Improving SCD compliance in trauma patients at Kings County Hospital Center: a quality improvement report.

Autor:	Hamid S; Department of Surgery, SUNY Downstate Health Sciences University, Brooklyn, New York, USA., Gallo Marin B; Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA., Smith L; Department of Surgery, SUNY Downstate Health Sciences University, Brooklyn, New York, USA., Agyeman-Kagya K; Department of Surgery, SUNY Downstate Health Sciences University, Brooklyn, New York, USA., George C; Department of Surgery, SUNY Downstate Health Sciences University, Brooklyn, New York, USA., Wetzler T; Department of Surgery, SUNY Downstate Health Sciences University, Brooklyn, New York, USA., Badami A; Department of Surgery, SUNY Downstate Health Sciences University, Brooklyn, New York, USA., Gendy A; Department of Surgery, SUNY Downstate Health Sciences University, Brooklyn, New York, USA., Roudnitsky V; Department of Surgery, SUNY Downstate Health Sciences University, Brooklyn, New York, USA valery.roudnitsky@nychhc.org.; Department of Trauma and Acute Care Surgery, Kings County Hospital Center, Brooklyn, NY, USA.
Jazyk:	angličtina
Zdroj:	BMJ open quality [BMJ Open Qual] 2021 Jan; Vol. 10 (1).
DOI:	10.1136/bmjoq-2020-001171
Abstrakt:	Venous thromboembolism (VTE) is the fourth most commonly reported complication in trauma patients. For these patients, thromboprophylaxis is a standard of care. Patient compliance with sequential compression devices (SCDs), a form of mechanical VTE prophylaxis, has been a focus of efforts to improve patient safety. At our institution, a baseline audit in July 2020 revealed that patients admitted to the trauma floors have poor compliance with the use of SCDs. In this quality improvement project, we developed a patient education intervention to improve SCD compliance. We distributed an informational flyer to patients and led short educational sessions on VTE risk factors and proper SCD use. Our aim was to increase our SCD compliance rate by 30% in 4 weeks. We used three plan-do-study-act (PDSA) cycles to implement and refine our intervention. We measured SCD compliance during morning and afternoon patient observations and generated run charts to understand how our cycles were leading to change. After a 4-week period, we did not achieve our aim, but increased our overall compliance from 45% to 60% and sustained this improvement throughout our PDSA cycles. Morning compliance was lower than afternoon compliance both at baseline (45% vs 48.5%) and at the end the project (45% vs 53%). Our results suggest that patient education should be coupled with interventions that address other barriers to SCD compliance. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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