Lee Jung-Ah, Grochow Donna, Drake Diane, Johnson Linda, Reed Preston, van Servellen Gwen
Program in Nursing Science, University of California, Irvine, Irvine, California.
Nursing Quality, Research & Education, Magnet Program, University of California, Irvine Medical Center, Orange, California.
J Vasc Nurs. 2014 Mar;32(1):18-24. doi: 10.1016/j.jvn.2013.06.001.
Venous thromboembolism (VTE) is a preventable cause of hospital death. Bedside registered nurses (RNs) are a key group that can be the first to recognize risks of patients in acute care settings. The purpose of this study was to identify bedside hospital RNs' perceived knowledge of VTE, their assessment practices, their self-efficacy in conducting VTE prevention care, and their perceived barriers to performing VTE risk assessment. An anonymous web-based survey on VTE risk assessment and prevention was conducted with RNs who provided direct patient care at two hospitals. RNs who were not directly involved in bedside patient care such as managers and educators were excluded. A total of 221 RNs completed the survey. Most participants rated their overall knowledge of VTE risk assessment between "good" (44%) and "fair" (28%). VTE assessment frequencies performed by participants varied widely. Participants reported high confidence in their ability to educate patients and families about VTE symptoms, prevention, and treatments. Participants were least confident in their own ability to conduct a thorough VTE risk assessment. Greater self-reported VTE knowledge was associated with greater VTE assessment frequency and self-efficacy for VTE preventive care. The most common perceived barriers in performing VTE risk assessment were lack of knowledge (21%) and lack of time (21%). The findings demonstrate a substantial need for focused education about VTE prevention for hospital nurses and support for hospital systems to monitor VTE care. Despite the Joint Commission emphasis on VTE risk assessment in all hospitalized patients, there remains a gap between current, evidence-based recommendations for VTE prevention and reported nursing practices.
静脉血栓栓塞症(VTE)是一种可预防的医院死亡原因。床边注册护士(RN)是关键群体,他们可能是急性护理环境中最早识别患者风险的人。本研究的目的是确定床边医院RN对VTE的认知知识、他们的评估实践、进行VTE预防护理的自我效能感,以及他们在进行VTE风险评估时感知到的障碍。对在两家医院提供直接患者护理的RN进行了一项关于VTE风险评估和预防的匿名网络调查。不直接参与床边患者护理的RN,如管理人员和教育工作者被排除在外。共有221名RN完成了调查。大多数参与者将他们对VTE风险评估的总体知识评为“良好”(44%)到“一般”(28%)之间。参与者进行VTE评估的频率差异很大。参与者报告称,他们对向患者及其家属宣传VTE症状、预防和治疗的能力有很高的信心。参与者对自己进行全面VTE风险评估的能力最缺乏信心。自我报告的VTE知识越多,VTE评估频率和VTE预防护理的自我效能感越高。进行VTE风险评估时最常见的感知障碍是知识不足(21%)和时间不足(21%)。研究结果表明,医院护士对VTE预防进行重点教育以及医院系统对VTE护理进行监测的需求很大。尽管联合委员会强调对所有住院患者进行VTE风险评估,但目前基于证据的VTE预防建议与报告的护理实践之间仍存在差距。