Administering Intramuscular Injections

Equipment:

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• Appropriate size syringe and needle that is based on patients age and site of administration
• Alcohol swab
• Small gauze pad
• Vial or ampule of medication
• clean gloves
• Medication administration record or computer printout
• Sharps container

Steps:

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1. Verify Order
2. WIIAPA:

1. 1. Wash hands
   2. Introduce self
   3. Identify patient (use 2 identifiers)
   4. Allergies – don’t forget food allergies
   5. Plan of care
   6. Assess patient

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3. Check accuracy and completeness of each MAR with provider’s written order including the patient’s name, medication name and dosage, route of administration and time of administration.
4. Review medications action, purpose, normal dose, side effects, time of peak onset and nursing implications.
5. Check medications expiration date.
6. Perform hand hygiene.
7. Utilizing aseptic technique, prepare medications for only one patient at a time and deliver medications to patient at correct time.
8. Close room curtain or door.
9. Apply the seven rights of medication administration.
10. Ensure patients name, DOB, and allergies.
11. Compare at bedside, MAR with names of medications on medication labels and patient name.
12. Educate patient on medications including action and possible side effects. Allow patient to ask questions.
13. Perform hand hygiene and apply clean gloves.
14. Select appropriate site.
15. Place patient in a comfortable position.
16. Relocate appropriate site using anatomical landmarks.
17. Clean site with antiseptic swab beginning at the center of site and rotating outward in circular direction for about 5 cm or 2 inches.
18. Remove needle cap by pulling it straight off.
19. Hold syringe between thumb and forefinger of dominant hand; like a dart, palm down.
20. Administer injection using Z track method, by positioning ulnar side of nondominant hand just below site and pull skin laterally approximately 1-1.5 inches and with dominant hand, inject needle quickly at 90-degree angle into muscle.
21. Pull back on plunger 5 to 10 seconds and if no blood appears, inject medication slowly. When administering vaccines, there is no need to aspirate after injecting needle.
22. Wait 10 seconds once medication is injected and then smoothly and steadily withdraw needle, release skin and apply gauze gently over site.
23. Apply gentle pressure to site but do not massage.
24. Apply bandage if needed and help patient to comfortable position.
25. Discard uncapped needle and attached syringe into sharps container.
26. Remove gloves and perform hand hygiene.
27. Stay with patient for several minutes and observe for any allergic reactions.
28. Document