TY - JOUR
T1 - Injection Techniques to Reduce Adverse Effects of Subcutaneous Low-Molecular-Weight Heparin Among Patients With Cardiovascular Diseases
T2 - A Scoping Review
AU - Wong, Arkers Kwan Ching
AU - Chu, Rachel Yui Ki
AU - Nan, Ying
AU - Cheng, Huilin
AU - Tong, Danny
AU - Leung, Ming
AU - Lam, Harris
AU - Chiu, Sin Hing
AU - Cheung, Heung Wan
AU - Chan, Miu Ching
AU - Chau, Mei Yi
AU - Lee, Terence
AU - Leung, Yuen Wa
AU - Mow, Hoi Ching
AU - Wan, Sylvia
AU - Wong, Lee Yuen
AU - Montarye, Jed
N1 - Publisher Copyright:
© 2024 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.
PY - 2024/9
Y1 - 2024/9
N2 - Aim(s): To systematically review the existing literature and address the following research question: What are the most effective techniques used to minimise adverse effects resulting from subcutaneous injections of low-molecular-weight heparin among patients with cardiovascular diseases?. Design: A scoping review. Methods: A comprehensive search was conducted across multiple databases, including CINAHL, PubMed, EMBASE and the Cochrane Library, from 1 February 2014 to 31 January 2024. Participants were aged 18 years or older, diagnosed with venous thromboembolism or arterial thromboembolism and had prescribed subcutaneous injections of low-molecular-weight heparin. The collected data were analysed following the Joanna Briggs Institute approach, and it was organised and categorised based on the main objectives of the review. Results: Twenty studies were eligible, including 1 best practice project, 7 randomised controlled trials and 9 quasi-experimental studies. The techniques under investigation encompassed various aspects, including the injection site, injection duration (e.g., 30 s vs. 10 s), injection method (e.g., needle insertion angle), duration of needle withdrawal after injection, pressure application time and cold pressure. Preliminary evidence suggests that techniques such as using the abdominal site and slower injection rates may help reduce adverse effects. However, the optimal parameters for injection duration, waiting time, pressure and cold application, including the duration of these applications, remain uncertain due to limitations in sample size and heterogeneity in interventions and outcome measures across the studies. Conclusions: Ensuring the accurate administration of low-molecular-weight heparin is of utmost importance as it plays a critical role in decreasing mortality rates and minimising substantial healthcare costs linked to complications arising from incorrect administration. The findings from the current review have significantly contributed to strengthening the evidence base in this field, providing more robust and reliable information. Implications for the Profession: This review emphasises the significance of implementing standardised subcutaneous injection techniques for low-molecular-weight heparin in patients with cardiovascular disease in order to reduce complications and enhance patient outcomes. Reporting Method: This study followed the applicable guidelines established by the PRISMA 2020 statement. The PRISMA checklist for systematic reviews was utilised for reporting purposes. Patient or Public Contribution: There is no patient or public contribution to declare. Trial Registration: OSF registries: osf.io/phk72.
AB - Aim(s): To systematically review the existing literature and address the following research question: What are the most effective techniques used to minimise adverse effects resulting from subcutaneous injections of low-molecular-weight heparin among patients with cardiovascular diseases?. Design: A scoping review. Methods: A comprehensive search was conducted across multiple databases, including CINAHL, PubMed, EMBASE and the Cochrane Library, from 1 February 2014 to 31 January 2024. Participants were aged 18 years or older, diagnosed with venous thromboembolism or arterial thromboembolism and had prescribed subcutaneous injections of low-molecular-weight heparin. The collected data were analysed following the Joanna Briggs Institute approach, and it was organised and categorised based on the main objectives of the review. Results: Twenty studies were eligible, including 1 best practice project, 7 randomised controlled trials and 9 quasi-experimental studies. The techniques under investigation encompassed various aspects, including the injection site, injection duration (e.g., 30 s vs. 10 s), injection method (e.g., needle insertion angle), duration of needle withdrawal after injection, pressure application time and cold pressure. Preliminary evidence suggests that techniques such as using the abdominal site and slower injection rates may help reduce adverse effects. However, the optimal parameters for injection duration, waiting time, pressure and cold application, including the duration of these applications, remain uncertain due to limitations in sample size and heterogeneity in interventions and outcome measures across the studies. Conclusions: Ensuring the accurate administration of low-molecular-weight heparin is of utmost importance as it plays a critical role in decreasing mortality rates and minimising substantial healthcare costs linked to complications arising from incorrect administration. The findings from the current review have significantly contributed to strengthening the evidence base in this field, providing more robust and reliable information. Implications for the Profession: This review emphasises the significance of implementing standardised subcutaneous injection techniques for low-molecular-weight heparin in patients with cardiovascular disease in order to reduce complications and enhance patient outcomes. Reporting Method: This study followed the applicable guidelines established by the PRISMA 2020 statement. The PRISMA checklist for systematic reviews was utilised for reporting purposes. Patient or Public Contribution: There is no patient or public contribution to declare. Trial Registration: OSF registries: osf.io/phk72.
KW - cardiovascular diseases
KW - low-molecular-weight heparin
KW - scoping review
KW - subcutaneous injections
UR - http://www.scopus.com/inward/record.url?scp=85205238562&partnerID=8YFLogxK
U2 - 10.1111/jan.16475
DO - 10.1111/jan.16475
M3 - Review article
AN - SCOPUS:85205238562
SN - 0309-2402
JO - Journal of Advanced Nursing
JF - Journal of Advanced Nursing
ER -