Amy Selter

NURS 360
M/S Clinical Rotation
Reflective Journal
Week 4: Evaluate and apply the facts and principles of biological, psychological,
sociological, cultural and spiritual functioning while providing nursing care to
clients with needs resulting from altered states of wellness throughout the lifespan.
a.

Evidence Based Practice

Select one nursing intervention you implemented for your patient today
and explain the scientific rationale for its use. Use electronic resources to
select an original research article supporting its use. Please provide at
least a 10 sentence synopsis of the article and provide appropriate
reference.

One intervention I implemented with one of my patients this past week was
administering a heparin injection as a prophylactic treatment against DVT
formation and possible thromboembolism. This practice is widely used with many
hospitalized patients whose mobility has been compromised. Qaseem, A., Chou, R.,
Humphrey, L., Starkey, M., & Shekelle, P. (2011), present a guideline for clinical
recommendations on prophylaxis of VTE in hospitalized adults. They looked at four
key questions to include, What are the benefits and harms of subcutaneous lowdose heparin products for VTE prophylaxis in hospitalized medical patients?
What is the comparative effectiveness of different low-dose heparin products (lowmolecular- weight heparin [LMWH], unfractionated heparin [UFH]) for VTE
prophylaxis?... What is the effectiveness and comparative effectiveness of
mechanical devices for VTE prophylaxis?...(and) Do results vary by general medical
patient populations: general medical inpatients and patients with acute stroke?
They performed over 32 different trials of varying population size to compare
different strategies for preventing VTE. In the end, their recommendations included

assessment for TE risk, the use of pharmacologic prophylaxis with heparin in

hospitalized patients unless risks outweigh the benefits, and they recommend
against the use of mechanical prophylaxis with compression stockings for
prevention of VTE (Qaseem, A., Chou, R., Humphrey, L., Starkey, M., & Shekelle, P.,
2011).

Qaseem, A., Chou, R., Humphrey, L., Starkey, M., & Shekelle, P. (2011). Venous
thromboembolism prophylaxis in hospitalized patients: a clinical practice
guideline from the american college of physicians. Annals Of Internal
Medicine, 155(9), 625-632.