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NURS 360 Clinical

Reflective Journal
Week 6
Tim Thomas
Professor KaUa'Alohi Aiu
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.

Address the question listed below:

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.

This week I chose to find an evidence based article that supports an
intervention that I used with one of my patients. I chose the use of ICD's and I found
an evidence based article about their use. The article I found was about the use of
SCD's and their importance of helping to prevent DVT's. In this article the author
states that critically ill patients have 20 to 50% incidence of venous
thromboembolism. It goes on to say that using sequential compression devices
correctly is an effective method of reducing the occurrence of thromboembolism.
The devices should be used for 90 percent of the time that the patient is in bed.
Sometimes patients refuse to use the devices, they say that they are
uncomfortable, that they are too warm, or they may refuse them if the sleeves
become soiled. When patients refuse to use the devices their risk is increased for a

possible DVT. This article stated that at least 21 hours a day of ICD therapy is
needed to prevent DVT. It went on to say that patients who used the device for an
average of 13 hours a day had an increased incidence of DVT despite their partial
use. The article explains that thigh high and knee high compression stockings were
about the same in their effectiveness. But the knee high compression stockings
were preferred for several reasons. The advantage of knee high compression
devices is that they are less likely to become soiled and they are more likely to be
accepted and used by the patient. The article showed a clear advantage of knee
high SCDs vs the thigh high version. Not only are the knee high stockings more
patient friendly, they require less storage space as well. An additional advantage is
that the knee high versions are more environmentally friendly due to reduced
material that is one time use going which must be discarded and ends up in
landfills. I had heard of but never seen thigh high compression devices. After
reading this article it is more apparent to me why the majority of the ICD's in use
are the knee high versions.

Reference:

Stone A, Chamberlin L. EB96: Out With the Thigh-High, In With the Knee-High
Sequential Compression Devices. Critical Care Nurse [serial online]. April
2011;31(2):e37. Available from: Academic Search Complete, Ipswich, MA. Accessed
April 18, 2016.