Venous Access Device management, epidural management,...

Invasive Procedure
Clinical procedure- Intramuscular Injections
The clinical procedure that I have chosen in Invasive procedures is “Intramuscular injections”. Intramuscular injections (IM injections or IMI) form a part of medical procedures for administering medications directly into the muscles. IM injections are provided to patients who typically need fast acting medications to be administered. Various sites maybe used for IMI typically the following sites are used depending on the amount and type of medication to be administered namely, Deltoid site, Dorsogluteal site, Ventrogluteal site, Castus lateralis site, Rectus femoris site.
Most common adverse event(s) associated with Intramuscular Injections
Adverse events in relation to nurses that may occur while administering IM injections are mostly non-lethal and have been declining in occu
ence in the recent years. There are a number of adverse events that may occur in the administration of IMI’s. These include haemo
hage in individuals with bleeding disorders, pain, sciatic nerve injury, injection fi
osis and infection.
These events may occur amongst other reasons, due to failure in ensuring the co
ect site of administering medication, or e
oneous depth or rate of delivery of medication. According to Wynaden et al. (2006), the most common cause for adverse events is inco
ect choosing of muscle group, coupled with proper or improper technique.
Equally important for nurses is to ensure the co
ect dosage in relation to the site of administration, ignoring which can result in adverse events. Larger doses need to be administered on sites with larger muscle mass (Glogau, & Kane, 2008; Malkin, 2008).
Thus, by taking necessary precautions nurses can reduce the occu
ence of adverse events in relation to Intramuscular injections significantly.
The most contemporary research associated with Intramuscular Injections
One of the most contemporary research in the nursing practice of administering IM injections was published in 2004, by Kathleen Greenway of Oxford Brookes University in the journal, ‘Nursing standard: Official newspaper of the Royal College of Nursing’. In this journal article titled “Using the ventrogluteal site for intramuscular injection” , the author proposes a change in prefe
ed IM injections administering site from Dorsogluteal to Ventrogluteal. This is suggested for a number of reasons (Greenway, 2004).
First, Ventrogluteal site is more appropriate since it is largely free from any major nerves and blood vessels, thereby reducing chance of adverse events. In addition, muscle in this area is also large and well defined.
Second, the Dorsogluteal region is one that is comparatively high risk. This is because, slight e
or in this region can result in inadvertent administration of drug into the superior gluteal artery. It can also result in damage to the sciatic nerve that may lead to pain or paralysis.
Third, since the amount of subcutaneous tissue on the Dorsogluteal region varies according from person to person, if medicine is mistakenly administered into the subcutaneous tissue, it can result in i
itation and negative uptake of the drug.
Fourth, Dorsogluteal site has also been found to be associated with gangrene, tissue necrosis, muscle contraction and even fi
osis.
Inco
ect administering can also lead to abscess and inflamed skin.
Due to all these reasons, the article suggests a change in practice from Dorsogluteal region as a site for IM injections to...