Inpatient & Outpatient Venous Thromboembolism: A Multifactorial Approach to Increase Mechanical and Pharmacological Prophylaxis Compliance
Date of Graduation
Project/Capstone - Global access
Master of Public Health (MPH)
School of Nursing and Health Professions
Venous thromboemboli (VTEs) are a clinical and public health problem as they are commonly linked to inpatient experiences, yet frequently occur in the outpatient setting. VTEs place a significant burden on health care organizations and patients alike, as VTEs are costly, require long-term medications, and frequently reoccur. Research has identified risk factors and determined best practices for VTE prevention and prophylaxis, however little consensus exists among health care organizations and the implementation of best practices is varied. This project studied the challenges and opportunities in VTE prevention and prophylaxis at a large metropolitan hospital in California. Environmental changes were made in patient rooms across ten medical surgical units to increase nurses’ compliance with sequential compression device (SCD) orders. New machines were labeled and placed on patient beds, signs were placed on documentation stations, and education sessions were conducted with over 300 medical surgical nurses. Informal interviews with nursing staff, discharge pharmacists, and the hospital’s outpatient clinic staff were conducted to determine obstacles in compliance and gaps in anticoagulant discharge education. The subsequent audits revealed that nurses’ compliance with SCD orders and documentation remain low and that SCD machines continue to be misplaced, transferred between units, and stored incorrectly. Additional observations further indicated that discharge anticoagulation education is inconsistent and a discharge checklist was developed in response. Future work will include increased education about SCD compliance and documentation. Additional research should be conducted to identify new barriers to compliance, interdisciplinary influences, as well as to determine local, state, or national similarities. Furthermore, interdisciplinary processes must be developed to ensure the tracking and return of machines. In addition, an institutional policy, such as the standardization of the discharge checklist, should be implemented to ensure consistent discharge patient education and optimal patient outcomes.
Scheierling, Suzanne E., "Inpatient & Outpatient Venous Thromboembolism: A Multifactorial Approach to Increase Mechanical and Pharmacological Prophylaxis Compliance" (2017). Master's Projects and Capstones. 524.
Community Health and Preventive Medicine Commons, Nursing Commons, Public Health Education and Promotion Commons