Deep Vein Thrombosis in Critically Ill Trauma Patients: Clinical Nursing Prophylaxis

Abstract

Deep vein thrombosis (DVT) is a silent killer and it is the third most common vascular disease. Critically ill patients have general and specific risk factors for DVT. DVT prophylaxis is the most efficient and cost-effective way to prevent fatal and nonfatal VTE in critical illness. Critical care nurses play a key role in the detection and prevention of DVT. Thereby, this study aimed to evaluate the clinical nursing prophylaxis of deep vein thrombosis in critically ill trauma patients. Subjects and method a descriptive exploratory research design was utilized. The study was conducted on a convenience sample of fifty critical care nurses who worked in trauma intensive care units (ICUs) at Emergency Hospital, Mansoura University. Data were obtained using one tool; Nursing performance observational checklist for DVT preventive measures. This tool includes two parts; demographic characteristics of the nurses and DVT preventive measures observational check list. Results revealed that 62% of nursing staff had 6-10 years of experience in ICU. It was found that 76% of the nursing staff graduated from secondary nursing school and 64% of them were in the age group of 30 years old and more with a mean age of (32.22 ± 5.29). It was noted that 88% of the nursing staff in the intended ICUs did not attended inservice training course on preventive measures of DVT. It was observed that all of the nursing staff applied elastic stocking to the patients but their performance was less than 80% from the total steps of performance and more than half of them changed patient's position, performed the range of motion exercises (ROM) for the lower limbs and provided the deep breathing exercises with more than 80% of the performance steps. Also, all of the nursing staff instructed the patients about coughing exercises with more than 80% of the total performance steps, While 80% of them moved the patient on the chair with less than 80% of total performance. Conclusion The critical care nurses didn't provide a prophylaxis for DVT in critically ill trauma patients with a high performance level and there is need for continuing education to improve nurses' practices regarding DVT prophylaxis. The study recommended designing an education program and protocol about DVT prevention and it must be provided to health team members to be used as a reference guide in their performance. Integrating the DVT prevention protocol into care plan to replace the traditional nursing care plan.