Effect of training on nursing professionals' knowledge about subcutaneous administration of enoxaparin
DOI:
https://doi.org/10.33448/rsd-v14i3.48259Keywords:
Nursing Care; Bruising; Heparin.Abstract
Blood extravasation resulting from venous trauma during subcutaneous administration of heparin can lead to complications such as pain and bruising. A recent meta-analysis indicates that slow injection (30s) of enoxaparin, compared to rapid injection (10s), is associated with reduced intensity and duration of pain, as well as lower occurrence and size of bruises after 48 to 72 hours. However, it is necessary to consider the knowledge about the applicability of the technique, as administering less than 1mL in 30 seconds is complex. The aim of the present research was to evaluate the pre- and post-intervention knowledge of nursing professionals regarding the administration of subcutaneous enoxaparin sodium injection. A quasi-experimental study was conducted in the postoperative ICU of a cardiac surgery hospital in São Paulo-SP. Included were nursing professionals, both nurses and active technicians. A semi-structured form containing 10 multiple-choice questions was applied in the pre- and post-intervention phases, and the impact assessment included direct observation, immediate feedback, and questionnaires filled out by participants before and after the intervention. The evaluation of knowledge level during the training was conducted descriptively, presenting results in frequency and percentage, as well as other statistical measures. Despite limitations such as the absence of long-term evaluation and the study being conducted in a single hospital, the findings reinforce the relevance of continuous investment in health education to reduce errors and promote patient safety.
References
Akpinar, R. B., & Celebioglu, A. (2008). Effect of injection duration on bruising associated with subcutaneous heparin: A quasi-experimental within-subject design. International Journal of Nursing Studies, 45(6), 812–817.
Amaniyan, S., Varaei, S., Vaismoradi, M., Haghani, H., & Sieloff, C. (2016). Effect of local cold and hot pack on the bruising of enoxaparin sodium injection site: A randomized controlled trial. Contemporary Nurse, 52(1), 30–41.
Cortés, A. C., Mier, I. T., Castãner, L. C., Jiménes, P. C., Álvarez, G. T., Ibáñes, L. F., ... & Garrigós, S. C. (2009). Administración de heparina de bajo peso molecular y aparición de complicaciones locales en pacientes de cardiología. Enfermería en Cardiología, Año XVI(47–48), 94–98.
Dehghani, K., Najari, Z., & Dehghani, H. (2014). Effect of subcutaneous enoxaparin injection duration on bruising size in acute coronary syndrome patients. Iranian Journal of Nursing and Midwifery Research, 19(6), 564–568.
Ginsburg, L., Norton, P. G., Casebeer, A., & Lewis, S. (2005). An educational intervention to enhance nurse leaders' perceptions of patient safety culture. Health Services Research, 40(4), 997–1020. https://doi.org/10.1111/j.1475-6773.2005.00401.x
Härkänen, M., Voutilainen, A., Turunen, E., & Vehviläinen-Julkunen, K. (2016). Systematic review and meta-analysis of educational interventions designed to improve medication administration skills and safety of registered nurses. Nurse Education Today, 41, 36–43. https://doi.org/10.1016/j.nedt.2016.03.017
Liu, Q., Zheng, X., Xu, L., et al. (2023). The effectiveness of education strategies for nurses to recognise and manage clinical deterioration: A systematic review. Nurse Education Today, 126, 105838. https://doi.org/10.1016/j.nedt.2023.105838
Palese, A., Aidone, E., Dante, A., & Pea, F. (2013). Occurrence and extent of bruising according to duration of administration of subcutaneous low-molecular-weight heparin. Journal of Cardiovascular Nursing, 28(5), 473–482.
Pereira, A. S., et al. (2018). Metodologia da pesquisa científica [e-book]. Editora UAB/NTE/UFSM.
Sena, C. A., Krempser, P., Silva, R. N. A., & Oliveira, D. V. (2013). Punção de vasos e paleta cromática: Subsídio para pesquisa e prática clínica de enfermeiros. Revista de Enfermagem do Centro-Oeste Mineiro, 3(1), 488–497.
Sendir, M., Buyukylmaz, F., Celik, Z., & Taskopru, I. (2015). Comparison of three methods to prevent pain and bruising after subcutaneous heparin administration. Clinical Nurse Specialist, 29(3), 174–180.
Shitsuka, R., et al. (2014). Matemática fundamental para tecnologia (2ª ed.). Editora Erica.
Simonsen, B. O., Daehlin, G. K., Johansson, I., & Farup, P. G. (2014). Differences in medication knowledge and risk of errors between graduating nursing students and working registered nurses: Comparative study. BMC Health Services Research, 14, 580. https://doi.org/10.1186/s12913-014-0580-7
Vieira, S. (2021). Introdução à bioestatística. Editora GEN/Guanabara Koogan.
Vitor, S. K. S., Daou, J. P., & Góis, A. F. T. (2016). Prevenção de tromboembolismo venoso (trombose venosa profunda e embolia pulmonar) em pacientes clínicos e cirúrgicos. Diagnóstico & Tratamento, 21(2), 59–64.
White, L., Duncan, G., & Baumle, W. (2012). Administração de medicação e terapia IV. In L. White, G. Duncan, & W. Baumle (Eds.), Fundamentos de enfermagem básica (3ª ed.). Editora Cengage Learning.
Yi, L. J., Shuai, T., Tian, X., Zeng, Z., Ma, L., & Song, G. M. (2016). The effect of subcutaneous injection duration on patients receiving low-molecular-weight heparin: Evidence from a systematic review. International Journal of Nursing Studies Science, 3(1), 79–88.
Zimmerman, S., Love, K., Sloane, P. D., Cohen, L. W., Reed, D., & Carder, P. C. (2011). Medication administration errors in assisted living: Scope, characteristics, and the importance of staff training. Journal of the American Geriatrics Society, 59(6), 1060–1068.
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Copyright (c) 2025 Keyler Emmanuel dos Santos Lopes; Sérgio Henrique Simonetti; Anderson Marques de Faria; Daiane Lopes Grisante

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