Intramuscular injection practices of nurses in the mental health setting

Intramuscular (IMs) injections are a routine clinical procedure performed by nurses in many healthcare settings. In acute mental health care, IMs are typically used for the administration of antipsychotics and benzodiazepines, as a method of chemical restraint. This occurs when patients are taking actions that may be harmful to themselves or others. The IM is preferred over the oral route because of enhanced bioavailability and absorption of the drug, helping the patient return to baseline more quickly. Best practices in administering IMs include using specific sites (deltoid, vastus lateralis, and ventrogluteal), using a Z-track method, and monitoring the amount of fluid injected. One commonly used site of IMs, in the mental health setting, is in the dorsogluteal muscle, due to its large size and easy accessibility during physical restraint of patients, who may be combative and uncooperative, and in an acute state of psychosis, mania, or violence. However, the use of the dorsogluteal site for IMs is contraindicated because of its close proximity to the sciatic nerve. Accidental contact with the sciatic nerve during routine IMs can result in permanent nerve damage. How nurses decide where to give IMs during a psychiatric crisis is rarely studied. Finding ways to inform nurses’ practices in administering IM psychiatric medications may decrease injuries in patients. We are conducting an in-depth review of the literature surrounding the topic of intramuscular injections in the acute mental health care setting. The aim of this review is to explore published research on current practices, techniques, and sites used for IMs in the acute mental health care setting. Using the PRISMA technique for conducting literature reviews helps authors transparently report why the review was done, what they did, and what they found, and is a requirement for publications in nursing journals. Our review is currently in process

Additional file 1 of A multicomponent intervention program to Prevent and Reduce AgItation and phySical rEstraint use in the ICU (PRAISE): study protocol for a multicenter, stepped-wedge, cluster randomized controlled trial

Additional file 1. SPIRIT checklist

Scaling informal learning: An integrative systems view on scaffolding at the workplace

While several technological advances have been suggested to scale learning at the workplace, none has been successful to scale informal learning. We review three theoretical discourses and suggest an integrated systems model of scaffolding informal workplace learning that has been created to tackle this challenge. We derive research questions that emerge from this model and illustrate these with an in-depth analysis of two workplace learning domains