When and How Grid-Based Information Management for VTE Prevention: Boundary Conditions and Configurational Pathways...

Venous thromboembolism (VTE) is a significant cause of preventable morbidity and mortality among hospitalized patients. Although grid-based information management systems have shown effectiveness in VTE prevention, the boundary conditions and configurational pathways leading to optimal outcomes remain unclear.

To investigate the impact mechanism of grid-based information management on VTE prevention effectiveness, identify boundary conditions of moderating effects, and explore configurational pathways leading to high prevention outcomes.

A mixed-methods study design was employed. A total of 119 hospitalized patients from Affiliated Hospital of North Sichuan Medical college were enrolled between January and December 2024, with 58 patients in the control group (traditional management) and 61 in the intervention group (grid-based information management). The Johnson-Neyman (J-N) technique was used to identify the boundary conditions of nurses' VTE knowledge and departmental collaboration on intervention effectiveness. Fuzzy-set qualitative comparative analysis (fsQCA) was employed to identify configurational pathways leading to high VTE prevention outcomes.

The intervention group demonstrated significantly higher VTE risk assessment completion rates (86.9% vs 63.8%, absolute difference 23.1%, 95% CI 8.7-37.5%, P<0.01), prevention measure implementation rates (90.2% vs 58.6%, absolute difference 31.6%, 95% CI 17.2-46.0%, P<0.01), and lower VTE incidence (3.3% vs 8.6%, absolute risk reduction 5.3%, 95% CI 0.4-10.2%, NNT=19, 95% CI 10-250, P=0.032). J-N analysis revealed that the positive effect of grid-based information management on VTE risk assessment became significant when nurses' VTE knowledge scores reached ≥42 points (P<0.05), and the effect on prevention measure implementation became significant when departmental collaboration scores reached ≥3.4 points (P<0.05). FsQCA identified three configurational pathways leading to high VTE prevention outcomes: technology-driven, collaboration-driven, and comprehensive support pathways, with an overall solution consistency of 0.892 and coverage of 0.684.

Grid-based information management effectively improves VTE prevention outcomes, but its effectiveness is contingent upon nurses' knowledge levels and departmental collaboration. Multiple equifinal pathways exist to achieve high VTE prevention outcomes, providing evidence for tailored implementation strategies.