Evaluation of a clinical nursing practice guideline for preventing deep vein thrombosis in critically ill trauma patients

STOPDVTs: Development and testing of a clinical assessment tool to guide nursing assessment of postoperative patients for Deep Vein Thrombosis

“…The lowest levels of agreement were found for items related to physical examination for local symptoms in the affected limb (e.g., presence of swelling, changes in skin temperature, skin discoloration) and worsening limb pain. The low levels of agreement for these local signs and symptoms confirm previous work that has found that clinical assessment for possible DVT (particularly in the early stages) is highly subjective and even well‐trained clinicians may miss early clinical signs (Falck‐Ytter et al., ; Songwathana et al., ; Strijkers et al., ; Tan et al., ; Tenna et al., ).…”

“…Despite nurses detecting signs such as increased limb swelling in their patients, this was documented in the patient medical record only 19% of the time. These findings are cause for concern because if surgical nurses overlook clinically significant combinations of symptoms suggestive of early DVT, particularly in a high‐risk patient group, they may fail to escalate care for patients that could benefit from further investigation and treatment (Ali & Young, ; Bacon, ; Goodacre et al., ; Songwathana et al., ; Wells & Ginsberg, ). This problem is compounded by the well‐known problem (Gatson et al., ; Roberts et al., ; Yin & Shan, ) of poor documentation of VTE risk assessments.…”

“…Despite its long history in clinical medicine, the diagnosis of DVT remains problematic, clinical signs are nonspecific meaning that potential cases of early DVT may go undetected by clinical staff (Ali & Young, ; Bacon, ; Songwathana, Promlek., & Naka, ). The typical signs and symptoms of DVT include pain, swelling, tenderness, muscle cramps, discoloration or redness of the affected area and skin that is warm to touch (Bauersachs, ; Tabei, Holtz, Schürer‐Maly, & Abholz, ).…”

Nursing Care and Barriers for Prevention of Venous Thromboembolism in Total Knee and Hip Arthroplasty Patients: A Qualitative Study

“…23 The lack of translation of VTE mechanical prophylaxis correctly is attributable to low self-efficacy among nurses and a lack of VTE knowledge. 38 Published literature shows that nurses’ adherence to prophylaxis increases dramatically through education programs and continuous follow-ups. 39 …”

“…23 The lack of translation of VTE mechanical prophylaxis correctly is attributable to low self-efficacy among nurses and a lack of VTE knowledge. 38 Published literature shows that nurses' adherence to prophylaxis increases dramatically through education programs and continuous follow-ups. 39 Work conditions are another barrier and include subcategories such as workload, lack of appropriate protocols, unfavorable supervision, and safety concerns.…”