Reflection on IM Injection
The reflective model that I have chosen to use is Gibb’s Reflective Cycle (1988). Gentamicin is an antibiotic administered via intramuscular (IM) injection before a catheter is removed, in order to prevent infection. I was asked to draw up and administer Gentamicin to a patient via IM injection. I had observed this clinical skill on a variety of occasions and had previously administered an IM injection under supervision. On this occasion I was being observed by a qualified nurse. I had drawn up the drug and was ready to administer it and the patient consented to me administering the injection. I asked the patient turn onto their side so that I could access the injection site (the gluteus maximus). I then used an alcohol wipe to cleanse the injection site, and the nurse interrupted and said that this was not necessary. On previous occasions I had always cleansed the site because I had been taught this practice at University. I found that when I asked other qualified nurses on the ward, their opinions varied as to whether you should cleanse the site or not.
The nurse instructed me not to cleanse the site in front of the patient. This made me feel self conscious and made me wonder whether the patient would now be doubting my practice. I thought that as I had been observed carrying out this clinical procedure on many other occasions then my practice must have been seen to be correct. I felt confused about the use of alcohol wipes and was concerned that the practice of the qualified nurses was different. I wanted to research this topic further.
Research by Workman (1999) suggests that the use of skin cleansing wipes prior to injection is inconsistent and not necessary if the patient appears to be physically clean and an aseptic technique is used along with thorough hand washing by the nurse. Whilst researching I found that Mallet and Dougherty (2000) agree with the use of skin cleansing wipes. However they adopt this when patients are immunocompromised
The nurse instructed me not to cleanse the site in front of the patient. This made me feel self conscious and made me wonder whether the patient would now be doubting my practice. I thought that as I had been observed carrying out this clinical procedure on many other occasions then my practice must have been seen to be correct. I felt confused about the use of alcohol wipes and was concerned that the practice of the qualified nurses was different. I wanted to research this topic further.
Research by Workman (1999) suggests that the use of skin cleansing wipes prior to injection is inconsistent and not necessary if the patient appears to be physically clean and an aseptic technique is used along with thorough hand washing by the nurse. Whilst researching I found that Mallet and Dougherty (2000) agree with the use of skin cleansing wipes. However they adopt this when patients are immunocompromised