Proposed Solution in Managing Deep Venous Thrombosis and Pulmonary Embolism

Developing an Implementation Plan
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Developing an Implementation Plan
Introduction
Deep Venous Thrombosis and Pulmonary Embolism are two of the common postoperative complications for patients who undergo total knee replacement. Many surgeons are faced with orthopedic problems concerning postoperative especially for patients who do not use prophylaxis. Although low-molecular-weight heparin is considered as a safe prophylaxis in preventing the two postoperative complications, the main concern is how to minimize risks of bleeding associated with LMWH (Sheth, Lieberman, & Valle, 2010).Problem Description
Several studies indicate the increased prevalence rate of deep vein thrombosis after knee arthroplasty among the adult population. Currently, the prevalence rate of thromboembolism has increased from 40 – 84 percent especially for patients who do not use prophylaxis (Giannoni, et al. 2009). Multiple orthopedic procedures are performed yearly including knee and hip replacement risking the lives of many people. These procedures activate blood clotting increasing the risk of venous thromboembolism especially for patients who do not use prophylaxis (Nocolaides et al., 2010). Thromboembolism is becoming an international health concern. According to international medical experts, PE is considered to be fatal but often overlooked. DVT leads to post-thrombotic venous insufficiency and ulceration that in turn impacts on the quality of life increasing the overall health cost (Nocolaides et al., 2010).
Despite concerns being raised about the risk of bleeding due to LMWH, several studies prove that LMWH is much safer than the other regime. One of the studies suggests that one daily subcutaneous injection of calcium nadroparin in a fixed weight-adjusted dosage scheme had greater impact compared to pneumatic. Furthermore, studies prove that LMWH is more effective in patients using warfarin and LMWH as prophylaxis. Patients given warfarin or LMWH had significantly lower prevalence of DVT and PE compared to patients using unfractionated heparin. The study confirms that low molecular weight heparins are more effective compared to other regimens after arthroplasty (Wang et al., 2011).
Several measures have been established to reduce the risk of VTE, medical experts agree that to reduce bleeding; the best option is to maximize the efficacy of VTE prophylaxis exploiting the advantages of each of them. The medical experts further support the superior efficacy and the safety of low molecular weight heparins (LMWHs). Numerous clinical trials prove that Nadroparin thromboprophylaxis reduces the incidences of DVT by 87 percent, according to the study, Nadroparin thromboprophylaxis did not show any risk of bleeding (Thirugnanam, Pinto, Cook, Geerts, & Fowler, 2012). Obtaining Necessary Approval and Securing Support from Your Organization's Leadership
Ensuring the proposal is approved and supported by all the stakeholders in the hospital is the main step towards reducing the increasing incidences of deep venous thrombosis (DVT) and pulmonary embolism for patients who undergo total knee replacement. It is important to follow the systematic procedures of approval process as indicated in the hospital guideli...