Healthcare systems have long grappled with the challenge of venous thromboembolism (VTE) in hospitals, a significant cause of preventable harm. Addressing this issue requires effective strategies that not only rely on evidence-based prescriptions but also ensure their administration. While efforts to enhance VTE prophylaxis have shown promise in academic institutions, the implementation within community hospitals presents unique challenges. Understanding these challenges and finding scalable, effective solutions could dramatically improve patient outcomes in non-academic settings.
Study Design and Methodology
The study, conducted in a community hospital setting, assessed a comprehensive strategy to tackle missed doses of VTE prophylaxis. Aimed at adults hospitalized from mid-2018 to the end of 2019, the research introduced a prospective cohort study approach. The preintervention phase extended from July 2018 to June 2019, while the postintervention phase lasted from July to December 2019. Data analysis spanned over two years, from January 2020 to January 2022, evaluating 15,752 patients across seven hospital floors.
Intervention and Outcome Measurement
To mitigate missed doses, the researchers rolled out a dynamic nurse education module alongside a patient-focused education bundle. Intriguingly, this strategy incorporated a real-time alert system for charge nurses whenever a VTE dose went unadministered. The primary outcome measure focused on the proportion of missed prophylaxis doses, while secondary outcomes assessed patient refusals and other reasons for missed doses.
– A notable decrease in missed doses was observed post-intervention (12.9% to 9.3%).
– Patient refusal rates significantly decreased from 8.8% to 5.8%.
– Missed doses for reasons other than refusal also showed an improvement (from 4.1% to 3.5%).
– No significant difference emerged in the VTE rates (0.08% vs 0.1%) among the patients.
This community hospital study highlights how immersive nurse education and real-time, patient-centered educational initiatives significantly enhanced compliance with prescribed VTE prophylaxis. The approach demonstrated that successful interventions in academic settings can transition to effective applications in community hospitals. As hospitals tackle preventable VTE-related harm, fostering a blend of effective communication, real-time intervention alerts, and evidence-based nurse education can reduce missed doses significantly. Utilizing such strategies, community hospitals can diminish preventable harm and align more closely with academic hospital standards. Such interventions not only enhance the administration of necessary medical care but also support a paradigm shift in how healthcare providers across various settings address systemic challenges.
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