Prevention of Deep Vein Thrombosis (DVT) after Hip and Knee Surgery

Deep Vein Thrombosis (DVT) is a serious health conditional that has the potential for fatal consequences. This condition basically involves the development of a thrombus in a deep vein and can take place in retinal veins, cerebral sinuses, upper extremities, and hepatic. The prevention of DVT, especially after a hip or knee surgery, is a major issue because of the increased risk of developing the condition in hospitals and community healthcare facilities. Given the increased risk for developing the condition across healthcare facilities, nurses, physicians and other health professionals face the need to understand the condition, identify it, and take suitable measures to prevent it. Consequently, there are some policies, procedures or standards for preventing deep vein thrombosis.

Based on existing policies, procedures and standards, the prevention of DVT should primarily focus on addressing the triad of influential factors. These factors include hypercoagulability, vein wall trauma/dilation, and venous stasis (Bonner, 2004). This is primarily because the immediate symptoms of the condition are usually resolved through anticoagulation alone. Additionally, the basis for intervention measures for DVT is lessening 75% of long-term risks associated with the condition. Notably, the development and implementation of suitable prevention requires identification of risk factors prior to admission to the healthcare facility.

One of the interventions that have been recommended for reduction of risk factors of deep vein thrombosis is intermittent pneumatic compression (IPC). A study conducted by CLOTS (2013) examined the effectiveness of IPC in lessening the risk of DVT in patients who have suffered from stroke. This study was conducted on the premise that stroke is associated with blood clotting in legs or stockings, which may require surgery. The procedure utilized in this study was IPC on a group of patients who had difficulties in walking because of acute stroke. Since it was a randomized controlled trial, the researchers divided the participants into two groups i.e. a control group (in which IPC was not utilized) and an experimental group (where IPC was utilized). After administering intermittent pneumatic compression, the experimental group was monitored for six months to examine the survival of the thrombus in the deep vein or the development of any other symptomatic venous thromboembolism (CLOTS, 2013). They found an absolute decrease in the risk of DVT, which led to the conclusion that IPC is an effective intervention for lessening the risk of this condition. In addition, this intervention enhances the likelihood of survival in a wide range of patients who had become immobile after suffering from acute stroke.

The basis for the use of IPC for this group of patients was based on the fact that prophylaxis, screening, and treatment are the standards for intervention measures utilized in prevention of deep vein thrombosis. IPC is one of the mechanical methods that have been established in existing policies and procedures for treatment of DVT. This technique of preventing and treatment of DVT is based on prophylaxis, which is a principal intervention/treatment measure for the condition. Therefore, IPC is supported by the established policies of mechanical techniques for prevention of deep vein thrombosis.

Finding quality, relevant and timely evidence on the prevention of DVT was a relatively difficult process. It seems that there is seemingly limited literature on evidence-based practice of prevention of this condition. The policies, protocols or procedures are similar with the evidence found in this study since they support the use of mechanical methods in preventing or treating the condition. The RN's performance was in line with the located evidence since it entailed prophylaxis, screening, and treatment.

References

Bonner, L. (2004, July 20). The Prevention and Treatment of Deep Vein Thrombosis. Nursing Times, 100(29), 38. Retrieved from https://www.nursingtimes.net/clinical-archive/haematology/the-prevention-and-treatment-of-deep-vein-thrombosis/204197.article

CLOTS. (2013, August 10). Effectiveness of Intermittent Pneumatic Compression in Reduction of Risk of Deep Vein Thrombosis in Patients who have had a Stroke (CLOTS 3): A Multicentre Randomised Controlled Trial. Lancet, 382(9891), 516-524.