Sequential compression device compliance in pregnant women requiring antepartum admission
| Autor: | Anna Palatnik, Kathryn A. Sarnoski, Timothy E. Klatt, Meinuo Chen, Laura Jacques |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
congenital
hereditary and neonatal diseases and abnormalities medicine.medical_specialty Quality management Article 03 medical and health sciences 0302 clinical medicine Pregnancy hemic and lymphatic diseases Humans Medicine cardiovascular diseases 030212 general & internal medicine 030219 obstetrics & reproductive medicine business.industry Sequential compression device Anticoagulants Obstetrics and Gynecology Venous Thromboembolism Compression (physics) Hospitalization Compliance (physiology) Pediatrics Perinatology and Child Health Physical therapy Patient Compliance Female Pregnant Women business |
| Zdroj: | J Matern Fetal Neonatal Med |
| ISSN: | 1476-4954 1476-7058 |
| DOI: | 10.1080/14767058.2019.1623873 |
| Popis: | BACKGROUND: A quality improvement study done at the Medical College of Wisconsin between 2014 and 2016 demonstrated that, at baseline, sequential compression devices (SCD) were ordered for 46.0% of admitted antepartum women. In response, provider education and a pre-checked SCD order in the electronic antepartum admission order set were implemented. OBJECTIVE: To examine the effect of these interventions on SCD compliance during antepartum admissions. STUDY DESIGN: This was a prospective observational study of antepartum women admitted for non-delivery indication for more than 24 hours, from June 2017 through March 2018, in a single tertiary center. The study was conducted a year after provider education and implementation of a pre-checked order for SCD in the electronic anterpartum admission order set. Women with an active venous thromboembolism (VTE) and those already receiving pharmacologic thromboprophylaxis were excluded. The primary outcome was the rate of SCD compliance, assessed both among obstetric providers and patients. SCD compliance for providers was defined as SCD order present in patient’s electronic medical record and documenting the presence of SCD in patient’s room. SCD compliance for patients was defined as documentation that the patient was wearing SCD that were turn on while in bed during morning study rounds. RESULTS: During the study period a total of 182 rounding encounters were documented for 76 women. SCD was ordered in 77.6% (59/76) of the admissions. Out of the 59 electronic orders for SCD, 45 orders (h 76.3%) were placed on hospital day 1. ( and 42 orders had confirmation of SCD present in the room (71.2%). SCD were in active use in 45.2% (19/42) of these women. When evaluating the daily course of the hospitalization (n=182), SCD were ordered in 86.8% (158/182) of the encounters and present in the room in 72.2% (114/158) of the daily encounters. After excluding 10 women who were ambulatory at the time of rounding (n=104), SCD were observed being used in 31.7% (33/104) of the non-ambulatory women encounters with SCD ordered and present in the room. CONCLUSION: A pre-checked antepartum order set for SCD increased the rate of provider compliance with SCD. However, this increase did not result in high patient compliance with SCD among antepartum women requiring admission for longer than 24-hours. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|