Theory-Practice Gap: Theory-Practice Gap Diagram

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When Florence Nightingale first identified the nursing theories, they were meant to improve the quality of care given to patients. However, in the past years, nursing theories have gained little impact on nursing practices to the extent that newly graduated nurses think their education was useless (Greenway et al., 2019). Even though nursing is an art based on theory, there are instances where the practice and the nursing theories are not in line. The difference between theory and practice is what is known as the theory-practice gap (Greenway et al., 2019). This paper will highlight the existence of a theory-practice gap in a case scenario involving the administration of intramuscular injections.

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Student nurses have different perspectives on what they learned in class regarding intramuscular injections (IMI) administration. This technique is an essential skill expected from all nurses, and although it might seem easy for onlookers, it is associated with multiple inconsistencies. The procedure is not evidence-based, thus attracting multiple techniques used without nurses fully rationalizing these techniques (Isaac-Dockery, 2016). Since the mentors in practice do not generally follow the university’s approach, students often fail to know which method to use. This inconsistency between what is learned in university and what is practiced in the field results in a theory-practice gap.

The administration of IMI exhibits several inconsistencies which might be considered as the gaps between theory and practice. Even though intramuscular injection administration can be regarded as an essential skill, the actual process is based on several concerns. These deliberations explain why nurses in practice apply the traditional routines that may seem different from what nursing students have learned in class. As shown in Figure 1, the decision made regarding the administration of IMI is influenced by factors such as site selection, equipment used, technique, and medication to be given. Nurses also consider the patients’ physical build, age, pre-existing conditions, and the environment. Educating nurses on IMI could improve the safety and efficacy of intramuscular injection techniques (Isaac-Dockery, 2016). However, the procedure is taught once during the pre-registration exercise. Lack of proper training is a gap that results in poor practice, including cases of needle-stick injuries.

There not much to support the existence of theories guiding the administration of IMIs. This essential skill has, for a long time, been considered a ritual practice among nurses. However, due to such an assumption, this primary practice results in reduced safety of patients. Therefore, evidence-based practices should be embraced in place of the ritualized techniques used by most registered nurses, as illustrated in Figure 1. Current evidence-based techniques address needle selection, site selection, aspiration, and insertion techniques associated with IMI (Isaac-Dockery, 2016). Educating nurses on these issues would improve the safety and efficacy of the practice.

Therefore, it would be more significant if registered nurses embraced the evidence-based techniques being established through research. Methods supported by researched evidence would rule out the lack of standard practice and create a standardized practice. If all nurses practiced the same technique in a similar situation considering all other factors, then there would be an improved quality of service delivered to patients. Even though intramuscular injections have been regarded as a ritualized practice in nursing, using evidence-based approaches in place of the rituals would reduce the theory-practice gap. All nurses would be empowered to make informed decisions if standard IMI techniques could be used instead of ritualized practices.

 Theory-Practice Gap Diagram
Figure 1: Theory-Practice Gap Diagram


Greenway, K., Butt, G., & Walthall, H. (2019). What is a theory-practice gap? An exploration of the concept. Nurse Education in Practice, 34, 1-6.

Isaac-Dockery, A. M. (2016). Proper technique when administering intramuscular injections. [Unpublished doctoral Capstone Project]. Gardner-Webb University

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NursingBird. (2022, July 7). Theory-Practice Gap: Theory-Practice Gap Diagram. Retrieved from


NursingBird. (2022, July 7). Theory-Practice Gap: Theory-Practice Gap Diagram.

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"Theory-Practice Gap: Theory-Practice Gap Diagram." NursingBird, 7 July 2022,


NursingBird. (2022) 'Theory-Practice Gap: Theory-Practice Gap Diagram'. 7 July.


NursingBird. 2022. "Theory-Practice Gap: Theory-Practice Gap Diagram." July 7, 2022.

1. NursingBird. "Theory-Practice Gap: Theory-Practice Gap Diagram." July 7, 2022.


NursingBird. "Theory-Practice Gap: Theory-Practice Gap Diagram." July 7, 2022.