Oral Anticoagulation in the Vascular Patient
The goal of every vascular intervention whether surgical or medical, is to improve the flow of blood from and to the heart. Consideration is made for each person on an individual basis to promote blood flow in the safest, most effective manner. Often blood flow is enhanced by the use of oral anticoagulants. Oral anticoagulation options for the vascular patient have traditionally been limited to warfarin which, while effective, has many limitations. Newer options include selective inhibitors of FXa and direct thrombin inhibitors. (Source: Journal of Vascular Nursing)
Source: Journal of Vascular Nursing - May 20, 2016 Category: Nursing Authors: Cindi Christensen Source Type: research
The Evolution of Inferior Vena Cava Filters
Inferior vena cava (IVC) filters are devices which are placed in the IVC for the purpose of preventing life threatening pulmonary embolism (PE). Venous thromboembolism (VTE) which is comprised of deep vein thrombosis and/or pulmonary embolism continues to cause significant morbidity and mortality. Medical management of VTE remains first line treatment, however in a subgroup of patients, anticoagulation may be contraindicated. In this group of patients endovascular treatment with IVC filter placement may be indicated. (Source: Journal of Vascular Nursing)
Source: Journal of Vascular Nursing - May 20, 2016 Category: Nursing Authors: Patty Bozeman Source Type: research
Hybrid Surgical Intervention in Severe Post-thrombotic Syndrome: Part 1
Post-thrombotic syndrome is a debilitating and costly complication of the occurrence of deep vein thrombosis (DVT). In about 5-10% of the population, severity of this syndrome leads to chronic and sometimes difficult to heal ulcers. Percutaneous iliac vein stenting has emerged over the last decade as a treatment of choice in the management of chronic venous disease complicated by venous outflow obstruction. Advances in technology, including intravascular ultrasonography (IVUS) and skilled technique offer a treatment option with low morbidity and mortality. (Source: Journal of Vascular Nursing)
Source: Journal of Vascular Nursing - May 20, 2016 Category: Nursing Authors: Theresa DeVeaux Source Type: research
Hybrid Surgical Intervention in Severe Post-thrombotic Syndrome: Part 2
This session will continue to expand on Part 1 above. (Source: Journal of Vascular Nursing)
Source: Journal of Vascular Nursing - May 20, 2016 Category: Nursing Authors: Gail Hadley Source Type: research
Synopsis of the New Wound Ischemia Foot Infection (WIFI) Classification System for Patients with Threatened Lower Extremity Limbs
The Society for Vascular Surgery (SVS) Lower Extremity Guidelines Committee published a new classification system for the diagnosis and treatment of lower extremity threatened limb in 2014. It is a risk stratification framework based on Wound, Ischemia and foot Infection (WIfI). It was developed to provide a more accurate assessment of disease burden in patients with threatened limbs. Existing chronic limb ischemia models were deemed inadequate since they rely on a purely ischemic classification, do not address the presence of infection, and were never indicated for use in the diabetic population. (Source: Journal of Vascular Nursing)
Source: Journal of Vascular Nursing - May 20, 2016 Category: Nursing Authors: Anne Foley Source Type: research
Are There Specific Patient Factors That Contribute to Vascular Wound Infections?
Purpose: Surgical site infections (SSI) are one of the major causes of morbidity and mortality in vascular surgery. The risk factors of SSI cited in the literature include age, gender, obesity, diabetes, COPD, CKD, high ASA class, emergency operation, history of smoking, use of steroids, and longer procedure time. There was a perception at our institution that there were an increased number of groin wound infections. The purpose of the study was to review the current management for vascular patients and develop protocols to better manage those comorbidities that may impact wound healing. (Source: Journal of Vascular Nursing)
Source: Journal of Vascular Nursing - May 20, 2016 Category: Nursing Authors: Catherine Ratliff Source Type: research
The UltraHeal Randomized Controlled Trial: Investigating the Effects of Low Frequency Ultrasound Debridement in a Nurse-led Vascular Wound Clinic
Background: Patients with lower extremity wounds resulting from complications of vasculopathy are challenging to heal and are at high risk for amputation. Ultrasound is known to stimulate healing by improving fibroblast response and biofilm bacteria kill rates. This randomized controlled trial investigated if 22.5kHz ultrasonic debridement could accelerate wound healing, improve granulation appearance and would be feasible to implement in a nurse-led vascular wound clinic. (Source: Journal of Vascular Nursing)
Source: Journal of Vascular Nursing - May 20, 2016 Category: Nursing Authors: Christine Murphy Source Type: research
Evaluation of a Novel Surfactant-based Gel Dressing on Wound Healing
Introduction: Hydrogels contain hydrophilic polymers that bind water to donate moisture to the wound. A surfactant-based gel dressing with biophysical properties and hydrogel properties may be able to facilitate the cleansing of the wound during use. Ten patients were prescribed the surfactant-based gel dressing to get somnolent and non-progressive wounds into a wound healing trajectory. (Source: Journal of Vascular Nursing)
Source: Journal of Vascular Nursing - May 20, 2016 Category: Nursing Authors: Catherine Ratliff Source Type: research
