Back to School Offer

Get 20% of Your First Order amount back in Reward Credits!

Get 20% of Your First Orderback in Rewards

All papers examples
Get a Free E-Book! ($50 Value)
HIRE A WRITER!
Paper Types
Disciplines
Get a Free E-Book! ($50 Value)

Prevention of Deep Vein Thrombosis, Research Paper Example

Pages: 4

Words: 1191

Research Paper

Problem Statement

Due to insufficient evidence for the efficacy of anticoagulant prophylaxis as a method for prevention of venous thromboembolism in hospitalized patients, there has been under-utilization of the anticoagulant prophylaxes like heparin and lovenox. Due to a lack of education about and risk factors for thromboembolism, this complication continues to be a major cause of deaths among hospitalized patients in the US.

Significance of the problem

Hospitalized patients at high-risk for Venous thromboembolism (VTE) may develop an asymptomatic deep vein thrombosis (DVT), and die from pulmonary embolism (PE) even before the diagnosis is suspected. There is clinical evidence that appropriately used thromboprophylaxis has a desirable risk/benefit ratio and is cost effective. Thromboprophylaxis provides an opportunity to improve patient outcomes and reduce hospital costs. The vast majority of patients admitted to a critical care unit have a major risk factor for VTE, and many may have multiple risk factors including advanced age, serious medical illness or recent surgical procedures or trauma. The use of thromboprophylaxis has been clinically demonstrated to be efficacious in preventing deep venous thrombosis in these patients(Abdel-Razeq, 2010).

PICO Question and Purpose

This paper aims to answer the question: Does the Use of anticoagulant prophylaxes such as lovenox and heparin prevent venous thromboembolism (DVT) in hospitalized patients?

In order to learn how to best prevent and treat VTE in hospitalized patients, two journal articles, one investigating the risk factors for VTE in patients (Abdel-Razeq, 2010) and one that determined the most effective pharmaceutical agents for treating VTE (Wein, Wein, Haas, Shaw, &Krum, 2007) , were reviewed. The research should help in identification of the best prophylaxis for prevention of VTE among hospitalized medical patents. In addition, the research should help in providing sufficient evidence for supporting the efficacy of the prophylaxis.Thus provide the medical practitioners with the necessary confidence to administer the appropriate anticoagulant drugs in order to prevent DVT in hospitalized patients.

Best Methodology for Answering the Question

In order to answer the question, the best approach was to search for studies that have investigated the subject and critically analyze the methodologies used and match with the findings. In addition, assessment of the peer-reviewed articles and journals was an instrumental aid in establishing a perspective that agrees with the professional aspect of scientific process.

Synthesis of Literature

A literature review was undertaken by Abdel-Razeq (2010) in order to determine risk factors for VTE in hospitalized patients. The matrices revealed that in western countries, 2 to 3 of 1000 inhabitants encounters VTE annually, a number that has remained consistent since the 1980’s. Additionally, some studies have showed that 10-26% of patients admitted to med-surgunitencounter VTE with the absence of prophylaxis. While VTE is typically not deadly, it can cause long term health complications. Being able to identify high-risk patients and treating them with a preventative dose of the appropriate prophylactic is the best way to prevent VTE. A review of the cases of medically ill patients who encountered VTE showed that age was a significant factor for VTE, especially those 75 and older. Other VTE risk factors included heart attack, cancer, and stroke. Patients who have had VTE previously are especially at risk. For females, “risk factors include hormonal therapy with oral contraceptive pills, hormone replacement therapy, and selective estrogen receptor modulators like Tamoxifen and Raloxifene.”(Abdel-Razeq, 2010, pp. 195-196).

The study by Wein et al. (2007) was carried out to investigate which pharmacological agents are most effective in the prevention of VDT. In this study, an analysis of 36 studies was done by searching the MEDLINE and other registers for controlled trials from 1950 to 2006. In the results, the researchers found that LMWH has a lower DVT risk than unfractionated heparin.

Findings

A review of the literature reveals that it is possible to reduce the instance of VTE in medically ill patients. The first step is in setting up a protocol in order to identify high-risk patients. The second step is in identifying the appropriate prophylaxis treatment for the patient.

The next step needed to help decrease the prevalence of VTE and DVT is to create a protocol that could be used by medical personal to identify patients that are at risk for VTE and the appropriate prophylaxis treatment for each type of patient, depending on their medical history and condition. Continuous education and training of all health care providers is key to the success of a VTE protocol.

Conclusion

After carrying out the careful investigation of literature and assessment of various studies, there is sufficient evidence pointing to the efficacy of low-molecular-weight heparin (LMWH) in prevention of DVT among the hospitalized medical patients. It would thus be appropriate to recommend LMWH to be used for treatment of hospitalized medical students for prevention of VDT (Wein, et al., 2007). Additionally, strategies to improve VTE prophylaxis in medically ill patients was suggested, including the establishment of a “VTE Prophylaxis Multidisciplinary Team” to identify high-risk patients for prophylaxis treatment, are suggested (Abdel-Razeq, 2010). For more information on the analyzed studies see appendix.

References

Abdel-Razeq H. (2010).Venous thromboembolism prophylaxis for hospitalized medical patients, current status and strategies to improve.Annals of Thoracic Medicine5, 195-200.

