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  • Subject Name : Nursing

Table of Contents 

Introduction.

Analysis.

The first articles selected is the.

The second selected article is.

The third selected article is.

The fourth article.

Conclusion.

References.

Introduction to Evidence for Nursing

The purpose of this paper is to demonstrate the evidence based conclusions in context to scenario 2. In this scenario there is a condition described that there are several stroke patients in a hospital ward and some doctors suggest them to give compression stockings to prevent the venous thrombosis in depth. All the doctors are not agreeing with the same kind of treatment. From here a question arises that should antithrombotic stockings be routinely used for patients with stroke or not? This question is the main topic of this assessment and all the research are made to clarify this question. To make a clear clarification for his question a number of scholarly articles are reviewed and select most appropriate articles from there and then used them as evidence against this question. Many articles are reviewed in detail and go through every aspect of them. Then for the purpose of the respective study four articles are selected from reliable sources which are peer reviewed. All the articles are selected after judging the credibility of the respective articles.

The authors have medical study or research background from a reputed educational institute or health institute. All their study both qualitative and quantitative in the past are related to the research topic and this gives credibility for their selection. Some of them are directly related to the medication system during the publication of the respective articles. Hence, they can better relate the topic with reality and are aware of the practical significance of this question. All the practical impacts whether positive or negative of applying compression stocking on stroke patients are encountered by them. The publication of the articles is not very old, they were published after the year 2016 and this also raises the reliability of these articles. Along with these criteria, in the selected articles reference lists are present, from where further detailed search can be carried out about the topic of the assessment. These reasons are enough to reflect the credibility of the article. All these stated points are the reason for the selection of the articles and they will be discussed briefly in the succeeding paragraph. To go through the study in detail a PICO model is created. This gives an opportunity to search with more efficiency. PICO model divide a question in few parts and allow going through any research with a little accuracy and in a detailed form. Every single important aspect can be judged by using PICO model and the outcome is quite accurate or satisfied. The PICO model is described below:

P

Patients

Stroke patients, various age groups, male-female both.

I

Intervention

Antithrombotic stockings

C

Comparison

intermittent pneumatic compression devices

O

Outcome

Maintain the blood flow and to reduce swelling and discomfort due to stroke.

 

This PICO model will be followed during the study of the selected articles and the findings will be on the basis of these criteria.

Analysis

The First Articles Selected Is The

Field, T. S., & Hill, M. D. (2012). Prevention of deep vein thrombosis and pulmonary embolism in patients with stroke. Clinical and Applied Thrombosis/Hemostasis, 18(1), 5-19.

According to this article, the problem deep vein thrombosis (DVT) is very critical among the patients suffering from movement issues and this is more serious in case of the patients with Cerebral Vascular Accidents (CVA). The common symptoms of CVA are paralysis in the lower limbs, muscle pain or weakness, and DVT. As per the author, the initial DVT factors are problem on the venous endothelium, venous blood statis and the coagulation of blood. The patients are suffering from CVA have a high chance of getting DVT affected. There is also a chance of getting affected by pulmonary embolism and for this about 40 percent patients of CVA are affected by DVT during the very initial 3 weeks of this disease. Around 18 percent of DVT issues are shown in the portion higher the knees. Along with that, pulmonary embolism symptoms are occurring in 1 to 6 percent of CVA patients. The main two issues of this type of patients are pulmonary embolism and deep vein thrombosis. By decreasing the venous clog and enhancing the flow of blood through the legs anti thrombosis compression stockings check DVT. This process enhances the activity of venous valves by enhancing the drainage efficiency of the venous, also decreases the symptoms of this diseases in the legs. Thus this process increases the patient’s life style according to this article.

The Second Selected Article Is

Chen, R., Zhou, Y., Li, P., Yang, H., Fei, Y., & Hu, X. et al. (2019). The efficacy and safety of antithrombotic therapy in patients with positive antiphospholipid antibodies receiving invasive procedures: experience from a single tertiary center. Clinical Rheumatology, 38(7), 1897-1904. doi: 10.1007/s10067-019-04483-8

The objective of this article is to find the safety and efficiency of anti-thrombotic prophylaxis and then the analysis of the critical risk elements for thrombotic or bleeding issues among the patients having antibodies of (+)ve anti phospholipids (aPL). For this article study a group of patients having (+) ve aPL were selected of Peking Union Medical College Hospital from the year 2002 in January to 2018 April. After the research the article reflects the result that 130 invasive methods were listed for 111 patients with (+) ve aPL. Among them 109 patients were given general anti thrombotic treatment 1 month before the invasive methods. 58 among them received anti coagulation treatment, 27 received anti platelet treatment and 24 received both types. Rest 2 was given peri procedural thrombotic treatment and there 18 bleeding issues were found. The articles then concluded that anti thrombotic treatment was connected with some thrombotic issues in the (+) ve aPL patients received invasive procedure but they increase the rate of bleeding mainly in major open surgeries. The study analyzes the prevention of prophylactic anti thrombotic treatment among the aPL (+) ve patients.

