Name: ________________________________________
Date: _________________________________________
Procedure 54-8:
Administering a Z-Track Injection
Objective: Administer a Z-track injection using proper technique.
Equipment and Supplies: Alcohol wipes; sharps container; disposable gloves; medication order
signed by the physician; pen; sterile needle and syringe; medication vial
Affective Behaviors: Affective behaviors provide a professional approach to a skill that enhances
the patient encounter. These behaviors may also display sensitivity to a patient’s rights and
enhance communication. Pay close attention to these skills, which will be in bold, italicized font.
Skills Assessment Requirements
Read and familiarize yourself with the procedure. Complete each procedure within a reasonable
amount of time, with a minimum of 85% accuracy.
Use the area below for any documentation needed to complete the procedure.
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Name: ________________________________________
Date: _________________________________________
= 3–6 points
= 7–9 points
# 1
# 2
1–15. Follow steps 1–15 of Procedure
54-10 for administration of an
intramuscular injection.
16. After withdrawing the medication
from the vial, change to a fresh
needle. This will eliminate any
irritating medication that may be
within the needle from coming into
contact with the patient’s tissue
until the needle is placed into the
muscle layer (Figure A).
17. When ready to administer the
medication, pull the skin of the
buttock to one side and hold it
in place with your nondominant
hand. You may wish to use a
dry gauze sponge if the skin is
slippery (Figure B).
18. With your dominant hand and
using a dartlike grip on the syringe,
insert the needle up to the hub
quickly into the gluteus medius
muscle. Do not move the needle
once it is in place (Figure C).
19. While still maintaining a firm
hold on the taut skin with your
nondominant hand, pull back on
the plunger of the syringe to check
for blood return with the fingers of
the hand holding the syringe. To
do this simply move your fingers
up the syringe, while keeping the
needle steady within the patient’s
buttocks, until your thumb and
index finger reach the top of the
plunger. If blood appears in the
hub of the syringe, then use the
correct technique to withdraw the
syringe, discard, and begin with
step 1 again.
20. If there is no blood return, then
very slowly inject the medication
into the muscle.
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Name: ________________________________________
Date: _________________________________________
= 3–6 points
= 7–9 points
# 1
# 2
21. Wait several seconds after
injecting the medication before
you withdraw the needle. Cover
the area with the alcohol wipe, and
withdraw the needle at the same
angle of insertion. Wait at least 10
seconds before releasing the skin
being held by the nondominant
hand (Figures D and E).
22. Do not massage the area. Observe
the patient for at least 15 minutes
for any untoward reaction. You
may advise the patient to walk
around to assist in the absorption
process of the medication.
23. Correctly dispose of all materials.
24. Remove and discard gloves and
perform hand hygiene.
25. Chart the medication
administration on the patient’s
record noting the time, medication
name, dosage, injection site,
route, and your name.
Points Earned
Points Possible 78 78
Percent Grade (Points Earned/
Points Possible)
Instructor Sign-O
Instructor: ______________________________________________ Date: _________________________
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