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Literature Review
The intent of this literature review is to assess the best practices surrounding skin disinfection before administering an injection. This review will look at the different views on this issue and the changes in practice over time. It will also evaluate the quality of the evidence and examine arguments for and against the use of skin disinfection prior to an injection. Numerous studies have been undertaken to debate the need to disinfect a patient’s skin before an injection and several of these will be reviewed in this paper.

In the medical field, an injection is the introduction of a drug, contraceptive, vaccine or an alternative therapeutic agent into the body using a needle or syringe (Qamar, Gillani, & Sulaiman, 2012, p. 1042). For the purpose of this review the term ‘injection’ is descriptive of various types such as intradermal, intra-muscular, venepuncture and subcutaneous injections.

Medical guidance on skin preparation prior to the administering of an injection has changed over the years. Nurses and other health care providers regularly disinfect the skin prior to injections (Pratt et al., 2002, p.18) and this has been customary for many years. However the World Health Organization (WHO), no longer recommends this practice of disinfection (Hutin, et al., 2003, p. 491) and has issued other guidelines.

The methodology for this review is to assess the quality of evidence using relevant sources. Databases used in this review are ProQuest, Medline, CIHAHL and CIAP.
The data was obtained from searches using the following key words: infection control, injection administration, skin preparation, clinical practices, best practice, standards, skin disinfection, skin preparation, alcohol wipes, swab or not to swab, and injections. The various methods that have been used in these research articles range from cross-sectional studies, expert opinions, qualitative and quantitative analysis, double blind peer reviews, cohort studies, longitudinal studies


References: Dann, T., C. (1969) Routine skin preparation before injection. An unnecessary procedure. Lancet 2(9), 96–8. Del Mar, CB., Glasziou, PP., Spinks, AB., & Sanders, SL Diggle, L., & Richards, S. (2007). Best practice when immunising children. Primary Health Care, 17(7), 41-46. Retrieved from http://search.proquest.com.acs.hcn.com.au/docview/217846678?accountid=130851 Franklin, L Infection Control Team, (2005) Retrieved from http://www.documents.hps.scot.nhs.uk/hai/infection-control/publications/skin-disinfection-review.pdf Kazuaki, Y., Seiichi, F., & Tomohiko, M Pratt, RJ., Morgan, S., Hughes, J., Mulhall, A., Fry, C., Perry, C. & Tew, L. (2002). The World Health Organization guidelines best practice for injections and the related procedure toolkit March (2010). Retrieved from http://whqlibdoc.who.int/publications/2010/9789241599252_eng.pdf
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