Wein, L Wein S., Haas S. J., Shaw, J & Krum H. (2007). Pharmacological Venous Thromboembolism Prophylaxis in Hospitalized Medical Patients: A Meta-analysis of Randomized Controlled Trials.Arch Intern Med. 167(14):1476-1486

Appendix

Evidence Matrix Table

Author, Year, Title, Source Purpose, Hypothesis, Study Question Measurement, Operational Definitions of Variables, Independent/Dependent Findings Design, Level of Evidence
Abdel-Razeq H. (2010) “Venous thromboembolism prophylaxis for hospitalized medical patients, current status and strategies to improve” Annals of Thoracic Medicine – Vol 5,        Issue 4, 195-200. Purpose: An extensive review of the medical literature from PubMed regarding the use of VTE prophylaxes in hospital settings to determine the current status of VTE prophylaxis to determine strategies for improvement. Tool: PubMed was searched to find all major articles focusing on statistics concerning risk factors and treatment for VTE. Qualitative analysis was performed in order to assess the current status of VTE prophylaxis in hospitalized medical patients so improvement strategies could be identified.

This is the search meachnism; not what tools were used in the studies

A review of the literature revealed that despite  consensus recommendations, showing the benefit of VTE prophylaxis in medically ill patients,  less than 40% are actually receiving prophylactic measures.

N=# of studies reviewed

Design:

Meta-Analysis

 

Level of Evidence: 1

Wein, L Wein S., Haas S. J., Shaw, J & Krum H (2007) “Pharmacological Venous Thromboembolism Prophylaxis in Hospitalized Medical Patients: A Meta-analysis of Randomized Controlled Trials” Arch Intern Med. 167(14):1476-1486

 

Purpose: A meta-analysis was performed comparing UFH or LMWH with a control to determine effectiveness. Tool: A search of MedLine, EmBase and the Cochrane Central Register of Controlled Trials was searched from 1950, 1966 and 1800, respectively, through June 30, 2006 for randomized controlled trials that involved patients that involved comparing the use of herapin (UFH) or low molecular weight herapin (LMWH) with a  control. 2 independent reviewers examined the studies and data synthesis was undertaken by 1 blinded investigator. A review of the literature revealed that both UFH and LMWH are effective in reducing the risk of VTE in hospitalized medical

patients, but that neither alters mortality. LMWH was found to be more effective than UFH in preventing DVT.

N=# of studies

Design:

Meta-analysis

Level of Evidence: 1

 

Time is precious

Time is precious

don’t waste it!

Get instant essay
writing help!
Get instant essay writing help!
Plagiarism-free guarantee

Plagiarism-free
guarantee

Privacy guarantee

Privacy
guarantee

Secure checkout

Secure
checkout

Money back guarantee

Money back
guarantee

Related Research Paper Samples & Examples

What Can Be Learned From the History of the Marshall Plan About the Importance of the United States, Research Paper Example

Introduction After the ending of the Second World War in 1945 Europe was changed forever and began a transformation of re-construction of buildings, culture and [...]

Pages: 8

Words: 2098

Research Paper

What Is the Future of the Canadian Economy as the Government Ends Stimulus Spending, Research Paper Example

Q1 |  Jim Flaherty, The Federal Minister of Finance for the Canadian Government expressed the following economic ideology on the ending of stimulus spending :-  [...]

Pages: 6

Words: 1595

Research Paper

Relationships Between Nursing Concepts, Research Paper Example

Abstract In the field of nursing, the major components come together in an almost limitless number of ways. The nurse, the environment, the state of [...]

Pages: 4

Words: 1091

Research Paper

PepsiCo Supply Chain, Research Paper Example

Abstract Supply chain management is an ongoing process that must constantly be evaluated and adjusted to enable corporations to improve efficiency and decrease costs.  Currently, [...]

Pages: 5

Words: 1432

Research Paper

Hearing-impaired Children, Research Paper Example

When parents have a child with hearing impairment, they are presented with a variety of challenges regarding their child’s social, physical, and academic development.  Hearing [...]

Pages: 10

Words: 2815

Research Paper

Crime Pattern Analysis, Research Paper Example

Abstract Crime Pattern Analysis is discussed within the context of Criminal Justice.  A brief definition exploring the concept of Crime Pattern Analysis and the theoretical [...]

Pages: 3

Words: 782

Research Paper

What Can Be Learned From the History of the Marshall Plan About the Importance of the United States, Research Paper Example

Introduction After the ending of the Second World War in 1945 Europe was changed forever and began a transformation of re-construction of buildings, culture and [...]

Pages: 8

Words: 2098

Research Paper

What Is the Future of the Canadian Economy as the Government Ends Stimulus Spending, Research Paper Example

Q1 |  Jim Flaherty, The Federal Minister of Finance for the Canadian Government expressed the following economic ideology on the ending of stimulus spending :-  [...]

Pages: 6

Words: 1595

Research Paper

Relationships Between Nursing Concepts, Research Paper Example

Abstract In the field of nursing, the major components come together in an almost limitless number of ways. The nurse, the environment, the state of [...]

Pages: 4

Words: 1091

Research Paper

PepsiCo Supply Chain, Research Paper Example

Abstract Supply chain management is an ongoing process that must constantly be evaluated and adjusted to enable corporations to improve efficiency and decrease costs.  Currently, [...]

Pages: 5

Words: 1432

Research Paper

Hearing-impaired Children, Research Paper Example

When parents have a child with hearing impairment, they are presented with a variety of challenges regarding their child’s social, physical, and academic development.  Hearing [...]

Pages: 10

Words: 2815

Research Paper

Crime Pattern Analysis, Research Paper Example

Abstract Crime Pattern Analysis is discussed within the context of Criminal Justice.  A brief definition exploring the concept of Crime Pattern Analysis and the theoretical [...]

Pages: 3

Words: 782

Research Paper

Get a Free E-Book ($50 in value)

Get a Free E-Book

How To Write The Best Essay Ever!

How To Write The Best Essay Ever!