2.50
Hdl Handle:
http://hdl.handle.net/10755/183152
Category:
Abstract
Type:
Presentation
Title:
Knee High Mechanical Compression Devices Vs. Thigh High Compression Devices
Author(s):
Kreiner, Ronye
Author Details:
Ronye Kreiner, RN, Doctors Hospital, Coral Gables, FL, email: RonyeK@baptisthealth.net
Abstract:
Purpose: Statistics over the last decade indicate that prolonged hospitalizations from the development of a deep vein thrombosis (DVT) secondary to the reduced mobility of the hospitalized patient can be avoided by simple, cost-effective measures. Use of these measures can significantly reduce the incidence of this life threatening illness. The correct application of mechanical compression devices for the prevention of DVT as well as patient discomfort of mechanical compression devices are factors in patient compliance. This is a constant challenge to the nurse and physician who are managing the medical and surgical patient. The purpose of this initiative was to determine the best practice and most effective method for providing DVT prophylaxis with the use of knee high or thigh high mechanical compression devices (sequential compression device or SCDs and anti-thromboembolic stockings or TEDs). Method: A search of the literature on the advantages and disadvantages of the different lengths of the available mechanical devices was performed using the electronic resources of CINAHL, PubMed, MEDLINE, OVID and the Cochrane Databases. An informal survey of nurses, physicians and patients was also performed regarding the use of knee high and thigh high devices. Findings: Review of the literature, including meta-analysis studies, revealed that knee-length mechanical compression devices for the prevention of DVT are either equally effective or more effective than thigh high mechanical devices. Literature findings confirmed that knee high mechanical compression devices were more likely to be correctly fitted and applied to the patient and more comfortable for the patient generating an increased rate of compliance. There was no literature found supporting the superiority of thigh high devices. The Informal interviews revealed that patients are more compliant with knee high devices because they are easier to apply and more comfortable when the patient is in bed, and they allow the patient to ambulate more easily than thigh highs. Physicians and nurses polled stated that non-compliance is greater with thigh high devices than knee highs, which findings are congruent with the literature. Implementation and Discussion: Based on the evidence, a hospital wide initiative to use only knee high mechanical compression devices when a physician orders "SCDs" was implemented. A letter was sent to appropriate medical and nursing staff to advise them that due to significant evidence indicating that knee high mechanical devices were more beneficial for the patient and more cost-effective for the hospital, effective July 1, 2009, only knee high devices would be dispensed when SCD's were ordered, unless the order clearly requested thigh high device. It was estimated that the hospital would save approximately $25,000.00 annually by implementing this practice and more than $150,000 if this practice was implemented system-wide. Post implementation cost analysis for the last four months indicates that the savings could be greater than first estimated by $10,000.00 annually for one hospital. This study demonstrates the fruitful outcomes of utilization of an evidence based process for determining best practice.
Repository Posting Date:
28-Oct-2011
Date of Publication:
28-Oct-2011
Conference Date:
2010
Conference Name:
7th Annual Florida Magnet Research Conference
Conference Host:
University of South Florida College of Nursing; Sigma Theta Tau International; Florida Organization of Nurse Executives
Conference Location:
Naples, Florida, USA
Description:
7th Annual Florida Magnet Research Conference - Theme: Research at the Point of Care. Held 11-13 February 2010 at the Naples Grande Beach Resort, Naples, Florida, USA.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleKnee High Mechanical Compression Devices Vs. Thigh High Compression Devicesen_GB
dc.contributor.authorKreiner, Ronyeen_US
dc.author.detailsRonye Kreiner, RN, Doctors Hospital, Coral Gables, FL, email: RonyeK@baptisthealth.neten_US
dc.identifier.urihttp://hdl.handle.net/10755/183152-
dc.description.abstractPurpose: Statistics over the last decade indicate that prolonged hospitalizations from the development of a deep vein thrombosis (DVT) secondary to the reduced mobility of the hospitalized patient can be avoided by simple, cost-effective measures. Use of these measures can significantly reduce the incidence of this life threatening illness. The correct application of mechanical compression devices for the prevention of DVT as well as patient discomfort of mechanical compression devices are factors in patient compliance. This is a constant challenge to the nurse and physician who are managing the medical and surgical patient. The purpose of this initiative was to determine the best practice and most effective method for providing DVT prophylaxis with the use of knee high or thigh high mechanical compression devices (sequential compression device or SCDs and anti-thromboembolic stockings or TEDs). Method: A search of the literature on the advantages and disadvantages of the different lengths of the available mechanical devices was performed using the electronic resources of CINAHL, PubMed, MEDLINE, OVID and the Cochrane Databases. An informal survey of nurses, physicians and patients was also performed regarding the use of knee high and thigh high devices. Findings: Review of the literature, including meta-analysis studies, revealed that knee-length mechanical compression devices for the prevention of DVT are either equally effective or more effective than thigh high mechanical devices. Literature findings confirmed that knee high mechanical compression devices were more likely to be correctly fitted and applied to the patient and more comfortable for the patient generating an increased rate of compliance. There was no literature found supporting the superiority of thigh high devices. The Informal interviews revealed that patients are more compliant with knee high devices because they are easier to apply and more comfortable when the patient is in bed, and they allow the patient to ambulate more easily than thigh highs. Physicians and nurses polled stated that non-compliance is greater with thigh high devices than knee highs, which findings are congruent with the literature. Implementation and Discussion: Based on the evidence, a hospital wide initiative to use only knee high mechanical compression devices when a physician orders "SCDs" was implemented. A letter was sent to appropriate medical and nursing staff to advise them that due to significant evidence indicating that knee high mechanical devices were more beneficial for the patient and more cost-effective for the hospital, effective July 1, 2009, only knee high devices would be dispensed when SCD's were ordered, unless the order clearly requested thigh high device. It was estimated that the hospital would save approximately $25,000.00 annually by implementing this practice and more than $150,000 if this practice was implemented system-wide. Post implementation cost analysis for the last four months indicates that the savings could be greater than first estimated by $10,000.00 annually for one hospital. This study demonstrates the fruitful outcomes of utilization of an evidence based process for determining best practice.en_GB
dc.date.available2011-10-28T16:16:46Z-
dc.date.issued2011-10-28en_GB
dc.date.accessioned2011-10-28T16:16:46Z-
dc.conference.date2010en_US
dc.conference.name7th Annual Florida Magnet Research Conferenceen_US
dc.conference.hostUniversity of South Florida College of Nursingen_US
dc.conference.hostSigma Theta Tau Internationalen_US
dc.conference.hostFlorida Organization of Nurse Executivesen_US
dc.conference.locationNaples, Florida, USAen_US
dc.description7th Annual Florida Magnet Research Conference - Theme: Research at the Point of Care. Held 11-13 February 2010 at the Naples Grande Beach Resort, Naples, Florida, USA.en_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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