The purpose of this comparative analysis essay is to discuss the different approaches used for the prevention of postoperative Deep vein thrombosis (DVT). There are a variety of prophylactic treatments to prevent DVT, but for the purpose of this essay only thromboembolic deterrent stockings (TEDs) in relation to Sequential compression devices (SCDs) will be covered and pharmacologic prophylaxis will be covered only briefly. DVT is the formation of blood clots in the deep veins (Kesieme, 2011). The most common sites for thrombus formation are the deep veins within muscle, typically of the calf or the thigh. The clots may dislodge and travel in the blood to the lung and cause pulmonary emboli (PE) (Australian Nursing Journal, 2008). DVT and PE are important pathologies that affect apparently healthy individuals as well as medical or surgical patients (Ageno, 2010). Collectively, DVT and PE are known as venous thromboembolism (VTE) (Australian Nursing Journal, 2008).
DVT is a major postoperative complication that has been estimated to occur in up to 40% of patients without prophylaxis (Novis et al., 2009). The highest risk for thrombosis is during the immediate postoperative period which then decreases during the first week following the operation (Bergqvist, 2007). DVT will often show no signs or symptoms; however, symptoms may include pain, tenderness, swelling, warmth and discolouration of the skin (Australian Nursing Journal, 2008). Risk factors for post surgical DVT includes the nature and duration of the surgery, sepsis, hydration, immobility and type of anaesthesia administrated. The risk increases with age, obesity, smoking and malignancy (Miller, 2011). These risk factors should be identified during the preoperative asse...
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of venous thrombosis. Polish Journal of Surgery, 81(8), 364-371.
doi:10.2478/v10035-009-0061-6
Update: Preventing venous thromboembolism. (2011). Chemist & Druggist, , 18-n/a.
http://search.proquest.com.libraryproxy.griffith.edu.au/docview/855655479?
accountid=14543
Walker, L., & Lamont, S. (2008). Graduated compression stockings to prevent deep
vein thrombosis. Nursing Standard, 22(40), 35-38.
Westrich, G. H., & Bornstein, L. J. (2009). Prophylactic modalities: Pharmacologic
and mechanical compression. Seminars in Arthroplasty, 20(4), 235-240.
doi:10.1053/j.sart.2009.10.007
Veiraiah, A., Shetty, H., & Routledge, P. (2008). Prevention and treatment of venous
thromboembolism in older people. Reviews in Clinical Gerontology, 18(3), 219-
228. doi:10.1017/S0959259809002871
After a thorough examination, J.P. was diagnosed with a deep vein thrombosis (DVT). “DVT develops most often in the legs but can occur also in the upper arms…” (Ignatavicius & Workman, 2013). Due t...
“Chronic diseases and illnesses are the leading causes of death and disability in the United States” (CDC.gov, 2014). These types of illnesses are the most common health problems that people in this country face today and they are also the most preventable (CDC.gov, 2014). Every year the cost to help care for and manage people with these types of illnesses increases and there is less being done about educating people about prevention. Venous Thromboembolism is one such chronic disease that is very deadly but also very preventable if the right precautions are taken. This paper will aim to educate about the disease, courses and costs of treatment, clinical microsystems that are involved and what barriers if any exist to achieving generative relationships among the various clinical microsystems involved.
Deep venous thrombosis(DVT) is the formation of a blood clot or thrombus in the large vein of the legs(Narani, 2010). The signs and symptoms of a lower limb DVT varies from asymptomatic to extensive ilio femoral thrombosis(Narani, 2010). The most common clinical manifestation can be sudden swelling of one limb accompanied with pain or tenderness,
Post-operative care includes checking the vital sings every four hours or more frequently as needed and reporting any abnormalities to the physician. Aggressive pain management as mentioned earlier is important in patients who have had a total knee replacement. There an accurate assessment of the patient’s pain level is the initial step in the management of pain in these patients. The patient should be advised to report if the pain goal is not been met. It is important for patients who have had a total knee replacement to ambulate early to prevent the formation of deep vein thrombosis (DVT) and pulmonary embolism (PE). Therefore the nurse with the advice of the surgeon and the physical therapy team has to assist the patient to start ambulating soon after the surgery. Also part of the nursing intervention to prevent DVT and PEs includes making sure that the patient is on chemical and mechanical prophylaxis. This will be discussed further in the complications section below. Indwelling Foley catheters are usually placed during a total knee replacement surgery. Part of the nursing intervention will also include making sure that the catheter is removed once it is no longer needed to prevent catheter associated urinary tract infection (CAUTI) (Parker
Deep vein thrombosis occurs when blood clots form in one of the deep veins in the thigh or calf. Many people with the condition do not have symptoms, but they may have leg pain, swelling or skin discoloration. It can be life threatening because it can cause a pulmonary embolism
In the health care industry, nurse to patient ratios is often a controversial issue. Registered nurses know and continue to reiterate the importance of safe staffing levels in health care facilities. Reductions in nursing budgets, coupled with the expanding nursing shortage, has resulted in a reduction of available nursing staff. As a result, the employed nursing staff are forced to work longer hours with more acutely ill patients. Consequently, patient care is compromised and ultimately perpetuates the nursing shortage because of this negative work environment. Providing safe quality health care is expensive. Health care facilities are always in search of ways to trim spending while maintaining the same quality of care. One of the methods in which hospitals trim the spending budget is through labor reduction. Tempting as this may seem, this method presents a massive dilemma to providing safe quality care. Less staff coupled with large patient workloads will lead to adverse patient outcomes. Evidence shows that it is more cost effective to maintain safe staffing levels and prevent adverse patient outcomes versus the estimated savings of labor reduction. Maintaining safe nurse to patient ratios reduces patient
