Effect of the Buzzy Application on Pain and Injection Satisfaction in Adult Patients Receiving Intramuscular Injections

Effect of a Non-pharmacological Intervention on Vaccine-related Pain: Randomized Clinical Trial

BACKGROUND

Acute pain during vaccine administration is an expected event; however, some strategies, such as the use of high frequency vibration devices associated with cryotherapy, may minimize it.

AIM

Evaluate the effect of high frequency vibration associated with cryotherapy on the level of pain related to the administration of influenza vaccine by intramuscular route in adults.

METHOD

A randomized clinical trial was conducted with 350 adults who received the influenza vaccine. Participants allocated to the intervention group used a high-frequency vibration device associated with cryotherapy during vaccination, and those in the control group administered the vaccine according to the service routine.

RESULTS

Mean self-reported pain after vaccination of participants who used the device was lower (1.5 ±1.7) when compared to those who did not use it (1.9 ±1.9) (p = .041). There was an association of higher levels of pain after vaccination with participants in the control group (p = .011), females (p = .042), with higher level of pain expected with vaccination (p < .001) and higher level of anxiety before (p < .001) and after vaccination (p = .001).

CONCLUSIONS

The use of high frequency vibration associated with cryotherapy has been shown to be a viable non-pharmacological intervention for the reduction of pain associated with influenza vaccination in adults.

The Impact of Cold Spray and Ice Application During Intravenous Access on Pain and Fear in Children Aged 7-15 Years in the Pediatric Emergency Unit: A Randomized Controlled Trial

INTRODUCTION

Many strategies have been developed to prevent procedural pain in pediatric emergency units, where nurses play a vital role in ensuring patient comfort. Easy-to-use and inexpensive nonpharmacologic analgesic methods are important in emergency units. This study was conducted to determine the effect of cold spray and ice applied during venipuncture on the level of fear and pain in children aged 7 to 15 years.

METHODS

This was a randomized controlled experimental study of 96 children between the ages of 7 and 15 years (cold spray group, ice group, and control group) who were scheduled to have venous access in the pediatric emergency clinic and met the sampling criteria.

RESULTS

Evaluations of the children, parents, and observers in the groups found a statistically significant difference between the pain and fear scores after the intervention compared with the preintervention (P < .001). The pain and fear scores of the children in the control group were higher than the scores of those in the spray and ice groups (P < .001); the pain and fear scores of the children in the spray group were lower than the scores of the children in the ice group and statistically significant (P < .001).

DISCUSSION

In conclusion, cold spray applied during intravenous access in children aged 7 to 15 effectively reduces pain and fear and should be used in the emergency unit.

Registered Nurses' Association of Ontario (RNAO) best practice guideline on the assessment and management of vascular access devices

INTRODUCTION

Vascular access is the most common invasive procedure performed in health care. This fundamental procedure must be performed in a safe and effective manner. Vascular access devices (VADs) are often the source of infections and other complications, yet there is a lack of clear guidance on VADs for health providers across different settings. A Best Practice Guideline (BPG) was developed by the Registered Nurses' Association of Ontario (RNAO) to provide evidence-based recommendations on the assessment and management of VADs.

METHODS

RNAO BPGs are based on systematic reviews of the literature following the GRADE approach. Experts on the topic of vascular access were selected to form a panel. Systematic reviews were conducted on six research areas: education, vascular access specialists, blood draws, daily review of peripheral VADs, visualization technologies, and pain management. A search for relevant research studies published in English limited to January 2013 was applied to eight databases. All studies were independently assessed for eligibility and risk of bias by two reviewers based on predetermined inclusion and exclusion criteria. The GRADE approach was used to determine certainty of the evidence.

RESULTS

Over 65,000 articles were screened related to the six priority research questions. Of these, 876 full-text publications were examined for relevance, with 174 articles designated to inform nine recommendations in the BPG on the subject areas of: comprehensive health teaching, practical education for health providers, blood draws, daily review of peripheral VADs, visualization technologies, and pain management. In June 2021, the RNAO published the BPG on vascular access, which included the recommendations and other supporting resources.

CONCLUSION

The vascular access BPG provides high quality guidance and updated recommendations, and can serve as a primary resource for health providers assessing and managing VADs.

Vapocoolant Spray for Pain Control in Intramuscular Injection Applications: A Prospective, Randomized Controlled Trial

Background Many pharmacological and nonpharmacological methods have been investigated along with advances in pain treatment. One of these nonpharmacological methods is the use of vapocoolant spray.

Objective This study aimedto demonstrate the effectiveness of vapocoolant spray to reduce pain during intramuscular (IM) injection.

