Open Forum

Our Medical Group has an MA On-boarding program which has been very successful in reducing turn over and teaching basic skills to MA entering the job. We had a recent question about teaching Z-Track injections. I have never see this injection technique used in the Ambulatory setting. I do not want to teach a skill that will likely not be used. Has anyone used the Z-Track method for injection in their offices? Thank you

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Holly Davis BSN, RN, AMB-BC
Clinical Quality Coordinator
Frederick Health Medical Group
New Windsor MD
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Outside of RNs in this specialty, do MA's ever give Z-track?

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Holly Davis BSN, RN, AMB-BC
Clinical Quality Coordinator
Frederick Health Medical Group
New Windsor MD
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Original Message:
Sent: 10-08-2025 11:01
From: Sharon Peacock
Subject: MA education on Z-Track injections

Hello Holly,

Z-track is used for some infectious disease medications. Our education team put together a PowerPoint on how to administer a medication via the z-track method for our annual skills a couple of years ago. There are also other medications that our pharmacy team recommends z-track method, such as some antibiotics, hormonal, and mental health medications.

 

Thank you,

 

J.J. Peacock, MSN-Ed., RN, AMB-BC

Professional Development Generalist, Sentara Ambulatory Services Division

Chair, AAACN Staff/Patient Education SIG

 

Office: 434-654-4529

Email: SJPEACOC@sentara.com | SASDClinEduTeam@sentara.com

590 Peter Jefferson Parkway, Suite 323, Charlottesville, VA 22911

 

RQI: RQI_SASD@sentara.com | Resuscitation Quality Improvement (RQI) (sharepoint.com)

 

 

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Original Message:
Sent: 10/8/2025 11:14:00 AM
From: Holly Davis
Subject: RE: MA education on Z-Track injections

Outside of RNs in this specialty, do MA's ever give Z-track?

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Holly Davis BSN, RN, AMB-BC
Clinical Quality Coordinator
Frederick Health Medical Group
New Windsor MD
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Since MAs in CT can only admin vaccines (and no medications), z-track training is not really needed. (see: from ask the experts: https://www.immunize.org/ask-experts/why-air-bubbles-expelled-injected/).

We do provide online asynchronous courses for vaccine administration though--for example a 24 hour course that our MAs take for immunizations for the new vaccinator--it includes simulations for both IM and SQ injections. This allows the MA to complete the course, and they can submit the CEU toward their MA re-certification as well. They then present the certificate to me for OLCP credentialing so that I can extend the "privilege" of administration...We have a 9 hour vaccine course that nurses take as well that review the vaccine schedule. 

It is something that is available to other organizations through NIMAA. Not sure if that is helpful to anyone--www.nimaa.edu

Best regards,

Mary

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Mary Blankson DNP APRN FNP-C FAAN
Community Health Center, Inc.
Middletown CT
(860) 227-5432
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We use Lippincott and their "Intramuscular injection, ambulatory care" procedure states: "The Z-track technique is the preferred method for administering an IM injection. By leaving a zigzag path that seals the needle track, this technique prevents drug leakage into the subcutaneous tissue, helps to seal the drug in the muscle, and minimizes irritation." Due to that statement and our own independent research, we taught our MAs this technique a couple months ago. 

Angela

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Angela Hall MN RN
Neighborhood Health Center
Oregon City OR
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