Changing practice for experienced nurses

Published

Today in class we were discussing ways to change practice for experienced nurses.

The example was: Most older (experienced) nurses still use the dorsogluteal site for IM injections instead of using the Ventrogluteal site. I wrote a paper on using Ventrogluteal site vs. dorsogluteal site, but I got 5 points deducted because I only indentified the right way to teach nursing students. I didn't mention how to go about changing how experienced nurses give IM injections.

Does anyone out there have any ideas on how we can change the way older (experienced) nurses give IM injections?

Up Vote Up Vote ×
Specializes in Ante-Intra-Postpartum, Post Gyne.

Ask your administrators to write a policy for giving IM injections. We use to give phenergan IV, but now we can only give it PO or IM; a notice went out from pharmacy.

Up Vote Up Vote ×
Specializes in NICU, PICU, PACU.

Focus on re-education with inservices and powerpoints. We have even done read and signs but have to demonstrate a certain skill back, such as heelsticks, etc. Also supply any EBP articles you have.

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I mean no offense......after successfully giving injections for 34 years, I won't change. I don't like the Ventrogluteal site at all. I am willing to learn anything and change if it is better. This isn't better by a long shot....JMHO.

Up Vote Up Vote ×
Specializes in PICU, Sedation/Radiology, PACU.

I agree with Esme that just because you go to a nursing floor and say, "I know you've been giving injections in the dorso-glueal site for 25 years, but that's not the best way to do it. The best way to do it is in the ventro-gluteal." It doesn't mean that the experienced nurses are going to change their practice. The thing is, they've learned what works and what doesn't work in their 25 years. Hands on experiences are better than an article posted in the bathroom that explains the new evidence-based practice.

Having the unit enact a policy that specifically states that IM injections cannot be given in the dorso-gluteal site is probably the only way to affect change.

Up Vote Up Vote ×
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

I've used the Ventro-gluteal site and I have had more complaints from patients that it hursts...alot....amongst other complaints when using this practice on real patients. I don't find it that much easier and on very thin patients I've accidentally hit the bone.....NO thanks. I don't like it.

Up Vote Up Vote ×
Specializes in Ante-Intra-Postpartum, Post Gyne.
i mean no offense......after successfully giving injections for 34 years, i won't change. i don't like the ventrogluteal site at all. i am willing to learn anything and change if it is better. this isn't better by a long shot....jmho.

the reason they don't use the dorsal gluteal site used is because of the risk of hitting the sciatic nerve.

changer or not. i prefer evidence based nursing...thats what is best...imho

Up Vote Up Vote ×
Specializes in Peds/outpatient FP,derm,allergy/private duty.

Most experienced nurses manage to stay on top of current evidence based practices. I find the idea that your instructor assumes you need to teach experienced nurses to be problematic.

Up Vote Up Vote ×

As one on the receiving end I want IM injections given to me in the DG site. If a nurse wants to use the VG location and won't accommodate me then I'll refuse the shot. New practice or not I enter into the decision especially since the DG location has been around since the beginnings of IM injections.

Up Vote Up Vote ×
Specializes in Adult Internal Medicine.

I have always used VG and feel very comfortable using the site.

As far as it hurting more than DG, I am willing to bet that is because most of the patient's previous DG shots haven't made it into muscle and instead been deposited SubQ.

Up Vote Up Vote ×
+ Join the Discussion