The Third Selected Article Is

Kearon, C., & O'donnell, M. (2010). Should Patients with Stroke Wear Compression Stockings to Prevent Venous Thromboembolism?. Annals of Internal Medicine, 153(9), 610. Doi: 10.7326/0003-4819-153-9-201011020-00285

According to this article, venous thrombo embolism with pulmonary embolism and deep vein thrombosis is a general and curable issue of stroke. Asymptomatic deep vein thrombosis attack near 40 percent and that of symptomatic nature attack near 5 percent of stroke affected patients who have movement difficulty without prophylaxis use. Minimal dosage of apportioned heparin and minimal molecular weight heparin controls vein thrombo embolism in about 2/3 portion but these treatment procedures may be connected with an enhancement of intracerebral hemorrhage among the patients having ischemic stroke. The study portraits the result as, stocking of thigh length are not so useful for the vein thrombo embolism and that of for down knee length stockings may increase number of incidences of thrombosis among the stroke patients and the study reconducted among different groups of people with compression stockings. According to the researchers this vast study is quite enough to reflect the symptomatic vein thrombo embolism and their results. The study raises several crucial medical questions and supports them with other studies. The research study finally concluded that the net positive outcomes and the risks of this procedure are quite unpredictable.

The Fourth Article

Razi, M., & Gu, J. (2018). Application of Intermittent Pneumatic Compression Devices and Graduated Compression Stockings in Venous Thromboembolism. Science Letters, 6(1), 13-17

According to this text, venous thromboembolism is that type of health issue that is the dual action of deep vein thrombosis and the pulmonary embolism. The text states that graduated stockings gives the expected anti thromboembolic impacts on the veins of lower limbs. This can be obtained by providing compression through a graded form over the local veins. They give the expected impact by countering the procedure included in pathogenesis of vein thrombo embolism and they are a) minimizing the venous statis by applying compression in the veins of the limbs in the lower portion and increase the flow rate of blood. b) Ankle compression in proximity and thus enhancing the rate of flow of blood. c) Minimizing the strain in the veins by accelerating the muscle of the calf by pumping enhancing the activity of the valve. d) Change in the impacts of fewer clotting elements. There are two types of stockings, knee length or thigh length. A thorough analysis is carried out to see that which type of stockings give better result. The article finally concluded that that intermittent pneumatic compression devices (IPCDs) and graduated compression stockings are effective alternatives in case of prophylaxis of vein thrombo embolism. They stated IPCDs shows little more efficacies that GCS. The article also finished with saying that this criteria vary according to the various hospitals.

Conclusion on Evidence for Nursing

After analyzing all the articles thoroughly, it can be concluded that the antithrombotic stockings are quite helpful for the patients with stroke. It gives satisfied result. After a large number of studies, examinations it can be said that antithrombotic stockings can be used as a routine basis in case of the patients who are affected by acute stroke. Though there are contradictory statements that these types of treatment are not so useful or effective over stroke patients and may act negatively in some cases but the supporting researches are more. Based upon this higher number of supporting study conclusion, this can be finalized that this is a good medication process that could be given to the stroke patients to improve their health condition. Also from the quantitative research studies the same can be concluded. A higher percentage of patients reacted positively who were given anti thrombotic stockings.

References for Evidence for Nursing

Chen, R., Zhou, Y., Li, P., Yang, H., Fei, Y., & Hu, X. et al. (2019). The efficacy and safety of antithrombotic therapy in patients with positive antiphospholipid antibodies receiving invasive procedures: experience from a single tertiary center. Clinical Rheumatology, 38(7), 1897-1904. doi: 10.1007/s10067-019-04483-8

Field, T. S., & Hill, M. D. (2012). Prevention of deep vein thrombosis and pulmonary embolism in patients with stroke. Clinical and Applied Thrombosis/Hemostasis, 18(1), 5-19.

Kearon, C., & O'Donnell, M. (2010). Should Patients With Stroke Wear Compression Stockings to Prevent Venous Thromboembolism?. Annals Of Internal Medicine, 153(9), 610. doi: 10.7326/0003-4819-153-9-201011020-00285

Razi, M., & Gu, J. (2018). Application of Intermittent Pneumatic Compression Devices and Graduated Compression Stockings in Venous Thromboembolism. Science Letters, 6(1), 13-17

Remember, at the center of any academic work, lies clarity and evidence. Should you need further assistance, do look up to our Nursing Assignment Help

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