title: Sequential compression devices in postoperative urologic patients: an observational trial and survey study on the influence of patient and hospital factors on compliance.
abstract: BACKGROUND
  Sequential compression devices (SCDs) are commonly used for thromboprophylaxis in postoperative patients but compliance is often poor. We investigated causes for noncompliance, examining both hospital and patient related factors.
  
  
  METHODS
  100 patients undergoing inpatient urologic surgery were enrolled. All patient had SCD sleeves placed preoperatively. Postoperative observations determined SCD compliance and reasons for non-compliance. Patient demographics, length of stay, inpatient unit type, and surgery type were recorded. At discharge, a patient survey gauged knowledge and attitudes regarding SCDs and bother with SCDs. Statistical analysis was performed to correlate SCD compliance with patient demographics; patient knowledge and attitudes regarding SCDs; and patient self-reported bother with SCDs.
  
  
  RESULTS
  Observed overall compliance was 78.6%. The most commonly observed reasons for non-compliance were SCD machines not being initially available on the ward (71% of non-compliant observations on post-operative day 1) and SCD use not being restarted promptly after return to bed (50% of non-compliant observations for entire hospital stay). Mean self-reported bother scores related to SCDs were low, ranging from 1-3 out of 10 for all 12 categories of bother assessed. Patient demographics, knowledge, attitudes and bother with SCD devices were not significantly associated with non-compliance.
  
  
  CONCLUSIONS
  Patient self-reported bother with SCD devices was low. Hospital factors, including SCD machine availability and timely restarting of devices by nursing staff when a patient returns to bed, played a greater role in SCD non-compliance than patient factors. Identifying and addressing hospital related causes for poor SCD compliance may improve postoperative urologic patient safety.
authors.affiliation: Division of Urology, The University of Arizona, Tucson, AZ, USA.
authors.forename: David F
authors.initials: DF
authors.lastname: Ritsema
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Watson
authors.forename: Amanda P
authors.initials: AP
authors.lastname: Stiteler
authors.forename: Mike M
authors.initials: MM
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices / Q000706:statistics & numerical data* / Q000600:supply & distribution; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires; D013520:Urologic Surgical Procedures; D020246:Venous Thrombosis / Q000517:prevention & control*