Journal articles and textbooks describe how to select the ventrogluteal injection site ("Revisiting IM Injections," Think Again, February), but I find this method to be potentially hazardous. Nurses must use their hands to select the appropriate site, and hands vary greatly in size, as do patients' bodies. These variations mean that the injection can be too high or low, potentially causing pain or injury to the patient.

Before retiring, I taught in an RN program for more than 15 years and found that I had to be very careful when teaching about the ventrogluteal site-especially with my male students, whose hands were larger than mine. We had detailed discussions that took us well beyond the typical textbook descriptions, and we practiced repeatedly.

I knew a patient who experienced a very painful injection in this site, because a nurse followed the appropriate directions but selected a site far too high, thus hitting the patient's bone. She hadn't taken into account that her hand was fairly large, and the patient's body was very small.

It's time for nurse researchers to develop a method for determining the proper ventrogluteal site entirely independent of the nurse's hand-a foolproof method that uses only the patient's body landmarks. If nurses don't correct this faulty practice, who will?

Shirley Thomas, MSN, RN

Staunton, VA