Sequential Compression Device Compliance During Inpatient Antepartum Management [26I

Abstract

INTRODUCTION: Recently, we implemented a quality improvement protocol where each antepartum admission order set included a pre-checked order for sequential compression device (SCD). The purpose of this study was to evaluate whether this change has led to increased compliance with SCD use during antepartum admission. METHODS: This was a prospective observational study including all pregnant women admitted for inpatient management in a single tertiary care center. The study was conducted between May 2017 and September 2017, a year after implementation of pre-checked order for SCD in the electronic antepartum admission order set. Prior to this implementation the rate of SCD order was 46.0%. Women receiving pharmacologic thromboprophylaxis were excluded. During daily morning rounds the study investigators assessed whether SCD was ordered, was in the room and whether it was in use. Woman was considered to be compliant if she was ambulating or in bed with SCD in use. RESULTS: During the study period a total of 356 rounding encounters were documented for 61 women. Mean length of stay was 6.51 days ± 7.6. 73.8% of admissions had a documented SCD order with 75.6% of these orders being placed on hospital day 1. Among women who had SCD ordered, 73.9% had the machine in the room and 33.3% were compliant with its use. Non-compliance increased with repeat rounding encounters (odds ratio of 1.35 per each rounding day, 95% CI 1.15 -1.54). CONCLUSION: Although pre-checked order set for SCD increased physician compliance with ordering SCD, patient compliance with SCD during antepartum admission was still low.