Abstract 16507: The Use of a Patient Directed Visual Cue Does Not Increase Adherence in the Use of Sequential Compression Devices
Without prophylaxis, hospital acquired venous thromboembolism (ha-VTE) occurs in 40-75% of moderate to high-risk patients. Pharmacologic and mechanical prophylaxes are clinically effective and cost-effective for prevention of ha-VTE. However, the use/effectiveness of mechanical devices is limited by compliance and proper application. We initiated a quality project to increase sequential compression device (SCD) use in med-surg patients. Visual materials are used to increase compliance with hand washing and similar behaviors to decrease hospital-acquired events. We hypothesized that prominently displayed visual cues illustrating the use and benefits of SCDs would increase use when appropriately ordered. Two floors were assigned for observation. Physicians and nursing staff were unaware of the observation. Standard prophylaxis was ordered on admission. The high pod (intervention) displayed an 8” x 10” visual cue visible from the patient bed. The lower pod (control) had no active intervention regarding SCD use. For 2 months new floor admissions were observed and followed until discharge. The electronic medical record (EMR) was reviewed to determine prophylaxis orders. Visual observation was performed twice daily, at variable daytime hours, to determine if SCDs were properly applied and operative. Results are documented in terms of observed SCD applications vs. total observations. A total of 400 patients were observed; 379 patients (95%) had active EMR prophylaxis orders. SCDs were ordered for 334 (84%), specifically for 188 (87%) of controls and 146 (80%) of the intervention group. The overall wear time for control vs. intervention was 31% vs. 28% (P=NS); <50% wear time was observed in 71% and 73% of patients respectively. Ordered SCDs application was never visually observed in 36.7% of controls and 36.3% of the intervention group. The use of an EMR ensures prophylaxis orders for all admitted patients. Compliance with SCD use is low and did not alter with a visual cue placed in patient rooms. This study is limited by the number of active observations performed. We did not perform overnight observations when compliance may be better. Further evaluation of modalities to increase daytime compliance with SCD use is warranted.
- © 2012 by American Heart Association, Inc.