Patients and Methods The study included ≥18 years old patients admitted to the emergency department who were asked to undergo IM injection. Patients were randomly divided into two groups as vapocoolant spray and control group. Demographic data, injection side, and visual analog scale (VAS) of the patients were recorded.

Results Mean VAS values during IM injection were significantly lower in patients treated with vapocoolant spray compared with the control group. The severity of pain during IM injection was lower in the vapocoolant spray group as both moderate pain (VAS > 3 cm) and severe pain (VAS > 5.4 cm) compared with the control group.

Conclusion Vapocoolant spray to be applied before IM injection is effective in reducing pain caused by the injection.

Comparison of cold spray and shotblocker to reduce intramuscular injection pain: A randomized controlled trial

WHAT IS KNOWN AND OBJECTIVE

It is important to identify effective, easy-to-use and cost-effective non-pharmacological methods in the management of pain caused by medical interventions. The purpose of this study is to compare the effects of cold spray and ShotBlocker on pain in adults in reducing pain caused by intramuscular injection in the adult emergency department.

METHODS

This is a randomized controlled trial with two experimental groups, two placebo groups and a control group. The study was conducted on 195 adults who received diclofenac sodium injections. In the study, the injection procedure was performed by following the same injection protocol in all five groups. In the injection process, cold spray or ShotBlocker was used in the intervention groups based on the group, and cold spray with distilled water or the smooth surface of the ShotBlocker was used in the placebo groups. Following the injection, the pain caused by the injection was evaluated using the Visual Analog Scale.

RESULTS AND DISCUSSION

The study was completed with the remaining 195 patients. In the study, the average pain scores due to injection of the individuals in the cold spray group were lower than those of the control group (p < 0.05). There was no statistically significant difference between the pain score averages due to injection of the individuals in the ShotBlocker group and cold spray, control, ShotBlocker placebo and cold spray placebo groups.

WHAT IS NEW AND CONCLUSION

The routine use of a fast-acting, cost-effective and easy-to-use method, cold spray, to reduce pain in the intramuscular injection will be beneficial in increasing patient satisfaction and quality of care.

The effect of manual pressure after subcutaneous injection on pain and comfort levels

BACKGROUND

The pain experienced after subcutaneous injections can also disturb the comfort of the individual. An individual who experiences pain may refuse treatment by experiencing anxiety for subsequent injections.

OBJECTIVE

This experimental study was conducted to compare the effects of standard injection application and manual pressure application use on injection pain and comfort level of having an subcutaneous injection.

METHODS

This study was carried out on a single sample group with pre-post design. The individuals in the sample group constituted both the control and intervention groups of the study. In the sample group, subcutaneous injection was applied to the upper outer side of the right and left arms by the same nurse by applying standard application and manual pressure, and then the pain and comfort levels were determined using the VAS and Comfort Scale.

RESULTS

It was determined that the mean pain scores of the SC injection application performed by applying manual pressure were statistically significantly lower than the SC injection application using the standard method. Again, it was determined that the mean comfort score of SC injection applied by applying manual pressure was statistically higher (p<0.05).

CONCLUSION

It has been determined that manual pressure application is a more effective method in reducing pain due to subcutaneous injection compared to the standard application. It was determined that as the pain experienced by the individuals due to subcutaneous injection application decreased, their comfort level increased. In line with these results, it is recommended that health professionals, especially nurses, use non-pharmacological methods with proven efficacy more frequently to relieve pain in SC injection, follow the developments in this field and put them into practice.

The Effect of Cold Application on Relieving Drug Infusion-Related Pain in Children: A Randomized Controlled Experimental Trial in Turkey

BACKGROUND

Parenteral IV drug administration in hospital environments can cause many complications at the infusion site. Nerve endings on the venous walls may be affected during antibiotic drug infusion, depending on the drug molecule, which results in pain.

PURPOSE

This study aims to assess the effect of cold application on relieving drug infusion-related pain (lincosamide class clindamycin phosphate) in children.

DESIGN & METHODS

This study included 120 pediatric patients (40 in the experimental, 40 in the placebo, and 40 in the control groups) aged 6 to 18 and hospitalized in a pediatric hospital. In the experimental group, a cold pack kept in the refrigerator was applied to the area above the IV catheter before drug infusion, while a cold pack kept at room temperature was applied in the placebo group. In the control group, drug infusion was routinely administered.