Validation of Predictors of Pressure Ulcers in Patients with Vascular Disease
Background: Our previous 2009 study revealed 10 factors of importance in determining a patient's risk for pressure ulcer (PU) development. They were lower right ABI, lower Braden score, ICU stay, low/high hematocrit values, female, non-white status, atherosclerosis, higher BUN & BMI, & history of diabetes. Based on the above 10 factors, a nomogram was developed which has a point value & patient's total score which would determine their predicted risk for hospital acquired pressure ulcer development. (Source: Journal of Vascular Nursing)
Source: Journal of Vascular Nursing - May 20, 2016 Category: Nursing Authors: Tonya Moyse, Jacqueline Bates Source Type: research
Complications of Antiphospholipid Syndrome: A Case Study Approach
While the intent of HCAHPS scores was originally to provide a standard survey for patient satisfaction, it has evolved into a tool that is used to measure quality of care. Internally, many organizations use these scores to highlight excellent care as well as identify places where improvements can be made. One team of leaders took this opportunity to impact patient satisfaction scores within their service line. The Heart and Vascular Division at McLeod Regional Medical Center in Florence, SC formed a Blue Ribbon Team (BRT). (Source: Journal of Vascular Nursing)
Source: Journal of Vascular Nursing - May 20, 2016 Category: Nursing Authors: Patricia Lewis Source Type: research
Endovascular Repair of the Juxtarenal AAA: The Future of Endovascular Nursing
Suprarenal and juxtarenal aneurysm (AAA) repair surgery is seen as a vascular surgical tour de force. Historically, this has been accomplished via open repair with prolonged surgical time and multiple visceral branch reconstructions. It remains the most complicated vascular surgical repair performed and has an operative mortality of 20 %. With the advent of minimally invasive endovascular technology, more and more endovascular centers around the country are utilizing hybrid operating rooms to repair complicated aortic aneurysms using an endovascular approach. (Source: Journal of Vascular Nursing)
Source: Journal of Vascular Nursing - May 20, 2016 Category: Nursing Authors: Kristen Alix Source Type: research
Speaking the Same Language: Standardizing Medication Communication
Patients have a choice in which hospital they go to, so enhancing their experience through engagement and better communication is key. According to the Beryl Institute (2014), the patient experience is “the sum of all interactions, shaped by an organization’s culture, that influences patient perceptions across the continuum of care”. Every patient is an opportunity to Increase our scores and improve outcomes. According to an article by Derjung et al. in the Archives of Internal Medicine (2006), only 35% of patients knew their medication side effects. (Source: Journal of Vascular Nursing)
Source: Journal of Vascular Nursing - May 20, 2016 Category: Nursing Authors: Suzanne Beels Source Type: research
Using Venous Occlusion Plethysmography to Measure Clinical Improvements in Peripheral Artery Disease Following Participation in a Supervised Exercise Program
With all chronic diseases, monitoring change is vital for proper management. The ankle brachial index (ABI) test is a safe, non-invasive, and cost-effective tool available for diagnosing peripheral artery disease (PAD). The ABI measures worsening of disease, however, it is not reflective of improvements in physical functioning. Currently, researchers are reliant on physical function tests such as maximal walking distance, pain free walking distance, and the 6 minute walk test to demonstrate clinical, patient-centered improvement variables in individuals following participation in supervised exercise programs or post proced...
Source: Journal of Vascular Nursing - May 20, 2016 Category: Nursing Authors: Rebecca Brown Source Type: research
The Use of Thrombolytic Agents in Vascular Patients: When Complications Arise
The use of thrombolytic agents is common in the vascular surgery patient who presents with an acute onset limb ischemia. At Beth Israel Deaconess Medical Center in Boston MA, patients requiring TPA for upper and lower extremity occlusions are cared for in the vascular intermediate care unit. These patients require frequent monitoring and astute nursing assessments to evaluate for potentially life-threatening complications. Subtle changes in this patient population can be difficult to recognize, and can lead to undesirable outcomes. (Source: Journal of Vascular Nursing)
Source: Journal of Vascular Nursing - May 20, 2016 Category: Nursing Authors: Kendra Conlon Source Type: research
Aggressive Notification of Lower Extremity Wound/Ulcers
A co-management committee of peripheral vascular surgeons along with the regional cardiovascular service line team developed to a process to identify patients presenting extremities with acute limb ischemia, cellulitis, gangrene, or discoloration of redness, necrosis, bluish, or purple in the emergency department (ED) and the inpatient areas of the acute care system. In addition to these symptoms nurses and physicians also thoroughly assessed patients with primary and secondary risk factors. Patients meeting the criteria of the wound ulcer alert algorithm were immediately consulted upon identification. (Source: Journal of Vascular Nursing)
Source: Journal of Vascular Nursing - May 20, 2016 Category: Nursing Authors: Danielle DeLaFuente Source Type: research
