Evaluation of a clinical nursing practice guideline for preventing deep vein thrombosis in critically ill trauma patients

Deep vein thrombosis (DVT) is the third leading cause of morbidity in critically ill trauma patients but it can be prevented by performing appropriate risk assessment and preventive strategies. The purpose of this study was to evaluate of implementing a clinical nursing practice guideline (CNPG) for preventing DVT in critically trauma patients at Songklanagarind Hospital. The CNPG content with 37 items initially developed from evidence-based knowledge related to DVT and its prevention was validated and approved by the consensus of an expert panel. The ‘expert panel’ consisted of a clinical (critical surgical patients) nurse specialist, a trauma surgeon, a medical doctor who experts in developing CNPG, and two surgical care nurse educators. The revised 30 from 37 items were tested for reliability thereafter and yielded of 0.90 and 1.00, respectively. Forty-two nurses participated in this study. The effectiveness of this CNPG was evaluated in terms of (1) feasibility and difficulty of using the CNPG, (2) nurse's satisfaction in implementation of CNPG, and (3) the patient's femoral blood flow velocity before and after 7 days. Results have shown that 23 items were performed by more than 90% of nurses and there were 7 items performed at rates lower than 90%. 79% of nurses rated their satisfaction at high (M = 8.06, SD = 0.96). There were no differences in femoral venous blood flow velocity before and after 7 days and without signs of DVT. The findings indicated that the use of evidence-based clinical practice guidelines for deep vein thrombosis prevention could enhance the quality of care in terms of early detection for DVT and maintaining blood flow velocity in those patients who are at risk. Further study could be explored to confirm its effectiveness with the large sample size.