RESULTS

The experimental, placebo and control groups' 5th minute mean VAS scores were 0.98 ± 2.17, 3.95 ± 4.08, and 4.73 ± 3.89, respectively (p < 0.001), being higher in the control and placebo groups compared to the experimental group. No difference was found between the groups based on the VAS measurements at the 10th minute (p = 0.053). A difference was found between the groups based on the VAS measurements at the 15th minute (p=0.026). The VAS score of control group was higher than that of the placebo group (p = 0.032).

CONCLUSION

Cold application was effective in relieving drug infusion-related pain.

IMPLICATIONS FOR PRACTICE

This method may be recommended for general use in clinics since it is easy-to-use and economic. This method can ease the treatment process between nurses and children and increase patient satisfaction.

The Effect of ShotBlocker Application on Intramuscular Injection Pain in Adults: A Meta-Analysis

This meta-analysis study was conducted to determine the effects of ShotBlocker application during administration of intramuscular injections to adult patients for providing an evidence-based practice. The PubMed, Scopus, Science Direct, Ovid and Google Scholar databases were used for the literature review. The literature review was conducted by two researchers using the key phrases intramuscular injection AND ShotBlocker AND pain AND adults. According to the result of the meta-analysis, the pain levels in the experiment group in which ShotBlocker was used during IM injection to adult patients was found to be significantly different in comparison to the control group (SMD = -0.769, 95% CI = -1.449 to -0.090, p = .027). As a result of the meta-analysis, it was found that ShotBlocker application in IM injection in adult patients reduced patients' pain intensity. High-quality studies conducted with appropriate research methods are required for achieving a more comprehensive and effective result.

The effect of vibration stimulation on intramuscular injection pain and patient satisfaction: Single-blind, randomised controlled study

AIMS AND OBJECTIVES

The aim of this study was to assess the effect of vibration stimulation application in ventrogluteal region on intramuscular injection pain and patient satisfaction.

BACKGROUND

Intramuscular injection pain caused distress for the patients and affected their compliance with the treatment.

DESIGN

This was a prospective, single-blind, cross-over study. The study complied with the guidelines of Consolidated Standards of Reporting Trials (CONSORT).

METHODS

Eighty-four patients who applied to the adult emergency department received an intramuscular injection of amoxicillin\ cefuroxime sodium to the ventrogluteal site with and without vibration in a random order following a standard procedure by the same investigator. Pain and satisfaction were assessed immediately after the injection with Visual Analogue Scale (VAS), by a researcher blinded to the study. The data were evaluated using mean, standard deviation, percentage, Student's t-test, paired sample t-test, linear regression analysis and generalised linear mixed model.

RESULTS

A total of 174 injections were analysed. The result of the study revealed that vibration decreased the severity of pain and increased the patient satisfaction.

CONCLUSIONS

Vibration is a non-pharmacologic approach, which can be effective in decreasing the injection pain and increasing patient satisfaction.

RELEVANCE TO CLINICAL PRACTICE

Intramuscular injection is the most frequently used nursing practice in the clinic. The use of vibration in decreasing pain due to intramuscular applications can help increase the self-confidence of nurses and the quality of the care they provide.

Virtual reality and distraction cards to reduce pain during intramuscular benzathine penicillin injection procedure in adults: A randomized controlled trial

AIM

The aim of this study was to determine the effect of using three-dimensional videos with virtual reality glasses and distraction cards including optical illusion pictures on patients' pain and satisfaction levels during intramuscular benzathine penicillin injection.

DESIGN

A randomized controlled trial.

METHOD

The study population consisted of 91 patients who were prescribed intramuscular benzathine penicillin medication. The participants were stratified by gender and assigned to three groups (control, virtual reality and distraction cards groups). The visual analogue scale was used to assess pain and patient satisfaction. A one-way analysis of variance and Dunnett's post hoc tests were used to compare the pain and satisfaction levels by group.

RESULTS

The mean pain was 6.67 (2.17) in the control group, 4.4 (2.71) in the distraction cards group and 4.93 (3.07) in the virtual reality group and the difference was statistically significant (F = 5.84, p ˂ .01). The average of the satisfaction levels in the groups was 3.57 (2.23) in the control group, 7.13 (2.86) in the distraction cards group and 8.07 (2.55) in the virtual reality group. The difference between the satisfaction levels was statistically significant (F = 25.77, p ˂ .01).

CONCLUSION

The three-dimensional videos with virtual reality glasses and distraction cards including optical illusion pictures were effective in reducing pain associated with intramuscular benzathine penicillin injection and increasing patient satisfaction.

IMPACT

The results of this study will contribute to evidence-based nursing practices for the pain associated with intramuscular benzathine penicillin injection.

CLINICAL TRIAL REGISTRY

NCT04420559.