English abstract Background: Anticoagulant medications help prevent thromboembolisms, and improve health. The most common negative consequences of anticoagulant injection are pain, bruising that affect negatively on patient satisfaction. Aim of the study: Explore the effectiveness of thumb manual pressure application on anticoagulant subcutaneous injection pain, bruising, and satisfaction experienced compared to routine SCI. Study design: A quasi-experimental nonequivalent one-group self-controlled design was used. Setting: the study applied in the orthopedic Surgery department at New-surgery hospital of Zagazig University hospitals. Subjects: a convenience sample of a single group from both males and females. It included 88 participants. Tools: Four tools were used in this study. The same participants were both in control and intervention. The same nurse applied a subcutaneous injection into the upper outer Lt arm followed by thumb pressure for 10 seconds as an intervention group. Whereas, the routine SCI in the upper outer Rt arm was injected in the same patient by the same nurse and considered as a control group. Pain level, bruising and patient satisfaction were assessed. Results: there was a statistical significance difference in the pain level, bruising and satisfaction, explored via less pain intensity, minor bruising and high satisfaction level where thumb manual pressure applied over the left arm SC anticoagulant injection. Conclusion: manual pressure application is a more effective method in reducing pain, bruising and increasing satisfaction level due to subcutaneous injection. Thus using such non-pharmacological methods was effective.