Seven out of ten hospital nurses who took part in a Canadian study used the dorsogluteal (DG) buttock site to administer intramuscular injections - despite the potential risks of sciatic nerve injury - with only 14% using the ventrogluteal (VG) hip site recommended by the nursing literature.
The research, published in the May issue of the Journal of Advanced Nursing, found that younger, newer nurses were significantly more likely to follow the latest VG site advice than their older, experienced colleagues. It also discovered that more than one in four nurses using the DG site were unaware of the potential risk of nerve damage.
Just over 40% of the staff nurses surveyed responded to the postal questionnaire. Most of the 264 respondents were aged between 30 and 49 years and had been working in nursing for more than ten years.
"Recent nursing literature suggests that the VG site is preferable because it is located away from major nerves and muscles, can provide better access to muscle tissue and offers faster medication uptake" says lead author Lorna Walsh, a nurse educator at the Centre for Nursing Studies, St John's, Canada.
"It's estimated that more than twelve billion intramuscular injections are administered every year throughout the world and unsafe injection practices have a significant impact on patient ill health and death. Complications can include skin and tissue trauma, muscle fibrosis and contracture, nerve palsies and paralysis, abscesses and gangrene.
"Although three-quarters of the nurses in our study said they were aware of potential nerve damage when using the DG site, this site was used significantly more often than other sites."
Key findings of the study include:
"Our research clearly shows that the majority of nurses are not using the VG site, as recommended in the recent nursing literature, and further research is needed to find out why" says co-author and fellow nurse educator Kathleen Brophy.
"Advocates of the VG site also need to base their rationale for using this site on reasons other than potential sciatic nerve damage when using the DG site, as the majority of nurses are aware of this, but still use the site.
"We also feel that additional research is needed to explore the safety of properly-mapped DG injections."