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Evaluation of a nurse-led intervention to improve adherence to recommended guidelines for prevention of venous thromboembolism for hip and knee arthroplasty patients: A quasi-experimental study
Background & Aim: Venous thromboembolism morbidity and mortality of hospitalized patients is a major concern for health
professionals. Venous thromboembolism prevention guidelines have been developed, however adherence to guidelines is
variable. The aim of this study was to measure adherence to a nurse-led evidence based venous thromboembolism prevention
program (intervention) compared to usual care in hip and knee arthroplasty patients and associated clinical outcomes.
Method: There were 410 potential participants who were adult patients’ booked for elective hip or knee arthroplasty at the
two study sites during a two-year period (2011-2013). Of these, 27 did not meet the inclusion criteria and the remaining were
eligible for inclusion in the study (intervention site n=196 and control site n=187, total population n=383). This study adopted
a quasi-experimental design, using an intervention and control study site, conducted in two private hospitals in a regional area
in Australia.
Result: The intervention group had a mean compliance score of 11.09, higher than the control group score of 7.19. This is
equivalent to a compliance rate of 85% and 55%, respectively and indicates that adherence at the study site was significantly
higher. Patient adherence and outcomes in the post-discharge period were not significantly different between the study sites.
Conclusion: This study demonstrated a nurse-led intervention achieved high adherence with translating evidence-based
guidelines into routine patient care for hip and knee arthroplasty patients. Nurses can be critical to implementing clinical
practice guidelines and adopting preventive programs in acute care to improve patient outcomes and reduce postoperative VTE
in arthroplasty patients.