Coronary artery bypass graft surgery is a procedure that can be life-saving for patients with heart disease, but it also carries risks after the procedure that can impact patient outcomes negatively. Because over 395,000 Americans have CABG surgery each year, and the risk-adjusted mortality rate for patients is 2%, according to Centers for Disease Control (CDC) statistics, health care professionals must find ways of reducing risks and complications to improve the outcomes for many patients (Ferguson, 2012). Heart disease is often comorbid with other conditions, like lung disease, peripheral arterial disease, hypertension, and diabetes, which can raise the risk of complications (Ferguson, 2012; Nejati-Namin, Ataie-Jafari, Amirkalali, Hosseini, Sheik Hathollahi, & Najafi, 2013). Complications that can arise following surgery include atrial fibrillation, prolonged inflammatory reactions, a build up of fluid near the heart, accelerated atherosclerosis, and nearby vein or artery blockage (Gokalp, Ilhan, Gurbuz, Cetin, Kocaman, Erdogan, & … Satiroglu, 2013; Ferguson, 2012; Scheiber-Camoretti, Mehrotra, Ling, Raman, Beshai, & Bowman, 2013; Sicaja, Starcevic, Sebetic, Raguz, & Vuksanovic, 2013). These complications can lead to increased lengths of stay, increased readmission rates, risk of further complications, failure of the bypass graft, cognitive dysfunction and memory loss, patient suffering, and even death (Ferguson, 2012; Gokalp et al., 2013; Sicaja et al., 2013). In turn, nurses, other care providers, and institutions may face negative consequences themselves, including a risk of lawsuits, increased employee workload, higher per-patient costs, reduced or withheld private insurance, Medicaid, and Medicare reimbursements, auditing...
In most aspects of life the saying “less is always more” may ring true; however when it comes to providing quality care to patients, less only creates problems which can lead to a decrease in patient’s quality of life as well as nurse’s satisfaction with their jobs. The massive shortage of nurses throughout the United States has gotten attention from some of the most prestigious schools, news media and political leaders. Nurses are being burnt out from their jobs, they are being overworked and overlooked. New nurses are not being properly trained, and old nurses are on their way to retirement. All the while the rate of patient admissions is on the rise. Nurses are reporting lower satisfaction in their job positions and hospital retention rates are at an all-time low, conversely this is affecting all patients’ quality of care. As stated in the article Addressing The Nurse Shortage To Improve The Quality Of Patient Care “According to an Institute of Medicine report, Nurses are the largest group of health care professionals providing direct patient care in hospitals, and the quality of care for hospital patients is strongly linked to the performance of nursing staff”.
Mr Edward Sales, RN, BSN, is a perioperative nurse in a 6 beds Operating Room unit. He is the Urology Lead RN, Orthopedics/Spine Service Second Lead RN, and also functions as the Acting Unit Flow Coordinator (in the absence of the Unit Coordinator). Over the past several years, Mr Sales has demonstrated continued leadership in Perioperative Nursing practice. His contributions to this area of practice have positively influenced client care at the nursing service and across the local medical center.
Ottawa Hospital Research Institute. (2010). Outcomes of saddle pulmonary embolism: a nested case-control study. International Society on Thrombosis and Hemostasis, 867-869.
Ofri, D (2000). Diagnosis and Treatment of Deep-Vein Thrombosis. Western Journal of Medicine; 173: 194-197.
Florence Nightingale was the Nurse of Nurses. In nursing school she is the first person you will hear speak of. She is known as “The lady with the lamp”. Her theory focused on the adjustment of the environment provided to protect the patient. She thought that a sleeping patient should never be awaken. Noise should always be avoided because it can startle the sleeping patient. This was a serious problem to her. She delegated tasks to other nurses, always keeping the patients safe and away from harm.
There are numerous risks for a patient during the preoperative stage of the perioperative journey. All patients undergoing a surgical procedure are at risk of developing perioperative hypothermia, although there are various factors which also further increase an individual’s susceptibility (Burger & Fitzpatrick, 2009). An individual’s body type can cause them more susceptible to heat loss during the perioperative period. The patient’s nutritional state and being malnourished, if the individual is female and is of low body weight therefore a high ratio of body surface area to weight and limited insulation to prevent heat loss, these are all factors which negatively affect heat loss and therefore increasing the individual’s risk of perioperative hypothermia (Lynch et al.,
Relational Practice is being mindful of your own actions, environment, and situations. It goes beyond treating the disease and focuses on the patient as an individual with his or her own unique needs. In order to establish and maintain a concrete nurse-client relationship, nurses must utilize a wide range of effective communication and interpersonal skills. The ability to communicate effectively is an important skill that not only proves to be imperative as a nurse but also in everyday interactions. That said, for the purpose of this paper, I will evaluate an interaction I had with a close family friend, where he disclosed his history of alcohol abuse and how it affects him every day. I will discuss the style and skills that I fulfilled during
Pharmacology is a vital component in the perioperative practice. Medication use is monitored closely during the perioperative period. Preoperatively, there are certain drugs that must be discontinued prior to a surgery as they increase surgical risk, including anticoagulants, tranquillisers, corticosteroids and diuretics (Laws, 2010b). In fact, these drugs can increase the risk of respiratory depression, infection, fluid and electrolyte imbalance and increased risk of bleeding (Hamlin, 2010). Open communication is important in obtaining a medication history, and in identifying the drugs taken prior to the surgery. If any of these medications has be...