Type of Document	Thesis
Author	Chenicek, Todd Eric
Author's Email Address	jtchenicek@yahoo.com
URN	etd-07012004-143606
Title	Effects of Injection Duration on Site-Pain Intensity and Bruising Associated with Subcutaneous Administration of Lovenox (enoxaparin sodium)
Degree	Master of Science
Department	Nursing, School of
Advisory Committee	Advisor Name Title Jeanne Flannery Committee Chair Denise Tucker Committee Member Sandra Faria Committee Member
Keywords	Lovenox Subcutaneous Bruising Site-Pain Injection Enoxaparin Chenicek
Date of Defense	2004-06-17
Availability	unrestricted
Abstract Deep vein thrombosis (DVT) is a leading cause of preventable death in the United States. The possibility of developing a DVT is one major complication for the patient population with damaged blood vessels, decreased circulation problems or restricted mobility. DVTs can eventually lead to strokes, myocardial infarctions or pulmonary embolisms, often preventable complications that not only harm the patient but increase the resources needed to treat and rehabilitate the individual. Lovenox (enoxaparin sodium), a low molecular weight heparin (LMWH), has been approved for prophylaxis prevention of DVTs. Research is demonstrating that LMWHs are becoming the drugs of choice in a range of clinical settings, due to their high bioavailability in the body, long half-life, and more predictable anticoagulation response. However, Lovenox can only be delivered as a subcutaneous injection, a potential cause of site-pain and bruising. Several local reactions, including mild irritation, pain, hematoma, ecchymosis, and erythema have been demonstrated at the injection site of Lovenox. The purpose of the study was to explore the effects of two different injection techniques (10-second and 30-second) on pain and bruising associated with subcutaneous administration of Lovenox. Only after a review and analysis of these techniques can nurses conclude which promotes the best patient outcome. Thirty-four patients received two injections of Lovenox, one over 10-seconds and the other over 30-seconds. The participants were asked to rate any perceived pain at the injection site for each injection. Additionally, any bruising noted with the injection site, if present, was measured and recorded. The hypotheses examined whether or not the use of a 30-second subcutaneous injection technique with Lovenox would result in lower levels of perceived site-pain and bruising when compared with a 10-second injection technique on the same hospitalized patient. Based on the data collected, there appeared to be no significant difference between the two techniques used and the patient’s perceived level of pain (p = 0.941) or measured bruising (p = 0.549). Therefore, the researcher’s hypotheses were not supported. These findings demonstrate the importance of conducting repeated research studies in the future to determine which technique to accept, or even reject, in clinical practice.
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