Reflection on IM Injection Technique in Acute Care Nursing Practice

This assignment presents a reflective journal entry from a nursing student focusing on intramuscular (IM) injection techniques within an acute care setting. The student reflects on their learning experience, particularly regarding the importance of sterile practices to prevent syringe contamination, and the utilization of the Z-track technique to ensure effective medication delivery and minimize patient discomfort. The reflection incorporates the DIEP framework, analyzing the experience, interpreting its meaning, evaluating its value, and planning for future practice improvements. The student emphasizes the need for practical training, patient-centered care, and adherence to safety protocols, including the use of clean rooms and sterile gloves. The reflection highlights the importance of continuous learning and competency in nursing practice to enhance patient outcomes and promote quality healthcare delivery, supported by relevant literature.

Running head: ACUTE CARE 1
Acute Care
Name
Institution

ACUTE CARE 2
ACUTE CARE
As administration of IM injections is commonly used, I observed more practical skills
should be given to the nurses. During a lesson, we were learning about the consequences of using
a contaminated syringe to perform an injection on a patient. We were taught about the procedure
to take before administering the injection. The procedure was to sterilize the needle. However, I
had the thought that the syringe can be contaminated even after sterilization. This happens when
the syringe needle is left out in the open. This is because even though methods to prevent
contamination are being applied like sterilizing the syringe with alcohol, cases of patients with
infections arising from contaminated syringes is on the rise. During a practical lesson I also
observed that after administering an injection, the medicine was tracking back and leaking. Our
instructor gave me a technique to follow to prevent back tracking. While I know how to
administer an IM injection, there are certain areas I need to improve on.
An IM injection is one of the most common injections administered to patients (Jin et al.,
2015). The IM injection is used to administer medication directly to the muscle tissues. This
allows quick absorption of the medication into the bloodstream. Administering the injection
improperly, resulting to leaking of the medicine will cause the medication to be ineffective. Also,
administering an injection with a contaminated syringe could lead a number of infections to the
patient. This is significant not to me but to the entire nursing profession as health care should be
patient centers. One of the main objectives in provision of health care is to provide quality
treatment to the patients.
This raises the questions, are the current nurses informed enough to use the correct
technique while administering injections? Do they follow the correct procedures to avoid
contaminating the syringe?

ACUTE CARE 3
Cocoman and Murray (2008) explain that the Z track technique should always be utilized.
This is done to prevent backtracking. I was guided by our instructor on how to perform the Z
track technique. It involves displacing the skin over the injection site. Using the non-dominant
hand, you the skin is pulled away from the underlying tissue and the medication injected. After
the injection, the skin is released. This traps the medicine in the muscle. This was a learning
experience for me. To be able to ensure the patients receives effective medication is a great
satisfaction.
Administration of medicine through injections is done in high numbers and can be
overwhelming to the nurse administering. Exposure of the syringe will lead to microbial
contamination. This brings about a number of infections to the patient. Drugs which are usually,
prepared and stored are at really high risks of contamination. It is a requirement by United States
Pharmacopeia to restrict the storage time of drugs in syringes to a maximum of one hour. I
realized apart from environmental factors Incompetency and lack of care from the nurse are the
major contributors to syringe contamination due to exposure. Knowledge of this type of
contamination, I believe to assist in reducing cases of infections from contaminated syringes. I
believe changes could be made to the nursing education system to provide competency to the
nurses.
When I evaluate the insight, it has shown me a new way of approaching healthcare
provision. While providing health care it should be patient centered. Interests of the patient
should be prioritized. It is important the patient gets quality care from me. Using the correct
technique, the Z track technique, will ensure the medication is effective and reduce pain
experienced by the patient. It is important to ensure the syringes are free from contamination.

ACUTE CARE 4
This insight has been a great learning point as I will ensure my future practice meets the level of
quality required by patients
In the future I would ensure when administering an IM injection, I would give my
complete attention. The patient is my number one priority and I leaving just a little room for
error could have negative consequences to the patient. I believe learning the correct injection
procedures could bring a big positive change in the future. However, just theoretical learning is
not enough, practical training should be included in the course work. Nursing educators should
ensure their students graduate already equipped with the necessary skills and will be competent
in their nursing practice (WHO, 2015).
I will set aside time, at least one hour a week for a practical lesson. I would like to be able
to master the Z track technique. Also, I would set aside time for discussions with my peers to get
their insights on the technique. To prevent syringe contamination through exposure, I will always
work in an ISO class 5 clean room (Chadwick, 2015). This is to meet the requirements by USP
chapter 797. Also, I will make a habit of washing my hands before handling the equipment and
always wearing sterile gloves.

ACUTE CARE 5
References
Chadwick A, Withnell N (2015). How to administer intramuscular injections. Nursing standard.
30(8), 36-39
Derryn A. et al., (2016). Microbiological contamination of drugs during their administration for
anesthesia in the operating room. Anesthesiology, 124(4), 752-762.
DOI:10.1097/ALN.0000000000001041
Kalra, S. (2017). Indian injection technique study: injecting complications, education, and the
health care professional. Cross mark, 8, 659-672 DOI: 10.1007/s13300-017-0244-9
Kara, D., Uzelli, D. and Karaman D., (2015). Using ventrogluteal site in intramuscular injections
is a priority or an alternative? International journal of caring sciences, 8(2), 507-512
WHO (2015). WHO guideline on the use of safety-engineered syringes for intramuscular,
intrademal and subcutaneous injections in health care settings.