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Evaluation of a Novel Mechanical Compression Device
Carmen R Davis1, Terrie Beeson, Haley M Porter
1Carmen R. Davis , Terrie Beeson , and Haley M. Porter are clinical nurse specialists at Indiana University Health University Hospital in Indianapolis, IN. Karen K. Giuliano is a professor at the University of Massachusetts, Amherst Institute for Applied Life Sciences and codirector of the Elaine Marieb Center for Nursing and Engineering Innovation in Amherst, MA. Contact author: Carmen R. Davis, cdavis33@iuhealth.org . The authors received an educational grant for the dissemination of this work from Recovery Force Health, LLC, which also supplied the mechanical compression devices used in this QI project. The authors have disclosed no potential conflicts of interest, financial or otherwise.
Background:
Venous thromboembolism (VTE) is a leading preventable cause of death in hospitalized patients. Current intermittent pneumatic compression (IPC) devices used to provide external mechanical compression for VTE prevention are associated with a multitude of clinical challenges that often result in subtherapeutic use. A comparative study was conducted of the real-world clinical use of a novel mechanical compression device (MCD) and a current IPC device.
Purpose:
The purpose of this quality improvement project was to compare use of the novel MCD and the standard IPC device on three clinical inpatient hospital units. Comparisons were based on the following patient outcome measures: evaluation of wear time, adherence to optimal wear time, evaluation of both patient comfort and device satisfaction, and perceived impact on mobility goals. Nurses' satisfaction with the clinical usability for mobility was also measured.
Methods:
This project used a pre-post design. A convenience sample of 89 surgical patients on the three clinical study units and 63 nursing staff members were recruited for the study. Data were collected using electronic health records, MCD data records, patient surveys, and nursing staff surveys. Data were analyzed using descriptive statistics and independent sample t tests. In the preintervention period, data were collected using the current IPC device. Nursing staff were then trained on use of the MCD. In the postintervention period, the MCDs were used in place of the IPC devices.
Results:
MCD patients had significantly longer (P ≤ 0.001) wear time (mean, 19.3 hours/day) compared with IPC patients (mean, 12.9 hours/day). MCD patients also reported significantly better sleep (P = 0.04), fewer problems with sweaty legs (P ≤ 0.001), and improved assistance with mobility goals (P ≤ 0.001) than IPC patients. Nursing staff reported significantly improved accuracy of mobility documentation (P ≤ 0.001) with the MCD, but no differences in their perception of patient satisfaction with meeting mobility goals.
Conclusions:
Use of the MCD device for VTE prophylaxis resulted in actual and perceived improvements from the perspective of both patients and nurses. While these results provide initial data in support of a potentially promising system, more research is needed.
