Deep Venous Thrombosis Prophylaxis; Lovenox vs Heparin On June 30, 2011, the Centers for Medicare and Medicaid Services (CMS) presented their final ruling on non-payment policies for provider preventable conditions (PPCs). One of the other provider preventable conditions includes the development of deep vein thrombosis (DVT) prophylaxis in any health care setting (Federal Register, 2011, p. 32817). Due to the significant cost of providing care for preventable conditions that are now not reimbursed through the CMS and many health insurance companies, hospitals around the country have implemented new policies to ensure patients remain free of venous blood clots during their hospital stay. The practice of injecting either Lovenox or heparin …show more content…
Can heparin injections every 12 hours instead of every eight continue to provide protection against DVTs due to the life of the pharmacokinetics? 3. Could this research improve our patient scores for satisfaction if patients only had one injection a day, not three? 4. Would our satisfaction scores go up if we did not wake them in the middle of the night to do an eight-hour heparin subcutaneous injection? 5. Is low-dose unfractionated heparin more effective that a low-molecular-weight heparin such as enoxaparin or dalteparin? These background questions are significant to providing evidenced based patient care in the prevention of DVTs while in an acute care setting. These questions on the topic of how often Lovenox injections are required to be therapeutic versus how often heparin needs to be injected and the resulting patient satisfaction during the hospital stay. With the emphasis on patient satisfaction and the government guidelines for preventable hospital acquired problems, finding a solution to DVT prevention is important for nursing. One study by Arnold et al. (2010) directly compared the two drugs in question for this project and provided credible information to the development of an evidenced-based answer to the problem (Arnold et al., 2010). A second systematic review by Akl et al. (2014) researched the effects of the two drugs in question in the thromboprophylaxis treatment of patients (Akl et al., …show more content…
Developing a question that is answerable with research is the critical step in solving a primary problem (Davies, 2011, p. 77). The PICO is a mnemonic that helps address research questions: P – Patient or Population: Who is the patient? What are the most important characteristics of the patient? What is the primary problem, disease, or condition? I – Intervention: What is the intervention being considered? C – Comparison: Is there a comparison intervention? O – Outcome: What are the anticipated actions, improvements, or affects? The addition of T – Time: Is included in this research due to the problems being acute setting care
Again, this is a section where the current Anticoagulation Management policy by Advocate Health Care (2014) should be developed to include the steps that should be taken in situations where the therapy is to be
The pilot study and the interviews are then discussed followed by the data analysis process. Finally the chapter concludes with a discussion on rigor and how it was
Moreover they significantly reduce antibiotic resistance.(19, 20) These goals are often achieved while saving hospitals resources.(14) In 2014, recognizing the urgent need for wise antibiotic use in hospitals and the benefits of ASPs, CDC recommended implementation of ASP in all acute care
The study also shows that it is important to identify and treat complications early as it helps to improve outcome and save
This type of issue can delay mobilization and prolonged the hospital stay. Therefore, these patients are at a higher risk for pulmonary embolism, DVT and the risk for potential
This shows that pre-hospital management of both hemorrhage and the resulting shock are crucial for positive patient outcome. The question becomes, how can providers provide the best chance for good patient outcome? New bleeding control techniques such as tourniquets and haemostatic agents are now being seen as the best methods for bleeding control and information showing a change to shock management with regards to fluid
Drug Kardexes were gathered and audited under certain criteria in order to identify potential risk areas in drug prescribing and administration, and also to provide ways in which these risks can be reduced or eliminated and reinforce drug management policies’ and guidelines. NICE (2002) audit cycle will be applied to this assignment to provide an acceptable framework (Appendix 1). Step 1: Preparing for Audit. The first step in the audit process is to identify which type of audit is to be carried out.
"Chapter 53: bleeding and thrombosis". In Kasper DL, Braunwald E, Fauci AS, et al. Harrison's Principles of Internal Medicine 16th ed.). New York, NY: McGraw-Hill. ISBN 0-07-139140-1.
The largest barrier to health maintenance that this patient has is that he has poor compliance with health maintenance. He showed that he was not interested in learning proper care techniques for his health, especially when it came to his incision site which could later lead to infection as it heals. Furthermore, the client stated that he “often stays in bed on his computer during the day.” This statement illustrates that the patient is at risk for not complying to ambulating throughout the day which is detrimental for a post-operative patient. “Regular periods of aerobic exercise, such as ambulating, help prevent respiratory infections that can occur in immobile patients” (Craven, Jensen, Hirnle, 2013, p.1002).
deep vein thrombosis, pulmonary embolism, coronary artery disease, myocardial infarction and ischemic stroke). 36-37There is no definitive treatment for PVT however prophylaxis using a combination of low molecular weight heparin and/or warfarin and/or thrombolytic agents is the cornerstone of managing the
It explains the reasons for not recommending the medication and the quality of the evidence for each
It increases the stress level, pain, financial burden and prolongs stay to the patient in hospital due to inflammation. Nurses are aimed to prevent the patient from complications, but here nurses are causing the complications and pain due to their ignorance and malpractice. According to Dychter, Gold, Carson, and Haller (2012) nurses should aware that the complications of intravenous cannula, which are done due to infusions can significantly affect health care costs. Complications of IV therapy are costly in terms of patient quality of life, morbidity, mortality, and treatment expense, specifically when there is a prolonged hospital
Effective perioperative management of medications requires an understanding of the patient and his or her co morbidities so that the risk of perioperative decompensation can be gauged. This understanding stems from a thorough medical history that includes a comprehensive medication history to provide a complete inventory of the all prescription medications, all over-the-counter agents and all herbal medications. Out of 288 cases collected, 88% were in the age group of 41-80 years. Hypertension and diabetes combination was found to be the comorbities in majority of cases. In most of the cases medication use during perioperative settings was as per available literature indicating appropriate medication reconciliation in the hospital settings.
The literature review yielded a number of 8 time-critical conditions and 35 potential indicators for the expert panel’s review. The indicator list comprised of 23 process, 2 structural indicators and 7 outcomes. The 43 time-critical and potential indicators encompassed 21 indicators, 4 global indicators, and 8 time-critical conditions, 6 admission specific indicators for the emergency department and 4 triangle-specific indicators from the existing Danish care quality data
• Define and apply best practices to reduce readmission rates. • Predict the risk of sepsis or kidney failure, and intervene early to reduce negative outcomes. • Better manage pharmacy costs and outcomes. • Create tools to improve each patient’s