Abstract
Knowledge of anatomy and physiology is said to be necessary for nurses to perform intravenous injections safely. However, no surveys of nurses’ anatomical knowledge or methods of performing intravenous injections have ever been conducted. We therefore elucidated nurses’ anatomical knowledge and methods of performing intravenous injections and assessed tasks linked to the performance of safe intravenous injections. The study method consisted of conducting an anonymous self-report questionnaire survey of nurses working in 10 general hospitals in 3 prefectures, and the data obtained from 482 nurses were the subject of the analysis. The results of the survey in regard to the fact that the median nerve and brachial artery lie close to the basilic vein showed that a combined total of 42.7% replied “I’ve heard that, but I don’t know the specifics” or “I didn’t know anything about their positions.” The results showed that 53.5% replied that the cephalic vein at the wrist or back of the hand was their first choice for intravenous injections (“oneshot” below), and 57.7% replied that it was their first choice for intravenous drip injections. The basilic vein in the cubital fossa was the first choice of 11.8% for one-shot injections, and of 9.3% for intravenous drip injections. Moreover, there was a tendency for nurses who replied “I don’t have” any knowledge in regard to the proximity of the median nerve or brachial artery to the basilic vein to choose the basilic vein in the cubital fossa, where there is a high risk of damaging the nerve or puncturing the artery. Also, in regard to awareness of venous valves when making intravenous injections a combined total of 55.6% replied that they were “completely unaware” or “don’t know,” and they may have been causing injuries by being unaware of venous valves when performing cutdowns. The results for knowledge about the proximity of the median nerve or brachial artery to the basilic vein or awareness of venous valves and nerves and arteries coursing deep to the cutaneous veins when performing intravenous injections showed that the fewer their number of years of nursing experience, the more nurses tended not to know and to be less aware. Based on the above findings, in order for nurses to perform safe intravenous injections they will need to acquire anatomical knowledge not only of the course of veins but of the course of nerves and arteries and venous valves as well. It will also be necessary to teach such knowledge in continuing education so that even nurses with few years of experience are able to perform intravenous injections safely.
