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Decreasing the incidence of hospital-acquired venous thromboembolism (VTE) through inter-disciplinary educational methods

Purpose: This study explored the knowledge of a venous thromboembolism (VTE) prevention protocol among residents, fellows and nurses and the impact of an educational module in an effort to improve adherence to this protocol and subsequently decrease the incidence of hospital-acquired VTE. 

Background: VTE significantly contributes to morbidity and mortality in hospitalized patients. Patients with gynecologic cancers are at high risk primarily due to malignancy, increased age, and recent surgery and immobility. Several evidence-based interventions are used to decrease the risk of hospital-acquired VTE commonly leading to institutional policies. The division of Gynecologic Oncology at University Hospitals Cleveland Medical Center  standardized VTE prevention guidelines in 2015.

Methods: Participants included OB-GYN residents, Gynecologic Oncology fellows and nurses on the Gynecologic Oncology floor. Participants received a fifteen question pre-test immediately followed by an educational presentation describing the venous thromboembolism prevention guidelines. They then received the same fifteen question post-test. The participants were re-tested in six months to gauge knowledge retention. The scores were compared using an unpaired T test.

Results: There were seventy-five eligible participants. The survey response rates were: pretest 68%, post-test 35%, follow up pretest 28% and follow up posttest 21%.Of the participants who identified their role, 62% were nurses, 33% were residents and 5% were fellows. There was a statistically significant difference between the test scores before and after the educational intervention during the initial intervention and the six month follow up (p= 0.0001). During the initial survey, the mean pre-test and post-test scores were 54.5% (95% CI 49.7-59.3) and 80.2% (95% CI 73.4-87.1) respectively. At the six month follow up, the mean pre-test and post-test scores were 62.2% (95% CI 56.5-67.9) and 82.1% (95% CI 75.3-88.9) respectively. There was no significant difference between the post-test scores at zero and six months (p= 0.7).

Discussions: These findings suggest that knowledge of the VTE prevention guidelines improved following an educational module. Further studies can elucidate the impact of this knowledge on compliance with the VTE protocol and incidence of hospital-acquired VTE.

Topics: CREOG & APGO Annual Meeting, 2019, Student, Resident, Faculty, Patient Care, Medical Knowledge, Systems-Based Practice & Improvement, GME, Quality & Safety, Gynecologic Oncology,

General Information

Patient Care,Medical Knowledge,Systems-Based Practice & Improvement,
Quality & Safety,
Clinical Focus
Gynecologic Oncology,

Author Information

Lauren Bouchard, Resident MD, University Hospitals Cleveland Medical Center; John Nakayama, MD

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