Improving the success rate of gluteal intramuscular injections

• Published in: Pancreas Vol. 42; no. 5; p. 878
• Main Authors: Boyd, April E, DeFord, Linda L, Mares, Jeannette E, Leary, Colleen C, Garris, Jeana L, Dagohoy, Cecile G, Boving, Valentine G, Brook, James P, Phan, Alexandria, Yao, James C
• Format: Journal Article
• Language: English
• Published: United States 01.07.2013
• Subjects: Aged; Antineoplastic Agents, Hormonal - administration & dosage; Body Mass Index; Buttocks; Drug Delivery Systems - instrumentation; Drug Delivery Systems - methods; Female; Humans; Injections, Intramuscular - instrumentation; Injections, Intramuscular - methods; Male; Middle Aged; Octreotide - administration & dosage; Tomography, X-Ray Computed
• ISSN: 1536-4828
• DOI: 10.1097/MPA.0b013e318279d552

This study aimed to improve the success rate of gluteal intramuscular (IM) injection. The outcomes of 328 intended gluteal IM injections in 115 patients receiving depot octreotide were evaluated using computed tomography performed in routine clinical practice. Patient-, nursing-, and technique-dependent factors were correlated with successful delivery of medication. Techniques associated with successful injection were taught to center nurses. At baseline, 52% of injections were successfully delivered (66% men, 36% women; P = 0.001). Factors associated with successful delivery included nurses' frequency of injections (P = 0.008), landmarks use to select injection site (P < 0.001), quick needle insertion (P < 0.001), and use of nonsyringe hand to compress injection site (P < 0.001). Patient-related factors included male sex (P < 0.001), lower body mass index (P < 0.001), and lower skin-to-muscle depth at injection site (P < 0.001). Techniques associated with successful injections were then taught to center nurses. After instruction, the success rate increased from 52% to 75% (P = 0.001). Importantly, improvements were observed in both men (66%-75%; P = 0.43) and women (38%-75%; P < 0.001). Successful injection was associated with better control of flushing among those with carcinoid syndrome (P = 0.005). Intended gluteal IM injections often are given into the subcutaneous space. Education in techniques associated with successful injections improves IM delivery rates.