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P120 Injecting, obesity and antibiotic resistance: an exploration of nursing practice in relation to the administration of intramuscular injection in the treatment of gonorrhoea
  1. Caroline Donnelly1,
  2. Sara MacDonald2
  1. 1Sandyford Sexual Health Services, NHS Greater Glasgow & Clyde, Glasgow, UK
  2. 2University of Glasgow, Glasgow, UK

Abstract

Background/introduction Traditionally, conventional green needles (1.5 inch) are used to reach the dorsogluteal muscle. However, in the face of increasing obesity, there may be difficulty in reaching the target muscle due to subcutaneous fat. This can lead to potential ineffective delivery of medication resulting in non-treatment of infection, and possibly contributing to antibiotic resistance.

Aim(s)/objectives To explore existing practice of sexual health practitioners in relation to site and technique when administering intramuscular gonorrhoea treatment, in NHS Greater Glasgow and Clyde.

Methods Focus group interviews with 22 sexual health participants with a variety of experiences. Interviews were analysed using a framework approach.

Results

  • The dorsogluteal muscle was used for all injections excluding vaccines.

  • Only two participants had heard of the recommended ventrogluteal site.

  • Mentors were key influences in role modelling within clinical situations.

  • No updates were reported since learning this basic skill as a student.

ResultsDespite awareness of the obesity epidemic, using a longer needle or changing target muscle site had not been contemplated until the focus group.

Discussion/conclusion Obesity constitutes health challenges to basic nursing care, and commands a practical skilled workforce in anticipation of these complexities. This study reveals a theory-practice gap in the essential assessment of appropriate target muscle, which has potential to compound resistance issues. As rapid emergence of resistant strains pose a threat to untreatable gonorrhoea, we recommend that adoption of best practice guidance is essential alongside further study to ensure efficacy of treatment.

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