Intramuscular injection: an integrative research review and guideline for evidence-based practice.

Intramuscular injections (IM) are a common yet complex technique used to deliver medication deep into the large muscles of the body. More than 12 billion IM injections are administered annually throughout the world. However, it is not a benign procedure, and unsafe injection practices are estimated to have significant impacts on patient morbidity and mortality and result in millions of dollars in direct medical costs on an annual basis. Although there is significant research, spanning 8 decades, on the procedure and techniques of administering medications by the IM route, instruction materials and clinician practice do not always reflect research-based practice. An integrative review of the literature has resulted in the development of a guideline for evidence-based practice of IM injections. Use of this guideline can assist the clinician to maximize the therapeutic effects of administered medication while minimizing or eliminating patient injury and discomfort associated with IM injections.