Sequential compression devices in postoperative urologic patients: an observational trial and survey study on the influence of patient and hospital factors on compliance

BMC Urol. 2013 Apr 11;13:20. doi: 10.1186/1471-2490-13-20.

Abstract

Background: Sequential compression devices (SCDs) are commonly used for thromboprophylaxis in postoperative patients but compliance is often poor. We investigated causes for noncompliance, examining both hospital and patient related factors.

Methods: 100 patients undergoing inpatient urologic surgery were enrolled. All patient had SCD sleeves placed preoperatively. Postoperative observations determined SCD compliance and reasons for non-compliance. Patient demographics, length of stay, inpatient unit type, and surgery type were recorded. At discharge, a patient survey gauged knowledge and attitudes regarding SCDs and bother with SCDs. Statistical analysis was performed to correlate SCD compliance with patient demographics; patient knowledge and attitudes regarding SCDs; and patient self-reported bother with SCDs.

Results: Observed overall compliance was 78.6%. The most commonly observed reasons for non-compliance were SCD machines not being initially available on the ward (71% of non-compliant observations on post-operative day 1) and SCD use not being restarted promptly after return to bed (50% of non-compliant observations for entire hospital stay). Mean self-reported bother scores related to SCDs were low, ranging from 1-3 out of 10 for all 12 categories of bother assessed. Patient demographics, knowledge, attitudes and bother with SCD devices were not significantly associated with non-compliance.

Conclusions: Patient self-reported bother with SCD devices was low. Hospital factors, including SCD machine availability and timely restarting of devices by nursing staff when a patient returns to bed, played a greater role in SCD non-compliance than patient factors. Identifying and addressing hospital related causes for poor SCD compliance may improve postoperative urologic patient safety.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Guideline Adherence / statistics & numerical data*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Intermittent Pneumatic Compression Devices / statistics & numerical data*
  • Intermittent Pneumatic Compression Devices / supply & distribution
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Patient Compliance / psychology
  • Patient Compliance / statistics & numerical data*
  • Postoperative Complications / prevention & control*
  • Practice Guidelines as Topic
  • Surveys and Questionnaires
  • Urologic Surgical Procedures*
  • Venous Thrombosis / prevention & control*