Presentation is loading. Please wait.

Presentation is loading. Please wait.

Colleagues Helping Achieve Model Practice EVIDENCE BASED PRACTICE COMMITTEE MODELING EVIDENCE BASED PRACTICE: SEQUENTIAL COMPRESSION DEVICES Ann Laramee.

Similar presentations


Presentation on theme: "Colleagues Helping Achieve Model Practice EVIDENCE BASED PRACTICE COMMITTEE MODELING EVIDENCE BASED PRACTICE: SEQUENTIAL COMPRESSION DEVICES Ann Laramee."— Presentation transcript:

1 Colleagues Helping Achieve Model Practice EVIDENCE BASED PRACTICE COMMITTEE MODELING EVIDENCE BASED PRACTICE: SEQUENTIAL COMPRESSION DEVICES Ann Laramee APRN MS Martha Jo Hebert RN Hollie Shaner-McRae DNP RN FAAN Linda Gruppi RN MSN

2 Colleagues Helping Achieve Model Practice Venous Thromboembolism Deep Vein Thrombosis – blood clot in the deep veins of legs that can travel to heart and lungs causing a Pulmonary Embolism Can be fatal, cause disability Accounts for 10% of hospital deaths Incidence of hospital acquired is 10-40% for med and gen surg, 40-60% for major orthopedic Post operative VTE 9.3/1000 discharges

3 Colleagues Helping Achieve Model Practice

4 Colleagues Helping Achieve Model Practice VTE The Most Common Preventable In-Hospital Death

5 Colleagues Helping Achieve Model Practice Risk Factors for VTE Advancing age Immobility Obesity Pregnancy or post partum Central Venous catheter Estrogen based therapy Smoking Family history Trauma Recent surgery Medical conditions –MI, CHF, stroke –Lung disease –Cancer –Sepsis Hospitalization

6 Colleagues Helping Achieve Model Practice Prevention of VTE Non-Pharmacological –Graduated Compression Stockings –Intermittent Pneumatic compression devices(SCDs) –Foot pumps –IVC filters Pharmacological –Unfractionated Heparin –Low Molecular Weight Heparin –Fondaparinux

7 Colleagues Helping Achieve Model Practice Fletcher Allen Health Care Observation audit October 2007: 38% use of SCD (n=20/53) SCD compression sleeves: averaged 1100 pairs/month VTE diagnosis: July 2008 – June cases - Incidence 8.9/1000 discharges SCIP: VTE prophylaxis overall compliance July 2008 – July Ordered 95% (n=201/211) - Received 96% (n=200/209) Issues –Variation in practice with ordering – Failure to follow policy –Knowledge deficit of appropriate use –Lack of patient education

8 Evaluate outcomes. Pilot the change Adopt practice change State the problem Form a team Synthesize Evidence Check research FAHC Nursing Evidence-Based Practice Model Adopted from: 2001 Iowa Model C olleagues H elping A chieve M odel P ractice

9 Colleagues Helping Achieve Model Practice

10 Colleagues Helping Achieve Model Practice Stetlers Levels of Evidence Level and Quality of Evidence Type of Evidence Level I (strongest evidence) Meta-analysis or systematic review of multiple controlled studies or clinical trials Level II Individual experimental studies with randomization Level III Quasi-experimental studies such as nonrandomized controlled single-group pre-post, cohort, time series, or matched case-controlled studies Level IV Nonexperimental studies, such as comparative and correlational descriptive research as well as qualitative studies Level V Program evaluation, research utilization, quality improvement projects, case reports Level VI (weakest evidence) Opinions of respected authorities; or the opinions of expert committees, including their interpretation of non-research based information

11 Colleagues Helping Achieve Model Practice Summary of Literature Systematic Review General recommendations: –Patients at high risk of bleeding –Patients with multiple risk factors as adjunct therapy –Used properly!! Compliance!! Lack of evidence for specifics –Initiation – when to start? –Duration –Type

12 Colleagues Helping Achieve Model Practice

13 Colleagues Helping Achieve Model Practice Next Steps Multidisciplinary Team Agree on the Systematic Review Revise and Reinstall SCD Policy Select Outcomes to be Achieved Pilot the change on a Surgical and Medical Unit

14 Colleagues Helping Achieve Model Practice Next Steps Collect Unit Baseline Data, Evaluate Process & Outcomes, Modify the Practice Institute the Change in Practice Hospital wide? Monitor and Analyze: Structure, Process, and Outcome Data Disseminate Results

15 Colleagues Helping Achieve Model Practice Summary The Iowa EBP Model can be effective The EBP Committee is a resource and champion for quality changes in nursing SCDs are an effective prophylaxis for the appropriate patients Compliance is essential


Download ppt "Colleagues Helping Achieve Model Practice EVIDENCE BASED PRACTICE COMMITTEE MODELING EVIDENCE BASED PRACTICE: SEQUENTIAL COMPRESSION DEVICES Ann Laramee."

Similar presentations


Ads by Google