Prophylactic Measures for DVT

Author(s): Madison Kerr, Lisa Davidson, Madeline Felsburg

Abstract

Introduction: Implementing prophylactic measures for deep vein thrombosis (DVT) will decrease the prevalence of DVTs in the inpatient setting.  Identifying patient risk factors and increasing the health care team’s compliance and education will lead to prophylactic treatment, resulting in decreased DVTs.  Only 10% of individuals who require DVT prophylaxis receive it; the remaining 90% do not receive prophylaxis as a result of lack of awareness (Kaur et al., 2012).

Methods: This project is a evidence based practice project. A literature review was conducted and a matrix of evidence was compiled. From the matrix, an evidenced based practice proposal was developed for potential adoption by nurses. One research study used a literature review to make a risk assessment tool.  After developing this tool, the researchers then used the assessment tool to stratify patients into risk categories (low, moderate, high) and further identified the reliability of the tool.  Another research study utilized a questionnaire to examine nurses’ and Doctors’ knowledge regarding DVT prophylaxis.  Observation was used in a research article by Kaur et al. (2012) to determine the compliance rates within the health care team.  The last article used a DVT monitor collection tool which identified the type of prophylaxis prescribed for the surgery with the type of surgery the patient underwent. 

Results: Risk factors were identified and determined reliable after three nurses scored patient charts using the risk assessment tool.  “Interrater reliability showed a strong correlation among the scores of the three nurses (.98)” (McCaffrey, R., 2007).  The second research study indicated that DVT awareness must be increased due to the lack of knowledge of the medical team.  It was found that noncompliance was due to busy schedules (36%) and lack of communication from the treating physician (32%) (Kaur et al., 2012).  A third article, however, stated that compliance rates were adequate pre and post-surgery, although intermittent pneumatic compression stockings were implemented more often than graduated compression stockings after adequate knowledge was obtained. However, it was found that 25% of graduated compression stockings were not sized and used correctly (Restrepo, Jameson, & Carroll, 2015). Lastly, Johnson (2009) indicated that graduated compression stockings had an increased compliance rate of 97%.  Foot pumps also had an increased compliance rate of 93% in the hospital.

Conclusions: If risk factors for DVT were identified earlier, then prophylaxis could be implemented to decrease DVTs.  Providing education for nurses and doctors could improve compliance with use of graduated compression stockings and intermittent pneumatic compression stockings, thereby decreasing DVT occurrence.  If adopted by providers it would limit the amount of DVTs.  A poster was created depicting the steps in the protocol a summary of the literature review and other significant findings from the project.

Presentation

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