title: Rituals in nursing: intramuscular injections.
abstract: OBJECTIVE
  To consider to what extent intramuscular injection technique can be described to remain entrenched in ritualistic practice and how evidence-based practice should be considered and applied to the nursing practice of this essential skill.
  
  
  BACKGROUND
  The notion of rituals within nursing and the value or futile impact they afford to this essential nursing skill will be critically reviewed.
  
  
  METHODS
  Discursive paper.
  
  
  METHODS
  Literature review from 2002-2013 to review the current position of intramuscular injection injections.
  
  
  RESULTS
  Within the literature review, it became clear that there are several actions within the administration of an intramuscular injection that could be perceived as ritualistic and require consideration for contemporary nursing practice.
  
  
  CONCLUSIONS
  The essential nursing skill of intramuscular injection often appears to fit into the description of a ritualised practice. By providing evidence-based care, nurses will find themselves empowered to make informed decisions based on clinical need and using their clinical judgement.
  
  
  CONCLUSIONS
  For key learning, it will outline with rationale how site selection, needle selection, insertion technique and aspiration can be cited as examples of routinised or ritualistic practice and why these should be rejected in favour of an evidence-based approach. The effect on some student nurses of experiencing differing practices between what is taught at university and what is often seen in clinical practice will also be discussed.
authors.affiliation: Oxford Brookes University, Oxford, UK.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Greenway
mesh_terms: D015400:Clinical Nursing Research; D019317:Evidence-Based Medicine; D006801:Humans; D007273:Injections, Intramuscular / Q000451:nursing*; D057184:Practice Patterns, Nurses'
keywords: cognitive dissonance; intramuscular injections; learning; nursing; rituals; skills; students