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Item type Presentation

Title Blood Aspiration During Intramuscular Injection

Authors Infanti Mraz, Megan A.; Thomas, Christine; Rajcan, Lois

Downloaded 17-Feb-2018 15:06:01

Link to item http://hdl.handle.net/10755/335264

BLOOD ASPIRATION

WHO and CDC recommendations to eliminate blood aspiration during IM injections

Decrease pain

Lack of reported adverse reactions

The rationale for aspiration was to prevent a serious reaction if a drug intended for IM injection was injected into a vein or artery

While there is no recent documented research evidence How does the lack of evidence, become evidence?

PURPOSE

The purpose of this study was to investigate the technique RNs use during IM injections and incidence of blood aspiration.

IRB for this purpose was sought and approved by West Chester University of Pennsylvania and The Chester County Hospital

METHODS

Descriptive Design Survey

How often is aspiration used during IM injection by RNs?

What amount of time do nurses spend in aspiration during IM injection?

What is the incidence of RN blood aspiration while performing IM injections?

What is the incidence of injury that occurs from IM injection by the RN?

SUBJECT SAMPLE

Power analysis yielded a total subject

sample of 122 subject participants

(power .80, alpha .05)

A total of 165 subjects were recruited

The total N for this study was 164participants

RESULTS Variable Mean (SD) n (%)

Age (years) 44.5 (11.5)

Years of RN practice 17.7 (12.1)

RN specialty

Adult acute, M/S,

ICU, ER

Maternal Child

Other

Pediatric acute

Psychiatric

85 (52%)

15 (9%)

52 (32%)

7 (4%)

2 (1%)

Highest level of

education

Diploma

ADN

BSN

Masters

Doctoral

Other

28 (17%)

25 (15%)

76 (46%)

24 (15%)

8 (5%)

2 (1.2%)

Sample

Demographics

RESULTS

Variable n (%)

Frequency of performing aspiration

during IM injection Never

Rarely

Occasionally – about 30%

Sometimes – about 50%

Frequently – about 70%

Usually – about 90%

Every time

3 (2%)

13 (8%)

8 (5%)

10 (6%)

5 (3%)

42 (27%)

75 (48%)

Frequency of Performing Aspiration

(n=156)

RESULTS

Incidence of

blood aspiration n (%)

0

1

2

3

4

5

> 13

99 (60%)

32 (20%)

11 (7%)

7 (4%)

4 (3%)

3 (2%)

6 (4%)

Blood Aspiration Incidence

ANALYSIS

Blood aspiration does occur in the acute care settings and other patient populations

Current recommendations to eliminate the practice of aspiration during IM injection for all IM injections may not be safe

Nurses should identify whether a medication, dose, administration rate, patient condition, or emergent situation if mistakenly given IV would be harmful for patients

When these instances occur and could pose a threat to patient safety if accidently given IV vs. IM, then the practice of aspiration during the IM injection procedure should be implemented

IMPLICATIONS FOR PRACTICE

1) No aspiration needed :

• length of time used would post a danger

•when the medications would not pose a patient safety concern

2) Aspiration needed :

•medication would be a safety concern - based on rate of administration, dose, viscosity, or other reasons. • high doses of narcotics

• Viscous medications such as Ativan (lorazepam) that

require a 1:1 dilution if administered IV.

FUTURE RESEARCH

Research investigating where the medication is disbursed and to what degree is needed.

There is a need for further evidence to inform the practice of IM injection technique that blends practice, theory and research.

The researchers recommend a systematic decision making process that includes patient condition, medication properties, and the situation at hand be used by nurses during to IM injections to decide if aspiration is warranted.

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Thank you for your time and attention

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