Date of Graduation

Spring 5-19-2017

Document Type

Project

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Abstract

Venous thromboembolisms (VTE) affect approximately 350,000 to 900,000 people in the United States annually and are the leading cause to preventable hospital death (Centers for Disease Control [CDC], 2017). Nearly 70% of these cases were preventable through the use of pharmacologic agents and/or mechanical compression devices, such as sequential compression devices (SCD). However, less than half of hospitalized patients receive VTE prophylaxis (CDC, 2017). At a large metropolitan hospital, compliance with VTE prophylaxis, specifically with SCDs, is an ongoing quality improvement project. Currently, SCD usage and nursing documentation compliance have been consistently below performance standards. Therefore, the aim of this quality improvement project is to increase SCD compliance in order to decrease the incidence of VTEs and improve nursing documentation. Based on previous data from a root cause analysis, one of the pivotal contributing factors to low SCD compliance was the lack of available SCD machines. In order to overcome this barrier, 180 SCD machines were place at the end of each patient bed across all medical-surgical units. Additionally, in-services were conducted to educate day and night shift medical-surgical nurses on the importance of VTE prevention, new SCD protocols, and were reminded to document SCDs. Audits were conducted to evaluate the effectiveness of these interventions. Results showed that having SCDs at the point of care did not increase SCD usage and nursing education did not improve SCD documentation compliance. These results led students to investigate other contributing factors, such as physicians. Future recommendations for this project are to conduct a six-month post audit to examine the location of SCD machines, work closely with physicians to study other contributing factors to low SCD compliance, and compose additional SCD procedures to close gaps in the current protocol.

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