Deep Venous Thrombosis Prophylaxis; Lovenox vs Heparin On June 30, 2011, the Centers for Medicare and Medicaid Services (CMS) presented their final ruling on non-payment policies for provider preventable conditions (PPCs). One of the other provider preventable conditions includes the development of deep vein thrombosis (DVT) prophylaxis in any health care setting (Federal Register, 2011, p. 32817). Due to the significant cost of providing care for preventable conditions that are now not reimbursed through the CMS and many health insurance companies, hospitals around the country have implemented new policies to ensure patients remain free of venous blood clots during their hospital stay. The practice of injecting either Lovenox or heparin …show more content…
Can heparin injections every 12 hours instead of every eight continue to provide protection against DVTs due to the life of the pharmacokinetics? 3. Could this research improve our patient scores for satisfaction if patients only had one injection a day, not three? 4. Would our satisfaction scores go up if we did not wake them in the middle of the night to do an eight-hour heparin subcutaneous injection? 5. Is low-dose unfractionated heparin more effective that a low-molecular-weight heparin such as enoxaparin or dalteparin? These background questions are significant to providing evidenced based patient care in the prevention of DVTs while in an acute care setting. These questions on the topic of how often Lovenox injections are required to be therapeutic versus how often heparin needs to be injected and the resulting patient satisfaction during the hospital stay. With the emphasis on patient satisfaction and the government guidelines for preventable hospital acquired problems, finding a solution to DVT prevention is important for nursing. One study by Arnold et al. (2010) directly compared the two drugs in question for this project and provided credible information to the development of an evidenced-based answer to the problem (Arnold et al., 2010). A second systematic review by Akl et al. (2014) researched the effects of the two drugs in question in the thromboprophylaxis treatment of patients (Akl et al., …show more content…
Developing a question that is answerable with research is the critical step in solving a primary problem (Davies, 2011, p. 77). The PICO is a mnemonic that helps address research questions: P – Patient or Population: Who is the patient? What are the most important characteristics of the patient? What is the primary problem, disease, or condition? I – Intervention: What is the intervention being considered? C – Comparison: Is there a comparison intervention? O – Outcome: What are the anticipated actions, improvements, or affects? The addition of T – Time: Is included in this research due to the problems being acute setting care