The assessment of knowledge and practical skills of intramuscular injection administration among nursing staff: a cross-sectional study

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Urska Fekonja
Zvonka Fekonja
Dominika Vrbnjak


Injections, intramuscular, primary healthcare, punctures, evidence-based nursing


Aim: This study aimed to assess the level of knowledge and practice of intramuscular injection among nurses and nursing assistants in primary healthcare. Background: Evidence-based guidelines recommend the use of the ventrogluteal site for intramuscular injection; however, it remains infrequently utilised by nurses. Study design and methods: Cross-sectional study was conducted using a convenience sample of 200 nurses and nursing assistants employed in one of the largest healthcare centres on the primary healthcare level in Slovenia. The data were collected using a self-reported questionnaire and analysed using descriptive and inferential statistics. Results: The majority of the participants (88.5%) prefer to use the dorsogluteal site for intramuscular injections, while the ventrogluteal site is commonly used only by 7.5% of the respondents. Participants avoid the ventrogluteal site because of not being used to it (30.5%), unfamiliarity (27.0%), lack of adequate knowledge (19.5%), fear of harming the patient (8.5%), and not knowing how to determine the site (10.3%). Conclusion: Nursing staffs knowledge and use of ventrogluteal site for intramuscular injection is limited and are using traditional methods instead of current evidence-based guidelines. Implications: Improvements are needed in nursing education and continuous training. The nurse administrators in clinical practice should increase awareness of the benefits of using evidence-based practice and re-evaluate how the nursing professionals provide the administration of intramuscular injections and the need for additional education. The education and training about intramuscular injections should be implemented regularly in daily clinical practice of nursing professionals for promoting the safest practice for patients.

What is already known about the topic?

  • The administration of intramuscular injections is a commonly performed nursing intervention in clinical practice.

  • The technique for delivering intramuscular injection is associated with potential safety risks for the patient when it is not done according to evidence-based guidelines and safe practices.

  • The use of ventrogluteal muscle has been recommended in nursing literature for many years now, but nurses still use it infrequently and prefer to use the dorsogluteal site.

What this paper adds:

  • Despite being both legally permitted to administer intramuscular injection, nurses and nursing assistants demonstrated different levels of knowledge and the use of evidence-based recommendations about intramuscular injection administration.

  • Nurses avoid using the ventrogluteal side due to lack of knowledge and skills.

  • Stronger emphasis on raising awareness about the importance of using evidence-based practices during nursing education and continuous training is needed.

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