Annotated Bibliography on correct site selection for intramuscular medical administration

Write anotated bibliography on the topic "the importance of correct site selection for intramuscular medical administration". Pick three relevant research papers.

Article 1

Selected Paper: Tugrul, E., & Khorshid, L. (2014). Effect ofpain intensity of injection sites and speed of injection associated with intramuscular penicillin. International Journal of Nursing Practice , 20, 468 - 474.
This paper by Tugrul and Khorshid, aims to conduct a study whereby the effect of the choice of different injection sites and the duration of injections on the severity and degree of pain associated with the injection of penicillin in the intramuscular regions will be explored and analyzed (Tugrul & Khorshid, 2014). The study was conducted using a single group design of quasi-experiment whereby 1 M pencillin injections were administered over two time durations of 5 seconds and 10 seconds.
Experiment was conducted on an outdoor clinic of a large government hospital and the sample population aged from 18 to 62 years of age. The results depicted that the intensity of pain did not differ for the 5 second and 10 second durations for DG and VG areas, and the scores of pain intensity for 5 second duration injections were not different between the two different sites of injection.
A minor negative correlation existed between the 5 second VG site with the growing age of the patient. The effectiveness of this study lies in the fact that it successfully, highlights the effect of speeds of injection, and the choice of the sites on the severity of the pain faced by the patients. Very few studies have examined this phenomenon of understanding pain severity on the choice of injection sites and injection durations but the limitation of this study lies in the small localized sample chosen for the experiment.
This paper will be useful for me, as I too intend to study the importance of the right site selection for IM administration of medicine. Hence, this paper helps me in understanding how the pain intensity can be optimized for the patients. 

Article 2

Selected Paper: Nakajima, Y., Mukai, K., Takaoka, K., Hirose, T., Morishita, K., Yamamoto, T., et al. (2017). Establishing a new appropriate intramuscular injection site in the deltoid muscle. Human Vaccines & Immunotherapeutics , 13 (9), 2122 - 2129.
The purpose of this paper by Nakajima et al was to identify the safe sites for intramuscular injections specifically in the deltoid muscles, as often post vaccine related injections complications arise in the patients. The study explored upon 4 intramuscular sites existing on the perpendicular lines drawn through the mid-acromion section for identification of the safer injection locations.
The study was conducted on 30 volunteers on whom USG was conducted to measure the thickness of the deltoid muscle and the PCHA through the path of the axillary nerve. It was found from the results that the intersection point between the mid-acromion and the anteroposterior axillary line was infact the most suitable region for IM injections as this region was distant from PCHA, the axillary serve and the sub-deltoid brusa (Nakajima, et al., 2017).
The usefulness of this study lies in the fact that, safe sites for IM injections can be identified which will help in designing and planning for vaccine administration, and where the patient will not be inconvenienced in any manner. The limitation of this study again is on the restrictiveness of the sample population chosen – smaller number and apparently healthy individuals.
For making the results generalized, the study has to be conducted on a larger and varied group of individuals. This study is definitely applicable and effective for me, as it my aim also to understand the safe sites for practising IM injections. This study not only helps me understand the right location in the deltoid muscles but also helps me to understand the implications of the potential dangers in terms of the patient, if such safe sites are not followed.

Article 3

Selected Paper: Gulnar, E., & Ozveren, H. (2016). An evaluation of the effectiveness of a planned training program for nurses on administering intramuscular injections into the ventrogluteal site. Nurse Education Today , 36, 360 - 363.
The aim of this paper was to understand and explore the level of expertise and knowledge nurses needs to have regarding the effects of the IM injections administered on the ventro-gluteal site of patients and also highlight the effects of training provided to the nurses (Gulnar & Ozveren, 2016). This experiment was conducted with a quasi-experimental design, on a single group of respondents based on the time sequence of pre test and post test.
The number of nurses involved in the study was 81, and the research was conducted on a University Hospital. As per the results, it was found that prior to the training, 76.5% of the nurses majorly used the dorso-gluteal region of patients for IM administering medicines.
After the training for 4 months given to the nurses it was found that, the number of nurses using the same dorso-gluteal region for IM injection had reduced and the rate for using the ventro-gluteal site has increased. Therefore, this study effectively studied the importance of knowledge given to the nurses. There is no such limitation of this study, and is effective for every individual intending to learn about IM medicine.
However, in this paper as specific training associated to ventro-gluteal site was focused upon, further research can always be conducted on other aspects of knowledge with IM injections. This study is effective for my knowledge as through these paper different safe sites for administering IM injections can be understood. And the importance of training and knowledge for the nurses also is stressed upon which indicates the knowledge I too need in understanding the safe IM administering practices. 

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Bibliography

Gulnar, E., & Ozveren, H. (2016). An evaluation of the effectiveness of a planned training program for nurses on administering intramuscular injections into the ventrogluteal site. Nurse Education Today , 36, 360 - 363.
Nakajima, Y., Mukai, K., Takaoka, K., Hirose, T., Morishita, K., Yamamoto, T., et al. (2017). Establishing a new appropriate intramuscular injection site in the deltoid muscle. Human Vaccines & Immunotherapeutics , 13 (9), 2122 - 2129.
Tugrul, E., & Khorshid, L. (2014). Effect ofpain intensity of injection sites and speed of injection associated with intramuscular penicillin. International Journal of Nursing Practice , 20, 468 - 474.

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