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Venous Thromboembolism (VTE) is the leading cause of preventable hospital deaths. It can be prevented by either mechanical or pharmacological prophylaxis. VTE describes two closely related conditions: deep vein thrombosis (DVT) and pulmonary embolism (PE). Sequential Compression Devices (SCD) is a mechanical prophylaxis and is among the least invasive prophylaxis to prevent VTE. At the hospital that the project is conducted there is a low compliance on SCD despite health care provider orders.   The Clinical Nurse Leader (CNL) student is working with nursing leadership to improve compliance of SCD. This particular issue involves a multidisciplinary team of professionals such as Sterile Processing, Central Processing and Distribution, Infection Control and Medical- Surgical Nursing Department.  The importance of this project is decreased mortality due to hospital acquired issues, to have better outcomes and lower readmissions.   The author’s approach with this hospital wide issue is providing patients with educational materials in order to be more informed on their health and increase patient satisfaction.

Problem Education Material

Data Assessment

ConclusionThe assessment was an invaluable tool for nursing leadership to utilize as a bases for hospital-wide improvement on SCD compliance and VTE prevention.  The finding from the assessment  illustrated by the root cause analysis that improvement in SCD compliance necessitated involvement of different departments.  The finding illustrate the requirement of a system wide policy change within all medical-surgical units, which goes beyond the time constraint and parameter of involvement of the CNL student.  Therefore, the student improvement project involved patient education materials, decided by nursing leadership. The intended goal is for the patient to be further informed in their healthcare experience, to improve on quality of care and better outcomes.   Further improvements are necessary to increase compliance of SCD orders and decrease hospital acquired VTE.

Financial Perspective• SCD Machines are available for no extra charge• SCD pair of sleeves is $727, a one time charge• Readmission for PE can cost as much as $14,722• Readmission for DVT can cost as much as $11,862Past Fiscal Year (July 1, 2014 - June 30, 2015)• 67 patients had a diagnosis code of VTE after admission• Approximately costing the hospital $986,374 - $794,754 for the past fiscal

year• 3/67 (4.5%) had no documentation that VTE prophylaxis was administered

prior to the day of the diagnostic test order for VTE

Alexander Wong, MSN

Improving Patient Outcomes: Development of Patient Education Material to Increase Use of Sequential Compression Devices

Background• The main public hospital in a major metropolitan area serving 1.5 million

residents. Predominately cares for the poor, elderly people, uninsured working families and immigrants.

• Patient population receives public funded health insures or is uninsured• Only hospital in the major metropolitan area that provides twenty-four hour

psychiatric emergency services and Trauma Center: Level 1care• This is a teaching hospital with over 600 beds for medical/ surgical and

psychiatric patients• Assessments were conducted on Cardiac Step Down and Traumatic Brain

Injury Unit•  VTE is the leading cause of preventable hospitals deaths; more than

pneumonia and infection.• Approximately 350,000 – 900,000 persons develop incident VTE annually in

the United States; about 100,000 die mostly of sudden death, caused of which often goes unrecognized (Tietze and Gurley, 2014)

Root Cause Analysis

Timeline

References: Available upon request