Authors (including presenting author) :
Sung HLS
Affiliation :
Nursing Service Division, Tseung Kwan O Hospital
Introduction :
Venous thromboembolism (VTE) refers to medical conditions of deep vein thrombosis and pulmonary embolism. It is caused by stasis of blood flow resulting in clots formation in veins. It is potentially fatal when affecting the pulmonary circulation. Patients can develop VTE after they have admitted to hospital. It may be related to co-existing debilitated medical illnesses, traumatic injury, major surgical operations and immobile conditions. Up-to-date, intermittent pneumatic compression device (IPC) is the mainstay non-pharmacological measure to reduce VTE. Studies showed that the use of IPC can reduce 11% VTE events. In line with international practice, a cross-specialty taskforce has been formed to implement measures to reduce the occurrence of VTE during hospitalization.
Objectives :
The aims of the taskforce are using evidence-based approach to develop practice guideline, establish operation workflow and educate health care team and patients. The objectives are to ensure appropriate care to high risk patients, enhance the compliance of IPC and promote psychological and physical care during interventions.
Methodology :
Using Problem Intervention Comparison Outcome model, the taskforce has reviewed updated evidence and implementation environment. A guideline has been drafted and cross-departmental consultation was sought. The key components of the guideline include identification of high risk patients, contraindications, caring procedures and administration. Patients undergoing orthopaedic, laparotomy and gynaecological surgeries, and those dense stroke patients will be offered the VTE preventive measures. One promulgation seminar and two training workshops had been conducted for staff engagement and familiarization of workflow. A newly designed observation chart and a patient education pamphlet have been applied for the purposes. Each department has a facilitator to monitor the implementation. To review this VTE program, relevant document and feedback have been collected after patients were discharged.
Result & Outcome :
There were 45 cases had IPC as VTE prevention in the first month. 66% was undergone orthropeadic surgery and 25% had received major laparotomy surgery. . None of them has developed pulmonary embolism or deep vein thrombosis. Nil patient was found to have adverse effects on skin colour, skin temperature, wound, circulation. 2 % patients complained of pain and swelling. For staff feedback, 87% nurses accepted the role of nurse in preventing VTE. 91% nurses indicated they were able to manage patients with IPC. 89% nurses satisfied with the use of IPC. 5% nurses found that it could be difficult for long term use of IPC for patients. Further evaluation for longer period is recommended.
Co-location with:
