![]() ![]() ![]() In light of these data, many surgeons have adopted mechanical methods as the standard for VTE prophylaxis in hospitalized post-operative patients. In a study comparing the use of heparin versus the use of a mobile compression device following total hip arthroplasty, major bleeding events occurred in 6% of patients in the heparin group while there were no major bleeding events in the compression device group. Mechanical methods are commonly favored for patients at high risk for bleeding, such as post surgical patients, because properly administered mechanical methods have equivalent prevention of thrombotic events with decreased risk of major bleeding. Options for prophylaxis include pharmacologic anticoagulation or mechanical thromboprophylaxis. Because of the high prevalence of VTE among hospitalized patients, the adverse consequences of VTE, and the efficacy of thromboprophylaxis, preventative measures against VTE are routine practice in most health care facilities to improve patient safety. This risk is higher for those patients who undergo urologic procedures involving pelvic organs for cancer such as prostatectomy or cystectomy. Venous thromboembolism (VTE) is a significant safety issue among all hospitalized patients, resulting in considerable morbidity, mortality, and financial burden to the patient and to the health care system. Identifying and addressing hospital related causes for poor SCD compliance may improve postoperative urologic patient safety. 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. Patient self-reported bother with SCD devices was low. Patient demographics, knowledge, attitudes and bother with SCD devices were not significantly associated with non-compliance. Mean self-reported bother scores related to SCDs were low, ranging from 1–3 out of 10 for all 12 categories of bother assessed. 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). Statistical analysis was performed to correlate SCD compliance with patient demographics patient knowledge and attitudes regarding SCDs and patient self-reported bother with SCDs. At discharge, a patient survey gauged knowledge and attitudes regarding SCDs and bother with SCDs. Patient demographics, length of stay, inpatient unit type, and surgery type were recorded. Postoperative observations determined SCD compliance and reasons for non-compliance. All patient had SCD sleeves placed preoperatively. Methodsġ00 patients undergoing inpatient urologic surgery were enrolled. We investigated causes for noncompliance, examining both hospital and patient related factors. Sequential compression devices (SCDs) are commonly used for thromboprophylaxis in postoperative patients but compliance is often poor. ![]()
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