Effectiveness of a novel subcutaneous enoxaparin injection technique in reducing injection-related pain and ecchymosis: a quasi-experimental study

Background: Subcutaneous injections frequently cause local complications like pain and ecchymosis. Pre-injection ice application is a simple, non-pharmacological nursing intervention that may reduce these complications. To evaluate the effectiveness and clinical applicability of pre-injection ice application. Methods: A quantitative, true experimental post-test-only control group design was used. Through purposive sampling, 100 patients aged 20–50 years were randomly assigned to an experimental group (n=50, receiving pre-injection ice application) or a control group (n=50, receiving standard protocol). Post-test pain was assessed via the numeric pain rating scale (0–10), and ecchymosis was evaluated using a graded observational scale. Results: In the experimental group, 40% reported no pain, 24% mild, and 36% moderate pain; none experienced severe pain. In the control group, 86% reported severe pain and 14% moderate pain. The mean pain score was significantly lower in the experimental group (2.38±2.24) than the control group (8.32±1.50), with a mean difference of 5.94 (t=15.57, p<0.001). For ecchymosis, 60% of the experimental group had no bruising (0% Grade III), whereas only 4% of the control group was bruise-free (52% Grade III). The mean ecchymosis score was significantly reduced in the experimental group (1.76±0.96) versus the control group (3.18±0.96; t=7.39, p<0.001). Sociodemographic variables showed no significant associations with outcomes. Conclusion: Pre-injection ice application effectively minimizes pain and ecchymosis, offering a practical, resource-efficient technique to enhance clinical nursing care quality.