Analysis of Deep Vein Thrombosis
Purpose of Study
Most Australian citizens present with deep vein thrombosis each year, which may lead to venous thromboembolism. Individuals who have untreated proximal deep vein thrombosis (DVT) usually have a 50% chance of getting pulmonary embolism which can be fatal if untreated (Lim et al., 2020). During management of deep vein thrombosis, there can be times when anticoagulant is not needed and it depends on how the blood clot occurred and the criteria used in the diagnosis. Most of the cases of DVT that were presented to the emergency department were treated using warfarin, an anticoagulant, which requires routine monitoring of drug levels to ensure its effectiveness. Department of hematology for northern hospital, Victoria, in Australia, conducted a study to help in reducing the use of warfarin in the treatment of out-patients presenting with proximal or distal DVT (Lim et al., 2020). However, direct oral anticoagulants (DOACs) were used to treat distal DVT. The DOACs are to be used to manage clients who present to the emergency department outside pharmacy hours.
Research Findings
The drug that was chosen for the research was rivaroxaban which is an anticoagulant that is taken orally. Rivaroxaban after-hours’ pack was used in the supply and administration of the drug with the help of the decision support computer rule. This aids the physician to know if the patient fits the criteria. The decision support system shows the indications and the contraindications of the drug. The patient should have the correct weight (50-120 kg) and an adequate glomerular filtration rate (Lim et al., 2020). During the study, it was realized that patients who presented with a history of venous thromboembolism and those diagnosed with active malignancy tumors were at risk of developing thrombosis.
Moreover, the contraindications of direct oral anticoagulants are patients with liver impairment, renal impairment, cancer, and those with antiphospholipid syndrome. During the study, 10% of the individuals presented with menorrhagia, 1% had thigh hematoma, and 1.7% presented with clot extension despite adequate administration of rivaroxaban (Lim et al., 2020). The advantage of using rivaroxaban is that it reduces the need for the use parenteral route of administration of the drugs since it is taken orally. The study (Lim et al., 2020) shows decreased hospital contact with the patients since the use of rivaroxaban does not require regular blood test monitoring. There was sufficient follow-up of the clients for hematology and pharmacy, which helped inadequate monitoring of the patients and the progress. There was adequate education of the patient on the side effects of the drugs and the proper rational use of the drugs.
Use of Information in Nursing Practice
With this information, nurses can easily administer the drug since it is taken orally and does not need parenteral administration. Using this drug, the nurses will not need to hospitalize the patient since rivaroxaban does not need regular monitoring. They can also identify the contraindications of the drug and the indications to help in the appropriate prescription. Rivaroxaban has a rapid onset of action and allows the nurse to ensure adequate recovery of the sick (Lim et al., 2020). Thus, the nurses will be required to take a proper medical history to help in identifying if the patient is fit for using the drug or if the drug is contraindicated for the patient. They will use the medicine to help in reducing the cases of pulmonary embolism or thrombotic attack for patients with untreated, deep vein thrombosis.
Nurses will find the research helpful in their workplace and time saving since it has a computerized decision-making system and is very efficient because it reduces the nurses’ workload.
References
Lim, H., Lambros, P., Krishnamoorthi, B., Chellaram, V., & Ho, P. (2020). Outpatient management of deep vein thrombosis using direct oral anticoagulants is safe and efficient. Journal of Pharmacy Practice and Research, 50(4), 351-355. doi: 10.1002/jppr.1645