Date of Graduation

Spring 5-17-2018

Document Type

Restricted Project/Capstone - USF access only

Degree Name

Master of Science in Nursing (MSN)

Abstract

Venous thromboembolisms (VTEs) contribute considerably to hospitalization-related deaths in the United States. In October 2008, the Centers for Medicare & Medicaid Services stopped reimbursing hospitals for the cost of treating hospital-acquired VTEs. This motivates hospital leaders to emphasize VTE prophylaxis. One metropolitan, Level 1 Trauma hospital sought to decrease VTE incidence by ensuring every bed in the hospital has a sequential compression device (SCD) machine. An assessment of the focus unit revealed this one-to-one bed to machine ratio was not maintained, nursing compliance and documentation related to SCD utilization was low, and SCD machines were not consistently monitored. This project sought to determine the root cause for missing SCD machines, increase SCD utilization through ensuring SCD machine accessibility, and increase nursing documentation rates concerning SCD utilization. SCD audits were conducted throughout the project to analyze SCD location and utilization. Nursing surveys were disseminated to understand baseline SCD usage and workflow. A multiple-component intervention was devised, including: educational nursing in-services on a VTE case study, posting educational VTE and broken SCD machine flyers, and rolling out a SCD monitoring tool. Post-surveys with the nursing staff were conducted to evaluate the intervention in addition to ongoing SCD audits.Though these results were found to be statistically insignificant, SCD audits (pre-intervention n=99, post-intervention n=68) revealed a 9% increase in SCDs that were found to be on the patient. Additionally, there was an 8% decrease in the number of SCDs that were most recently charted as observed on the patient more than 24 hours prior. The efforts of this project demonstrate the potential efficacy of increased SCD machine understanding and accountability on prevention of hospital-acquired VTEs.

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