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CPD practice profile
Deep vein thrombosis A CPD article highlighted to Mike Jackson the importance of recognising DVT and post-thrombotic syndrome Deep vein thrombosis (DVT) is a thrombus or blood clot that can occur in any of the deep veins in the body. DVTs occur most commonly in the leg or pelvis but also travel to the lungs, causing pulmonary embolism. As a community nurse, I found the CPD article on DVT most interesting and thought-provoking. After reading it I have gained a greater understanding of DVT, including recognition of the signs and symptoms, tests and interventions, and possible complications. I am now aware of the usefulness of the DVT Wells score to determine the likelihood of DVT. One of the questions suggested on the Wells score prompts the nurse to ask the patient whether he or she has experienced a DVT. Post-thrombotic syndrome is a complication of DVT that can occur in more than one third of patients and can significantly affect quality of life. It causes pain, heaviness and swelling in the leg, and may result in the development of venous leg ulcers.
NURSING STANDARD
In my area of work, there is an emphasis on the assessment and management of patients with lower limb problems. Many patients on my caseload are old and frail, with poor mobility. Some bedbound patients choose to remain at home, while others have been referred to community nursing services following surgery or a prolonged stay in hospital. All these patients are at risk of DVT and/or post-DVT complications, and may call on the community nurse for help and support at any time. It is not uncommon for patients with venous leg ulceration to experience leg pain, and this can
This practice profile is based on NS727 Bonner L, Johnson J (2014) Deep vein thrombosis: diagnosis and treatment. Nursing Standard. 28, 21, 51-58.
be the result of many associated factors from poor circulation to the nature of the ulcers themselves. Quite often, ulcerated lower limbs become infected, and common symptoms are warmth, redness, pain and swelling. As a result of reading this CPD article I now take the examination of these patients a step further and observe the whole limb, palpate for tenderness, and observe signs of warmth, erythema, cyanosis, oedema and any prominent collateral veins. Treatment for DVT involves anticoagulation therapy. As a community nurse, I am often required to administer lowmolecular-weight heparin via subcutaneous injection. This article provided information on pharmacological interventions, rationale for the medication, dosage, period of administration, and possible side effects, giving me the confidence to answer patients’ questions, reassure them and provide health education. The CPD article highlighted the importance of recognising DVT and post-thrombotic syndrome. Early recognition results in positive outcomes for patients because they can be referred immediately for appropriate treatment. Personally, I have gained confidence in terms of my knowledge, skills and experience relating to DVT NS Mike Jackson is a community staff nurse at East Lancashire Hospitals Trust – Community Division
Write your own practice profile You can gain a certificate of learning by reading a Nursing Standard CPD article and writing a practice profile. Turn to page 50 for this week’s article and on page 62 you can find out how to present and submit your practice profile.
Visit the RCN Learning Zone The RCN Learning Zone is a FREE online service to help RCN members with their continuing professional development and professional portfolio management. The RCN Learning Zone can be found at www.rcn.org.uk/members/learningzone.php june 18 :: vol 28 no 42 :: 2014 61
Nursing Standard 2014.28:61-61. Downloaded from journals.rcni.com by University of British Columbia on 11/23/15. For personal use only.
CPD practice profile
Deep vein thrombosis A CPD article highlighted to Mike Jackson the importance of recognising DVT and post-thrombotic syndrome Deep vein thrombosis (DVT) is a thrombus or blood clot that can occur in any of the deep veins in the body. DVTs occur most commonly in the leg or pelvis but also travel to the lungs, causing pulmonary embolism. As a community nurse, I found the CPD article on DVT most interesting and thought-provoking. After reading it I have gained a greater understanding of DVT, including recognition of the signs and symptoms, tests and interventions, and possible complications. I am now aware of the usefulness of the DVT Wells score to determine the likelihood of DVT. One of the questions suggested on the Wells score prompts the nurse to ask the patient whether he or she has experienced a DVT. Post-thrombotic syndrome is a complication of DVT that can occur in more than one third of patients and can significantly affect quality of life. It causes pain, heaviness and swelling in the leg, and may result in the development of venous leg ulcers.
NURSING STANDARD
In my area of work, there is an emphasis on the assessment and management of patients with lower limb problems. Many patients on my caseload are old and frail, with poor mobility. Some bedbound patients choose to remain at home, while others have been referred to community nursing services following surgery or a prolonged stay in hospital. All these patients are at risk of DVT and/or post-DVT complications, and may call on the community nurse for help and support at any time. It is not uncommon for patients with venous leg ulceration to experience leg pain, and this can
This practice profile is based on NS727 Bonner L, Johnson J (2014) Deep vein thrombosis: diagnosis and treatment. Nursing Standard. 28, 21, 51-58.
be the result of many associated factors from poor circulation to the nature of the ulcers themselves. Quite often, ulcerated lower limbs become infected, and common symptoms are warmth, redness, pain and swelling. As a result of reading this CPD article I now take the examination of these patients a step further and observe the whole limb, palpate for tenderness, and observe signs of warmth, erythema, cyanosis, oedema and any prominent collateral veins. Treatment for DVT involves anticoagulation therapy. As a community nurse, I am often required to administer lowmolecular-weight heparin via subcutaneous injection. This article provided information on pharmacological interventions, rationale for the medication, dosage, period of administration, and possible side effects, giving me the confidence to answer patients’ questions, reassure them and provide health education. The CPD article highlighted the importance of recognising DVT and post-thrombotic syndrome. Early recognition results in positive outcomes for patients because they can be referred immediately for appropriate treatment. Personally, I have gained confidence in terms of my knowledge, skills and experience relating to DVT NS Mike Jackson is a community staff nurse at East Lancashire Hospitals Trust – Community Division
Write your own practice profile You can gain a certificate of learning by reading a Nursing Standard CPD article and writing a practice profile. Turn to page 50 for this week’s article and on page 62 you can find out how to present and submit your practice profile.
Visit the RCN Learning Zone The RCN Learning Zone is a FREE online service to help RCN members with their continuing professional development and professional portfolio management. The RCN Learning Zone can be found at www.rcn.org.uk/members/learningzone.php june 18 :: vol 28 no 42 :: 2014 61
Nursing Standard 2014.28:61-61. Downloaded from journals.rcni.com by University of British Columbia on 11/23/15. For personal use only.
