Testing the effect of a targeted intervention on nurses' compliance with "best practice" mechanical venous thromboembolism prevention

Abstract

The aim of this study was to examine whether educational outreach visits improve nurses' compliance with applying best practice mechanical venous thromboembolism prophylaxis. The design was as a pretest/posttest study with a 7-week follow-up. It was conducted in a mixed medical/surgical unit in a 250-bed private hospital in Sydney, Australia. The target population was 25 medical/surgical nurses in educational outreach visits (EOVs). The main outcome measures included change in percentage between baseline and endpoint of eligible patients receiving mechanical VTE prophylaxis and all patients having VTE risk documented in their medication charts, as well as nurses' feedback on how supportive and useful they found EOVs. The results showed an overall, but not significant increase (p = 0.201) in the percentage of patients who received mechanical VTE prophylaxis (59.4% baseline to 75% endpoint). There was a significant increase in the percentage of patients having VTE risk status documented in the medication chart (0%-28%) (p = 0.002). Improvements in compliance were more likely for surgical than medical patients (95% and 35%, respectively) and risk documentation (47% and 6%, respectively). Most nurses reported that the EOVs supported them in implementing best practice VTE mechanical prophylaxis. Researchers conclude that improvements in compliance with best practice VTE prevention can be achieved using EOVs which were easily conducted and well-received in a busy unit setting. More work is needed to increase the compliance rate with medical patients.