Evaluation of perioperative mechanical prophylaxis of venous thrombosis in patients undergoing total knee and hip replacement and analysis of its obstacle factors
10.3760/cma.j.cn211501-20201010-04115
- VernacularTitle:全膝髋关节置换术患者围手术期静脉血栓机械预防审查指标构建及障碍因素分析
- Author:
Yanan LI
1
;
Yongchao HOU
;
Chunmei WU
;
Jue GUO
;
Juzi WANG
Author Information
1. 山西中医药大学护理学院，晋中 030600
- Keywords:
Physical prophylaxis;
Evidence-based nursing;
Clinical audit;
Venous thromboembolism;
Knee replacement;
Hip replacement
- From:
Chinese Journal of Practical Nursing
2022;38(12):881-887
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To understand the current status of perioperative physical prevention of venous thrombosis in patients undergoing total knee and hip replacement and to analyze the barriers to clinical transformation of evidence and improve measures.Methods:Based on the evidence-based continued quality improvement model, then building a team, systematically searching, evaluating and summarizing evidences, establishing review indicators and review methods according to FAME principles (feasibility, appropriately, meanfulness, effectiveness), selecting patients undergoing total knee and hip replacement, nurses, and doctors who underwent total knee and hip replacement surgery from April 30 to August 31, 2020 in Shanxi Provincial People's Hospital as the review objects, and conducting a baseline review according to the review indicators one by one, and analyzing the obstacle factors and improvement measures based on the review results.Results:This study included 29 best evidences, and 17 review indicators were formulated based on the best evidences. Among them, the clinical compliance rate of 5 review indicators were greater than 80%, and the clinical compliance rate of 12 review indicators were less than 80%. The main obstacles were due to the imperfect venous thromboembolism (VTE) risk assessment and management process at the system level, and the low level of knowledge of VTE prevention and management among medical staff at the individual level.Conclusions:This study was based on the best evidences, scientifically and systematically developed clinical review indicators, rigorously and comprehensively analyzed obstacles, and constructed targeted improvement measures, not only for the future physical prevention of perioperative venous thrombosis in patients with total knee and hip replacement surgery transformation provides the basis but also can further promote clinical practice changes and continuous quality improvement.
