10 Sep Direction PICOT immobile post-surgical client

Direction PICOT immobile post-surgical client

1. Review the documents associated with this assignment.

This the PICOT question that I have already completed, no need to do another one. For immobile post-surgical client who are at an increased risk for deep venous thrombosis (P) how effective is the application of sequential compression devices (SCDs) (I) in comparison to leg exercises (C) in reducing the prevalence of deep vein thrombosis (O) within one month time (T)?

2. Create a problem statement in 3 pages look at the attached example. These are the section I would like assistance with……(2-4 has not been completed as yet)

· There is a good example of the problem statement paper posted with this assignment. Review this. 

· Use at least 2 references to support your PICOT/problem statement. (You can use these two references for your annotated bibliography assignment in a few weeks. I suggest looking at this assignment now so you have an idea).

· Write the problem statement in APA 7th edition format (cover page, paper, reference page).

3. Insert the PICOT question at the bottom of the problem statement document.

4. Submit the APA written paper (that includes the problem statement AND the PICOT question).

This is the work I have done so far related to this project.

PICOT immobile post-surgical client

PICOT question

For immobile post-surgical client who are at an increased risk for deep venous thrombosis (P) how effective is the application of sequential compression devices (SCDs) (I) in comparison to leg exercises (C) in reducing the prevalence of deep vein thrombosis (O) within one month time (T)?

Reason for question selection.

While completing my clinical rotation at Methodist hospital I recalled a post-surgical client who was recovering from cholecystectomy. As part of his treatment plan, I was informed by the nurse to encourage the client to complete five to ten ankle pump leg exercises to increase circulation and reduce the client risk of deep vein thrombosis. I also observed that the client was wearing a sequential compression devices (SCDs) it was set at intermittent compression and a sleeve pressure set at 35 mmHg. When I informed that client that it was necessary to complete his exercises, he reluctantly stated that “ why do I need to exercise when my leg squishing machine is doing all the work for me”. I informed the client that the doctor had prescribed this regiment for him as the combination of SCDs and exercises may be more effective in reducing post-surgical complication (Carvalho et al., 2017).

When prompted to complete this PICOT question I reflected on my clinical experience, believing this is an appropriate topic to investigate. My goal is to evaluate the effectiveness of both SCDs in comparison to leg exercises to see which is more effective, or if the combination of both is preferred. This is a study of man vs. machine to assess the effectiveness of both.

Relevance of topic.

Reflecting on our nursing fundamentals and adult medical surgical class we were informed venous stasis pose serious health risk to post-surgical clients. When clients have limited mobility or are confined to bed, venous return to the heart is impaired and the risk of venous stasis increases (Dhakal et al., 2019). Venous stasis may allow clots (venous thrombosis) to develop in a deep vein, often in the thigh or calf. This is called deep venous thrombosis or deep vein thrombosis (DVT). If the thrombus breaks free, it can travel and become a PE where it blocks a pulmonary artery or one of its branches. Blood flow and gas exchange in the lungs are then impaired. If the clot is large enough, sudden death can occur (Kozier & Berman, 2012)‎.

Reference

Carvalho, B., Zheng, L. L., & Butwick, A. (2017). Comparative Effectiveness of Lower Leg Compression Devices Versus Sequential Compression Devices to Prevent Postspinal Hypotension During Cesarean Delivery. Anesthesia & Analgesia, 124(2), 696–697. https://doi.org/10.1213/ane.0000000000001750

Dhakal, P., Wang, L., Gardiner, J., Shrotriya, S., Sharma, M., & Rayamajhi, S. (2019). Effectiveness of Sequential Compression Devices in Prevention of Venous Thromboembolism in Medically Ill Hospitalized Patients: A Retrospective Cohort Study. Turkish Journal of Hematology. https://doi.org/10.4274/tjh.galenos.2019.2018.0413

Kozier, B., & Berman, A. (2012). Kozier & Erb’s fundamentals of nursing: concepts, process, and practice. Pearson.