Improving rates of intermittent pneumatic compression therapy utilization.
BACKGROUND
The most preventable causes of death in the hospitalized patient are deep vein thrombosis (DVT) and pulmonary embolism. Despite the long-term (> 15 years) availability of evidence-based consensus guidelines for prevention of venous thromboembolism, thromboprophylaxis remains underused. Improving staff and patient utilization of prophylactic treatment for postoperative patients reduces hospital-acquired venous thromboembolism and improves patient outcomes. Anecdotal evidence and observations of intermittent pneumatic compression (IPC) therapy utilization at the authors' institution suggested that ordered IPC therapy was not consistently in use with postsurgical patients.


OBJECTIVE
We sought to increase the use of IPC devices by all staff on our hospital pilot units and to promote sustained use of IPC devices.


METHODS
Multiple methodologies were employed to address this issue, including point prevalence audits, root-cause analyses, a nursing survey, and a pilot project on selected surgical units.


RESULTS
Statistically significant improvements on the pilot units were achieved by implementing a 3-tier interventional plan.


CONCLUSIONS
Our pilot project demonstrated that nurse education, patient education, and nurse attention to solving systems issues can significantly improve IPC use in surgical patients.
Surgical Trauma and Surgery, Thomas Jefferson University Hospitals, Philadelphia, PA. deborah.gardiner@jeffersonhospital.org.
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Gardiner
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Kelly
D000925:Anticoagulants / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D048228:Intermittent Pneumatic Compression Devices / Q000706:statistics & numerical data*; D035002:Lower Extremity; D008297:Male; D009723:Nurse-Patient Relations; D010353:Patient Education as Topic; D010865:Pilot Projects; D057184:Practice Patterns, Nurses'; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000451:nursing / Q000517:prevention & control*; D012307:Risk Factors; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000451:nursing / Q000517:prevention & control*
D000925:Anticoagulants