Evidence-based for venous thromboembolism prevention to Perioperative patients in Orthopedic / 中国实用护理杂志

ABSTRACT

Objective To integrate the best evidence of venous thromboembolism (VTE) prevention into practice, improve nurses′compliance, and reduce the incidence of VTE in orthopaedic department. Methods Guided by the standard procedure in the JBI-Paces program, collected the best evidence from online databases and set the standards. Collected data through field observation, interviews and review of nursing records. A total of 167 patients and 36 nurses we recruited in the study and audited twice. We judged the result by the knowledge level of nurses and patients, nurses′ compliance with the evidence and the incidence rate of VTE. Results In baseline review, three criteria of poor compliance,"the correct situation of daily inspection of VTE risk assessment", "Wear gradient pressure stockings correctly for VTE high-risk patients " , "Intermittent pneumatic compression device (IPCD) used twice a day for 30 minutes each time ", were significantly improved after the application of evidence , increased from 47.22%(17/36),36.11%(13/36),36.11%(13/36)to 86.11%(31/36), 86.11%(31/36), 91.67(33/36) respectively (χ2=12.25, 18.94, 24.08, all P<0.05);The incidence of VTE decreased from 2.7% to 0 (P=0.195);the correct rate of VTE risk assessment, awareness rate of health education among patients, implementation rate of physical preventive measures and qualified rate of VTE-related knowledge and skills among nurses increased from 82.43%(61/74),74.32%(55/74),83.78%(62/74),77.03%(57/74)to 97.85%(91/93),91.40%(85/93), 97.85%(91/93),96.77%(90/93)respectively (χ2=8.86-15.24, all P<0.01). Conclusion The integration of best evidence standardize nurses′behaviors, reduce the incidence rate of VTE, improve the quality of clinical care and promote the satisfaction of patients continuously.