Wang Yu, Wu Xin-Juan, Ma Yu-Fen, Xu Yuan, Wang Xiao-Jie, Zhu Chen, Cao Jing, Jiao Jing, Liu Ge, Li Zhen, Liu Ying, Zhu Li-Yun
Department of Nursing, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China.
Outpatient Department, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital, Beijing, China.
J Clin Nurs. 2021 Mar;30(5-6):773-782. doi: 10.1111/jocn.15615. Epub 2021 Jan 31.
Venous thromboembolism is a severe preventable complication among orthopaedic surgical patients. Integrating therapeutic guidelines into clinical practice can help improve patient safety and reduce the burden of this pathology. Improving the quality of patient care is important for bridging the gap between the prophylaxis for venous thromboembolism and therapeutic guidelines.
This study aimed at evaluating the knowledge, attitude, and venous thromboembolism and prophylaxis practices of Chinese orthopaedic nurses to guide quality care improvements.
The data used in this study are secondary data obtained from a multicentric survey. An anonymous questionnaire was used to measure the attitude and knowledge of venous thromboembolic prophylaxis among orthopaedic nurses. VTE prophylactic practices were extracted from medical records within the electronic case report form immediately after the nurses' investigations. The STROBE statement for observational studies was applied.
Results indicated that although 94.0% of the responding nurses had attended training courses in their wards, a majority of them (68.9%) achieved a median knowledge score of 7 points or below (range 0-9). Knowledge regarding the proper use of prophylaxis, identification of risk factors, signs and symptoms for pulmonary embolism was limited. Self-reported attitudes underestimate the relationships between venous thromboembolism and low-quality nursing care. Pharmacological prophylaxis was highly used (90.9%), while the utilisation of mechanical prophylaxis and its proper use was relatively low.
Chinese orthopaedic nurses demonstrated enthusiasm for venous thromboembolism and prophylaxis. Their knowledge needs to be improved, including the proper use of prophylaxis, identification of risk factors, signs and symptoms. Mechanical prophylaxis practice for VTE prevention after THA and TKA surgical procedures is not optimistic. Further studies should analyse the causes from multiple perspectives, including the availability of resources, the knowledge and attitude of doctors, nurses and patients.
The findings from this study can be used to develop and implement interventions for venous thromboembolism after orthopaedic surgery.
静脉血栓栓塞是骨科手术患者中一种严重但可预防的并发症。将治疗指南融入临床实践有助于提高患者安全性并减轻这种病症的负担。改善患者护理质量对于弥合静脉血栓栓塞预防与治疗指南之间的差距至关重要。
本研究旨在评估中国骨科护士对静脉血栓栓塞的知识、态度以及预防措施的实施情况，以指导改善护理质量。
本研究使用的数据是从一项多中心调查中获得的二手数据。采用匿名问卷来衡量骨科护士对静脉血栓栓塞预防的态度和知识。在护士调查后，立即从电子病例报告表中的医疗记录中提取静脉血栓栓塞预防措施的实施情况。应用了观察性研究的STROBE声明。
结果表明，尽管94.0%的受访护士在其病房参加过培训课程，但其中大多数（68.9%）的知识得分中位数为7分或更低（范围为0 - 9分）。关于预防措施的正确使用、危险因素的识别、肺栓塞的体征和症状的知识有限。自我报告的态度低估了静脉血栓栓塞与低质量护理之间的关系。药物预防措施的使用率很高（90.9%），而机械预防措施的使用及其正确使用率相对较低。
中国骨科护士对静脉血栓栓塞及其预防表现出热情。他们的知识需要改进，包括预防措施的正确使用、危险因素的识别、体征和症状。全髋关节置换术（THA）和全膝关节置换术（TKA）手术后预防静脉血栓栓塞的机械预防措施实施情况不容乐观。进一步的研究应从多个角度分析原因，包括资源的可用性、医生、护士和患者的知识与态度。
本研究的结果可用于制定和实施骨科手术后静脉血栓栓塞的干预措施。
