Abstract
ObjectivesTo explore how to integrate the “best” practice into nursing of venous thromboembolism (VTE) based on the integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework.MethodsA mixed-methods design was used. A steering group for clinical evidence implementation (EI) was established to conduct pre-implementation baseline surveys, a thorough analysis of the evidence, and an analysis of the survey results. The hindering and enabling factors associated with the clinical implementation of the evidence were analysed based on the three core elements of i-PARIHS, to formulate the clinical implementation plan for VTE nursing evidence. On-site expert reviews and focus group interviews were used to evaluate the feasibility of the draft plan, make adjustments, and finalize the evidence-based practice plan, which was then put into practice and evaluated.ResultsA new nursing process, a health education manual and a nursing quality checklist on VTE has been established and proved to be appropriate through the implementation. Compliance with evidence related to VTE nursing increased significantly in the two units, with better compliance in unit B than unit A. The knowledge, attitude and behaviour scores for VTE nursing increased substantially in both nurses and patients.ConclusionThe EI programme of incorporating the “best” evidence on VTE nursing into clinical practice using the i-PARIHS framework demonstrated feasibility, appropriateness and effectiveness and could serve as a reference.
Highlights
Venous thromboembolism (VTE), encompassing deep venous thrombosis (DVT) and pulmonary embolus (PE), has been deemed a major threat to the safety of hospitalized patients [1]
Compliance with evidence related to venous thromboembolism (VTE) nursing increased significantly in the two units, with better compliance in unit B than unit A
We found that there were no sufficient intermittent pneumatic compression (IPC) pumps in the two intensive care unit (ICU) for implementation
Summary
Venous thromboembolism (VTE), encompassing deep venous thrombosis (DVT) and pulmonary embolus (PE), has been deemed a major threat to the safety of hospitalized patients [1]. Patients in the intensive care unit (ICU) are known to be at elevated risk for VTE [1]. VTE, especially PE, may seriously influence patients’ prognosis, prolong the length of stay, and increase mortality [3]. Significant increases have been found in both ICU and hospital mortality rates for patients not receiving thromboprophylaxis within 24 hours [4]. A series of VTE prophylaxis guidelines have been developed; these guidelines have not been properly implemented and are extremely underutilized [3]. It is necessary to explore how to effectively integrate VTE prophylaxis evidence into clinical practice
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