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Skill

Intramuscular Injection

Prerequisite Skills

Safe medication administration; aseptic technique

Critical Element Criteria

Students must meet criteria of Critical Elements to safely perform the skill based on evidence-based practice. Score can be pass/fail, letter grade, or point assignment. Only acceptable score for Critical Elements is 100%

Critical Elements

  • Prepare medication for one patient at a time.
  • Calculate accurately, the dosage, confirming safe dose range.
  • Verbalize potential adverse effects and any monitoring requirements.
  • Perform 3 checks for safe medication administration.
  • Utilize 2 patient identifiers.
  • Evaluate patient allergies.

Procedure

Prior to Treatment: (Critical Thinking)

  • Assess patients need for treatment.
  • Confirm order.
  • Gather equipment: medication, medication administration recorded (MAR), clean gloves, sterile syringe of appropriate size and gauge, alcohol swabs, small gauze square, band aid, label for syringe.

Patient Interaction: (Safety)

  • Patient identifiers.
  • Provide for privacy.
  • Explain procedure.
  • Confirm allergies.
  • Wash hands.

Steps of the Procedure (Patient Centered Care; Infection Control)

  1. Select the appropriate administration site using landmarks.
  2. Cleanse the injection site using an alcohol wipe, using firm, circular motion while moving outward from the insertion site. Allow the area to dry.
  3. Remove the needle cap – pull straight off. Hold the syringe in dominant hand between thumb and forefinger.
  4. Displace the skin using if using the Z-tract technique.
  5. Quickly dart the needle through the skin at a 90 degree angle.
  6. Use thumb and forefinger of non-dominant hand to hold the lower end of the syringe. Slide dominant hadn"t other end of the plunger.
  7. Inject the medication slowly.
  8. Withdraw the needle at the same angle. If oozing is present, apply gentle pressure using gauze band aid or alcohol wipe. Do not massage the site.
  9. Activate needle protection device and dispose in sharps container.
  10. Dispose of or remove equipment and supplies.

After Procedure (Patient Centered Care, Safety)

  • Straighten room making patient comfortable, replace call light.
  • Re-assess site.
  • Wash hands before leaving room.

Documentation (Inform lessthan ulatics, Communication)

  • MAR should reflect: right patient, medication, dose, frequency, and route.
  • Reassessment for PRN medications after 30 minutes.