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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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.,
For this assignment I was able to interview Regina Bowman RN, BSN. Her current position is that of the Director of Medical Surgical Nursing. Her position places her over top of seven nursing units between two facilities. Regina graduated from the Mercer Medical School of Nursing in 1979 with her diploma in nursing. The Mercer medical school of nursing is still in operation although it has been renamed the Capital Health School of Nursing. Her return to school started after graduation. She enrolled at Mercer County Community College to obtain her Associates. Secondly she attended La Salle University and received her Bachelor’s in Nursing in 2003. Lastly she is currently enrolled at the Thomas Edison State University, and has a prospective graduation of 2011 with her Masters Degree in Nursing. Regina has work in many clinical jobs, both in and out the hospital. Initially she began her nursing carrier as a medical surgical nurse shortly after graduation. After she gained experience she worked in the emergency room only to return to med-surge as an assistant manager. Subsequently the unit in which she worked closed and Regina was placed in an outpatient setting managing hospital owned physician groups. This position leads to her return as the manager of 7 East a general medical unit. This position eventually gave her the opportunity to hold her current position as a hospital director.
Melling, C. A., Baqar, A., Eileen, M. S., & David, J. L. (2001, September 15). Effects of preoperative warming on the incidence of wound infection after clean surgery; a randomised control trial. The Lancet, 358, 876-880.
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.
Ofri, D (2000). Diagnosis and Treatment of Deep-Vein Thrombosis. Western Journal of Medicine; 173: 194-197.
The purpose of this case study is to hypothetically conduct a complete project analysis on the ambulatory surgery center and to present my findings and recommendations.
For my research paper, I will be taking the position that low nurse-patient ratios (the number of patients a nurse is assigned to care for during their shift) are beneficial to patient safety and should be adopted on a larger scale.
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...
Working in long-term care can be overwhelming. Imagine you are a new graduate nurse putting your new found knowledge and skills to practice for the first time. Your orientation lasted three days which is standard for nurse home orientation compared to hospital orientation that last approximately six to eight weeks for new grads. The shift has just begun and already you have a new admit, new found pressure ulcer to assess, a possible medication reaction, several new orders to take off and eight patients to document on for varying reasons. Feelings of frustration and confusion take over as you are the only nurse on the unit along with a Certified Medication Technician (CMT) and three Certified Nursing Assistants (CNAs) taking care of 47 patients. Ideal nurse-to-patient ratio continues to be a national issue in both the hospital and long-term care setting (LTC). In the LTC setting there is no official nurse-to-patient ratio; there is a suggested staff-to-patient ratio. This issue not only affects the new licensed nurses but the seasoned nurse as well. Recently, there has been controversial debates as to whether heavy workloads are detrimental to patients. The federal, state, and local government regulates many aspects of healthcare. However, it is the physicians, nurses and other healthcare professional that provide care directly to patients. Consequently, does insufficient staffing, heavy workloads, and unsupportive work environment directly contribute to poor patient satisfaction, nurse burnout, high turnover and job dissatisfaction?
administered to prevent clots and perhaps continues post-op. If such a patient is not given
I certify that this assignment is my own work in my own words. All resources have been acknowledged and the content has not been
Ottawa Hospital Research Institute. (2010). Outcomes of saddle pulmonary embolism: a nested case-control study. International Society on Thrombosis and Hemostasis, 867-869.
1.I currently work in the surgical unit and one of the major recovery enhancements is early ambulation after any surgery, especially orthopedic and abdominal. Early ambulation will accelerate the return of bowel function (as evidenced by passage of stool and flatus) reduce the rate of overall complications and decrease the length of hospital stays. Evidence-based practices have shown that early post-operative ambulation contributes to decreased pulmonary complications. “When exploring postoperative activity in the general and orthopedic nursing literature, there is sparse evidence outlining nursing's critical thinking skills associated with decreasing the first postoperative activity from the historical 14-day mark to the most current model of day 1 or 2 for the joint replacement population. Also, there were no recently published reports describing a contemporary
The role of the nurse in the preoperative area is to determine the patient’s psychological status to help with the use of coping during the surgery process. Determine physiologic factors directly or indirectly related to the surgical procedure that may cause operative risk factors. Establish baseline data for comparison in the intraoperative and postoperative period. Participate in the identification and documentation of the surgical site and or side of body on which the procedure is to be performed. Identify prescription drugs, over the counter, and herbal supplements that are taken by the patient that may interact and affect the surgical outcome. Document the results of all preoperative laboratory and diagnostic tests in the patient’s record
Although students were not allowed in the recovery unit, I was able to talk to one of the recovery nurses. I learned that a nurse’s duty of care includes monitoring the patient’s vital signs and level of consciousness, and maintaining airway patency. Assessing pain and the effectiveness of pain management is also necessary. Once patients are transferred to the surgical ward, the goal is to assist in the recovery process, as well as providing referral details and education on care required when the patient returns home (Hamlin, 2010).