The use of anti-embolism stockings is commonly used among airline passengers and in general hospitals to reduce the risk of Deep Vein Thrombosis (DVT). The wearing of anti-embolism stockings has been rated as the number one intervention for safer health care practices however it should be stressed that pharmacotherapy is also a treatment option and certain medical conditions may preclude their use. Anecdotal evidence would suggest that this condition is not being adequately assessed by mental health care professionals despite recent initiatives to promote physical wellbeing among mental health service users. Unfortunately there is clear documented evidence to suggest that the risks associated with this condition among the general mental health population is very real and needs to be seriously addressed by mental health care professionals at the earliest opportunity.
Deep Vein Thrombosis (DVT), a potentially life threatening illness, is the formation of a blood clot or Thrombus usually deep within the vein of the muscles of the lower leg. According to an article in the European Journal of Psychiatry incidence of greater than 1 per 1000 persons and mortality rates above 15% in the first 3 months after diagnosis have been recorded. In the United Kingdom the Royal Marsden Hospital Manual of Clinical Nursing Practice states that ALL patients admitted to hospital should have a risk assessment made for DVT and the National Institute for Clinical Excellence (NICE) has produced clinical guidelines on this issue yet fails to mention the risks associated in mental health treatments (NICE, 2010 Guideline number 92).
For the mental health patient population certain additional risks apply over and above other patient groups. During an inpatient admission some patients may need to be restrained and this can, according to Zaragoza (2009) increase the risk of blood clots. Severe depression is also a risk factor as is the use of some medications to treat other mental health disorders with risk being increased among patients who have been prescribed atypical antipsychotics (Parker, C. Coupland, C. Hippisley-Cox, J 2010). Research conducted by Dr. Gwen Zornberg at the Boston School of Medicine found that patients prescribed antipsychotic medications were seven times more likely to develop a DVT than patients who were given a placebo with risk increasing during the first three months of taking the medication.
When a decision has been made to recommend the use of anti-embolism stockings the patient should be measured and worn according to manufacturer's instructions. As mentioned earlier there are a number of health related conditions which contraindicate their use and patients advised of all possible alternatives including the use, if appropriate, of pharmacotherapy.
Mental health professionals, especially nurses need to adequately assess and continue to assess, the physical aspects of their patients/service users as well as their emotional and mental state. Time and an ever increasing work load is, regrettably a major constraint imposed upon health care providers but that should never impinge on the nature and quality of care given to those entrusted to us.
For a full list of references or for clarification on any of the issues raised in this article please do not hesitate to contact the author or your health care provider.
John Higham is a United Kingdom Registered Nurse Mental Health with post graduate qualifications in drug & alcohol use/misuse currently working in the United Arab Emirate as a Clinical Resource Nurse within a Behavioural Science Institute. Visit http://www.nursesdohealthpromotion.webs.com/.
No comments:
Post a Comment