MISAMIS UNIVERSITY

Ozamiz City 7200, Philippines

Tel No. +63 88 521-0367 / Telefax No. +63 88 521-2917
E-mail Address: mu@mu.edu.ph

CERTIFIED: ISO 9001:2015 Risk Management System– DNVGL, Australia Pty Ltd.
ACCREDITED: Philippine Association of Colleges and Universities Commission on Accreditation (PACUCOA)

Performance Checklist on Administering Intramuscular Injections

(ADMINISTERING INTAMUSCULAR INJECTION)

Name of Student: Date:

ADMINISTERING INTAMUSCULAR INJECTION

Able to Able to Unable to
Perform Perform with Perform
Procedure Competently Supervision (0 Point)
(2 Points) (1 Point)
Consider safety considerations:
• Check physician’s order.
• Check MAR: patient’s name, medication name, dosage,
route and time of administration.
• Check expiration dates and perform calculations if
necessary.
Consider other safety considerations:
• Organize the equipment.
• Prepare the medication from the ampule or vial for drug
withdrawal.
• Perform hand hygiene and observe other appropriate infection
prevention procedures.

Consider other safety considerations:

• Provide for client privacy.
• Introduce yourself to patient.
• Explain the purpose of the medication and how it will help, using
language that the client can understand.
• Assess patient’s body build, muscle size, and weight.

1. Select, locate, and clean the site.

• Select a site free of skin lesions, tenderness, swelling, hardness, or
localized inflammation and one that has not been used frequently.
(If injections are to be frequent, alternate sites. Avoid using the same site
twice in a row.)

2. Help patient to comfortable position: Position patient

depending on site chosen (e.g., sit or lie flat, on side, or
prone)
3. Clean site with an antiseptic swab. Apply swab at center of
site and rotate outward in circular direction

4. Hold syringe between thumb and forefinger of dominant

hand. Hold as dart, palm down.
 Able to Able to Unable to
Procedure Perform Perform with Perform
Competently Supervision (0 Point)
(2 Points) (1 Point)
5. Remove needle cap or sheath from needle by pulling it
straight off.
6. If patient’s muscle mass is small, grasp body of muscle
between thumb and fingers.
7. Option: Injection using the Z-track technique.
Position ulnar aspect of your non-dominant hand just
below site and pull skin approximately 2.5 to 3.5 cm (1.5
inches) down or laterally to administer in a Z-track. Hold
position until medication is injected. With dominant hand,
inject needle quickly at 90-degree angle into muscle.
Under some circumstances, such as for an emaciated
client or an infant, the muscle may be pinched.
8. Insert needle into the muscle using a smooth, steady
motion. After needle pierces skin, grasp lower end of
syringe barrel with non-dominant hand to stabilize syringe.
Continue to hold skin tightly with non-dominant hand.
Move dominant hand to end of plunger. Do not move
syringe.
9. Pull back on plunger 5 to 10 seconds. If no blood
appears, inject medicine slowly, at a rate of 1 mL/10
seconds.
10. Withdraw the needle smoothly at the same angle of
insertion.
11. Help patient to comfortable position.
12. Discard uncapped needle or needle enclosed in safety
shield and attached syringe into puncture-proof and leak-
proof receptacle.
13. Remove and discard gloves and perform hand hygiene.
14. Document each medication given on medication chart or
record using required format. If drug was refused or
omitted, record this in appropriate area on medication
record.
15. Check on patient within 30 minutes of drug administration
to verify response to medication.
Total Score:
Highest Possible Score: 50

Remarks: _____________________

Signature of Student Name & Signature of Clinical Instructor

References:
Potter, P. A., Perry, A. G., Stockert, P., & Hall, A. (2016). Fundamentals of nursing (10th ed.). Kozier.