Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second preferred): :
Staff Engagement and Empowerment (motivating staff / teamwork / work revamp tackling manpower issue / staff wellness / OSH / retention)
Authors (including presenting author) :
Wu WM(1), Boo MS(1), Lam KW(1), Choi MK(1), Pun HY(1), Yu YXK(1), Cheng KF(1)
Affiliation :
(1) Department of Neurosurgery, Queen Mary Hospital (QMH)
Introduction :
Deep vein thrombosis (DVT) is a major cause of morbidity and mortality worldwide, and is associated with pulmonary embolism which is highly fatal. A mechanical DVT prophylaxis protocol has been adopted in QMH Neurosurgery since 1/1/2021. However, nursing staff compliance with this protocol was suboptimal. Inaccurate DVT risk assessment and lack of documentation on daily use of mechanical DVT prophylaxis were also observed. An interventional bundle was hence developed for improving staff compliance with the protocol, which may in turns enhance its effectiveness in DVT prevention.
Objectives :
(1) To enhance nursing staff knowledge on correct assessment of DVT risk and provision of corresponding intervention. (2) To promote regular assessment and proper documentation on the use of mechanical DVT prophylaxis. (3) To improve nursing staff compliance with the existing mechanical DVT prophylaxis protocol. (4) To decrease incidence of DVT in QMH Neurosurgery.
Methodology :
Implementation of the interventional bundle since 24/3/2023 included staff education, development of prophylaxis documentation label, reminder of prophylaxis in use in electronic bed panel, and patient education. A staff compliance assessment form was used to compare pre- and post-intervention nursing staff compliance with the existing mechanical DVT prophylaxis protocol. Pre- and post-intervention DVT incidence in QMH Neurosurgery was also compared.
Result & Outcome :
The overall staff compliance with the existing mechanical DVT prophylaxis protocol in an interim review was improved from 69.7% to 90.7%. Availability of proper documentation on daily use of mechanical DVT prophylaxis was increased from 0% to 85%. Compliance of adding reminder of prophylaxis in use in electronic bed panel was 85% after the intervention. However, there was no significant improvement in DVT risk assessment accuracy nor availability of DVT risk reassessment after condition change. Scenario-based training was then implemented for better knowledge retention. Results will be reviewed afterwards. DVT incidence will also be reviewed in March 2024. The interventional bundle was shown to be effective in improving the overall staff compliance with the existing mechanical DVT prophylaxis protocol, facilitating regular assessment and proper documentation on the use of mechanical DVT prophylaxis. Its effect on staff knowledge on DVT risk assessment will be reviewed after change of staff training format.
