Nurse education in a resource limited environment: An evaluation of an educational teaching package on intramuscular injections, in Blantyre, Malawi

Summary 

This paper describes the implementation and evaluation of a pilot nursing education package of best practice guidelines involving intramuscular injections in a developing world setting. We briefly examine what is known about intramuscular injection techniques through reviewing the evidence on the topic, and disseminate best practice guidelines, in order to update and improve nursing technique in the paediatric departments of The Queen Elizabeth Central Hospital.

Methodology

A teaching package of safe intramuscular injection techniques was implemented in October/November 2008. All paediatric wards were involved, and consisted of a 30min structured package, with theory and then practical sessions. The effectiveness of the intervention was evaluated by a knowledge based questionnaires and non-participant observations of intramuscular injections taking place, to see if new techniques were being used.

Results

Theory based learning tested was at a high level and showed the nurses had a good scientific and evidence based understanding for their practice change. A convenience sample of 223 intramuscular injections was observed over December and January. Overall 188 (84.3%) took place in the thigh, the remainder in other locations.

Conclusions

Theory with practical teaching can have an impact upon the care given, possibly reducing the complications associated with intramuscular injections. Further plans include ensuring sustainability of the programme and extention of the project to other developing countries.

Keywords: Intramuscular injections, Developing world, Paediatrics