Prevention of deep vein thrombosis in pregnant mothers during prolonged bedrest

Objective: Conduct and evaluate system-level evidence-based practice intervention for deep vein thrombosis (DVT) prevention. Design: One group post-intervention survey evaluation. Setting: A mother-baby unit in a tertiary hospital. Interventions/measurement: Educating nurses, implementing an evidence-based deep vein thrombosis (DVT) prevention guideline in the mother-baby unit, and recommending policy changes. Outcomes were measured using Omaha System Knowledge, Behavior, and Status scales (1 = lowest -5 = highest) for nurse DVT knowledge and practice behavior, and implementation of policy recommendations. Results: Twenty nurses (80%) completed the evaluation survey. The nurses reported that their knowledge increased significantly (3.70 vs. 4.40; p < 0.001). Behavior was variable in DVT guideline adherence. After training, most nurses (65%) usually or always assessed women for DVT risk, and some (35%) usually or always applied compression boots for DVT. The majority of nurses (70%) reported that women refused compression boots. Nurses who did not usually or always assess patients were statistically less likely to apply boots (p = 0.022). The nurses who reported discomfort with the procedure (30%) were statistically less likely to apply stockings (p = 0.028). Policy implementation to support evidence-based DVT prevention increased significantly (p = 0.008). Conclusion: Comprehensive evidence-based interventions resulted in practice and system change to prevent DVT. Nurses' knowledge about DVT prevention increased and some nurses consistently assessed for DVT and applied compression boots. The facility supported the implementation of the guideline and implemented unit/facility policy changes.