Recognizing the evidence and changing practice on injection sites

Evidence-based practice requires the integration of the best available evidence in conjunction with clinical expertise to make decisions about patient care. At times new research and evidence will contradict established or traditional methods and clinical textbooks: this is in the nature of progress, and the challenge lies in disseminating this new evidence throughout the profession as quickly and widely as possible. The nursing literature cites a number of barriers to evidence-based nursing, and notes that the research evidence for clinical practice utilization does not always percolate down to the clinical setting. This article considers the attitudes of nurses to evidence that challenges traditional practice, focusing in particular on conventional and contemporary best practice regarding injection sites. Nurses in clinical practice continue to use and instruct student nurses in the use of the dorsogluteal (the large gluteal muscle in the buttocks) injection site as the site of choice for intramuscular injections, despite abundant evidence regarding the complications associated with using this site. Advancing the use of the ventrogluteal (located in the hip) injection site is a challenge, primarily owing to nurses' lack of familiarity with its anatomical landmarks and the published evidence on its benefits. The authors of this article present the current evidence on the dorsogluteal and ventrogluteal intramuscular injection sites in an attempt to assist nurse decision-making and guarantee the integration of evidence-based knowledge in order to improve patient care.