Masters Thesis

A Comparative Analysis of Venous Thrombosis Embolism Prophylaxis Compliance: Mechanical Versus Pharmacological

Introduction Venous Thromboembolism (VTE), defined as Deep Vein Thrombosis (DVT), Pulmonary Embolism (PE), or both, affects an estimated 300,000-600,000 individuals in the U.S. each year, causing considerable morbidity and mortality (Center for Disease Control and Prevention [CDC], 2016). It is a disorder that can occur in all races and ethnicities, all age groups, and all genders. With many of the known risk factors --advanced age, immobility, surgery, and increased obesity --VTE is an important and growing public health problem. For these reasons all inpatients and outpatients should be assessed for the need of VTE prophylaxis prevention. Purpose The purpose of the study was to conduct a comparative analysis of Venous Thromboembolism: mechanical versus pharmacological to determine compliance rates. Findings After analyzing fifty abstracted charts based on inpatient status, the Patient Care Unit department was consistent with maintaining a ninety percent or higher compliance rate for the months of January, March, May, and June. After further assessment of the Patient Care Unit abstracted charts, it was noted that the compliance rate decreased from ninety-one percent to eight-two percent in the month of February and from ninety-two percent to ninety percent in the month of April. This was related to new employee hirers not being familiar with the process and nurses not documenting mediation administration and the application of Graduated Compression Stockings (GCS). Recommendations 1. Implement an educational plan for patient awareness. 2. Implement a process for improving the employees’ knowledge about VTE risk assessment and prophylaxis practice through a continuing educational process. 3. Implement a method that can flag the staff to assess patients for VTE risk and possibly documentary aids to assist in the ordering process. 4. Invest in electronic computerized charting for standardized order sets, computerized decision support, E-alerts, human alerts, and raising situational awareness. Conclusion Research has shown the lack of knowledge regarding risk classification for VTE and inappropriate treatment, which may be contributing to the lack of knowledge and understanding.

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