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In the study reported in this article, the researchers attempted to raise awareness among practitioners of the importance of intramuscular drug administration technique in reducing injection site complications following antipsychotic depot injections. They also aimed to improve and expand the scope of present practice by comparing the effect of two accepted techniques, the `air bubble' and 'Z-track' on these complications, and demonstrate that the air bubble technique is more effective in reducing seepage and causes less discomfort. A `within subjects' design was used, and Likert scales for scoring subjective and objective assessment of complications were established and scored at each injection. The study showed that there was no significant difference between the effects of either technique. Date of acceptance: February 25 1998.
KEY WORDS
MENTAL HEALTH
NURSING
INJECTIONS
These key words are based upon work undertaken by the RCN Library.
This article has been subject to double-blind review.
Antipsychotic medication has been used for the treatment of mental illness since the 1950s (Frankenburg 1994), increasingly in the form of intramuscular (IM) depot injections (Day et al 1995). As large numbers of patients have been discharged from institutional care, their mental health has been maintained, by IM injection, in the community. Health professionals have been able to monitor more effectively compliance with treatment and assess patients' mental state against administered medication (Barnes and Curson 1994).
Complications can occur at the site of the injection following IM drug administration, such as: seepage of the injection solution and/or bleeding from the injection site onto the skin; pain; irritation; and even skin lesions. Such complications are widely recognised and have been investigated (Hay 1995, Murphy 1991).
One cause of complications noted in these investigations is some degree of fault in the IM injection administration technique itself. However, there is little evidence in the literature of studies comparing different techniques or examining the effect of particular techniques on local site complications. This gives cause for concern because most mental health nurses will, at some stage of their career, be involved in administering IM depot injections.
A literature review by staff at the Bracton Centre, Specialist Mental Health Service, identified only two studies which compared the effects of different techniques on local site complications (Keen 1986, Quartermaine 1995). There...