Subcutaneous Enoxaparin Injection Effect on Bruising Size


The nursing practice employs studies to solve problems, answer questions concerning the practice, enhance the quality of care to patients and shape the policies in health. The critical analysis of the Effect of Subcutaneous Enoxaparin injection duration on bruising size in acute coronary syndrome patients’ article, provides an opportunity to evaluate a conducted study. This study is significant because it provides solutions to nurses in taking care of individuals suffering from physical injuries and discomfort as a result of Subcutaneous Enoxaparin injection. The analysis evaluates all parts of the article to determine its suitability for solving nursing problems in their duties.

Critical Analysis

The critical analysis is carried out on the Effect of subcutaneous Enoxaparin injection duration on bruising size in acute coronary syndrome patients article by Khadije, Zahra, and Hamideh. The title clearly describes the article’s content, and it is easy to identify the research being conducted. This research is essential in nursing practice because it enables nurses to learn new techniques of handling physical injuries and discomforts while treating acute coronary syndrome patients (Dehghani, Najari, & Dehghani, 2014).

Article Abstract

The abstract summarizes all contents of the article. It provides a background of the study, summarizes material and methods, results, and conclusion of the study. The background provides a clear understanding of the type of bruising, its effects on patients and the purpose of the trial. It provides an overview of how the trial was conducted, including the sample size, its selection, techniques of the study and data collection methods. The results and conclusion of the study are briefly stated. Thus, it is possible to know what to expect in the rest of the article (Dehghani, 2014).

Article Introduction

The introduction identifies the problem and purpose of the study. The number of coronary diseases reported in the U.S in 2005 amounted to $ 142.1 Billion and fact that the use of Enoxaparin is cheaper than other types of treatment identifies the problem. This is because, despite being cheap, Enoxaparin is among the treatments that cause abnormal bruising in patients. This greatly affects the quality of care nurses provide. The literature review in the introduction describes various studies conducted, and techniques tested by other researchers. The literature review is comprehensive since it includes five different studies recently conducted. Nevertheless, its relevance is questionable because it is only comprised of studies concerned with other types of treatments. Most of the sample sizes in these studies are also minimal ranging from 35-40 patients except one with a sample size of 80 patients. On the other hand, the literature review shows the need for this study since there is a deficit in Enoxaparin treatment studies (Dehghani, 2014).

Material and Method

This part uses the trial to addresses the question of the effect of Enoxaparin injection duration on the bruise size. To find out the answer, sample size is selected, two techniques are employed, and results are collected after the stipulated time. Firstly, the study selected a good sample size of 70 patients that was neither too small nor too big and within an appropriate age of 35-75 years. Additionally, it did not involve patients who were at high risk. The injection technique was effectively used following the right standards of nursing care. However, the study should have selected two groups to undergo different techniques of injection. Besides, the study could have used better methods of collecting comprehensive data from the sample because interviews may have consumed a lot of time (Dehghani, 2014).


The presentation of the results and statistics explanation was done properly. The results of the 10-second injection are first presented followed by the 30-second injection results. It is possible to identify from the presented results that the two tests used did not bring out any significant difference in the bruise sizes in the two techniques. The tables with the results are well labeled and properly presented for easy interpretation and analyzing the results. However, it is not possible to deduce from the tables how the standard deviation, Spearman correlation coefficient, Wilcox on P-value and Mann-Whitney P value are calculated (Dehghani, 2014).


The discussion is based on results obtained from the study. The article compares the results obtained in this study with other studies in Enoxaparin injection. There is no similarity in these studies regarding the techniques and measurement methods. Most of them indicate that the size of a bruise can be reduced by increasing the duration of the subcutaneous heparin injection. Further, recommendations on how to administer the injection effectively are given. It also discusses other findings of the study such as the association between a patient’s age and the bruise size, lack of relation between gender, and bruise size. However, it cites this finding is controversial since a different study indicates women develop bigger bruises compared to men. This shows that the study could be having some limitations that are not highlighted in the study (Dehghani, 2014).


The conclusion plays a critical role in the article since it offers recommendations for the nurses that are involved in administering this injection, recommends areas of future research and proposes an investigation on the relation of bruise size and body mass index (Dehghani, 2014).

Evaluation applicability of the study in nursing practice

This study applies to the nursing practice as it offers new ideas and recommendations in the provision of quality care services. It proposes various ways of enhancing patients’ experiences. For instance, nurses should ensure their hands are stable, to ensure the procedure is safe. Additionally, the environment of care should be quiet and peaceful ensuring patients are well relaxed before the injection procedure.


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.