Date of Graduation

Winter 12-15-2023

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

First Advisor

Nicole Beamish, DNP, APRN, PHN, CNL

Abstract

Problem: This quality improvement project aims to improve nurse education on Lovenox prophylaxis to reduce pulmonary embolism occurrence post-discharge amongst high-risk postpartum women who underwent vaginal/cesarean deliveries and to increase patient medication compliance in the Family Baby Unit (FBU) at Hospital X.

Context: The quality improvement project occurred on the Family Baby Unit (FBU) at Hospital X. This 25-bed unit has recently had an increased rate of pulmonary embolisms post-discharge due to poor Lovenox medication adherence amongst patients and lack of education among nurses.

Intervention: Data was collected in the microsystem. This data was collected through questionnaires to assess nurses' knowledge of Lovenox prophylaxis. Surveys were administered before and after nurses received education on Lovenox prophylaxis.

Measures: The quality improvement project began with a microsystem needs assessment using the 5Ps. Assorted candy was offered as an incentive to encourage nurse participation. We assessed the nurse's knowledge through a Lovenox prophylaxis questionnaire (see Appendix G and H). The outcome measure would be to decrease pulmonary embolism post-discharge and increase medication adherence amongst patients due to nurses being adequately educated on Lovenox prophylaxis.

Results: The results were a mix of quantitative and qualitative data. The survey responses allowed us to understand the nurses' knowledge before receiving any Lovenox prophylaxis education. The presurvey questionnaire revealed a need for more Lovenox prophylaxis education; most nurses reported not receiving anticoagulant education since nursing school (see Appendix K).

Conclusions: Patients who do not adhere to the postpartum Lovenox regimen post-discharge are at an increased risk for PE/DVT/VTE because of a lack of teaching and poor comprehension of the self-admin education. Per Hospital X policy, nurses must only witness patient self-administration once before discharge. However, research shows that nurses who see patient self-administration more than twice have higher medication compliance rates and decreased pulmonary embolism (Elmaghraby et al., 2022). By providing Lovenox prophylaxis education to nurses, we hope to see an increase in understanding of Lovenox prevention and a decrease in rates of pulmonary embolism post-discharge through increased medication compliance amongst patients and an increase in knowledge among nurses.

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