DVT In Nursing

ABSTRACT

There is an ever growing introduction of new anticoagulants i.e. blood thinning medications into the health care market. Due to the associated risk of DVT prophylaxis with concurrent anti-coagulation therapy, it is imperative that detailed medication reconciliation is completed pre and post hospital admission/discharge or special procedures to prevent complications of increased bleeding. Factors influencing these risks include; multiple dosing providers, poor patient compliance, and adverse concurrent anticoagulant use. Improved nursing research has been initiated to improve awareness and the incidence of adverse affects on patient populations.

Deep Vein Thrombosis (DVT) is the collection of blood within the deep veins of

Proper health and medication history/reconciliation is important pre-admission, during, and discharge from the hospital setting. Ziaeian et. al. conducted a study on the medication accuracy and patient understanding of intended medication changes at discharge. This article concluded that “Medication reconciliation and patient understanding are inadequate in older patients post discharge. Errors and misunderstandings are particularly common in medications unrelated to the primary diagnosis. Efforts to improve medication reconciliation and patient understanding should not be disease specific, but should be focused on the whole patient”. The responsibility to educate patients is shared among various disciplines. At discharge, nurses play a vital role in medication reconciliation with the transition of patients back into the home or post hospital care setting. A major observed preventative risk with DVT prophylaxis is multiple dosing providers, poor patient compliance, and adverse concurrent

Some DVT prophylaxis therapeutic levels cannot be measured immediately, timing varies according by medication. Education also needs to focus on patients stopping and restarting of blood thinning medications pre/post discharge. Discontinuation or holding of medications pre surgery has to be closely monitored post op. Some diseases processes require blood clotting times to be at a certain therapeutic level. Postsurgical procedures routinely have standard DVT prophylaxis. A mistake within the medication reconciliation is that patients are ordered DVT prophlaxis without addressing the previous anticoagulation medication pre-hospital admission, and when the patient goes home to resume medications. They continue to take medications as previously with the additional discharge medication. This error isn’t often found until the next doctors’ office visit, home care nurse visit, or complications arise where the patient has to return back to the health care facility for sever and life threatening emergency. Safe practices policy and procedures have been put in place to ensure such adverse occurrences are prevented from happening. Some of these practices include: “The following basic principals can be used to reduce errors when using fibrinolytics and related drugs (Jennings,