Does Staff Education Increase Sequential Compression Device Utilization: A Retrospective Study

Venous thromboembolism (VTE) is a significant perioperative safety concern among orthopedic patients, with an incidence of 0.4%-1.0% and a substantial risk of chronic complications. Sequential compression devices (SCDs) are recommended for VTE prophylaxis, yet compliance remains suboptimal due to staff misconceptions. This study evaluates the impact of a resident-led educational intervention on SCD utilization among nursing staff in orthopedic postoperative care.

This retrospective study was conducted at 2 hospitals (HCA Florida JFK Hospital and HCA Florida Palms West Hospital). Nursing staff participated in a single educational session addressing SCD benefits, application techniques, and operational protocols. Data on SCD utilization were collected pre- and post-intervention over 4-week periods. Appropriate use was defined as bilateral application (when indicated) with operational devices. Demographic and surgical data were also collected. Chi-square tests compared pre- versus post-intervention proportions. Multivariable logistic regression modeled appropriate SCD use using the binary "yes/no" outcome data as the dependent variable and intervention status (pre vs post) as the primary predictor, adjusting for age, sex, elective status, race, and laterality.

The study included 73 patients (45 pre-intervention, 28 post-intervention). Appropriate SCD utilization increased from 73.3% pre-intervention to 89.3% post-intervention (P = .089). After adjusting for age, sex, elective status, laterality, and race, patients in the post-intervention group had higher odds of appropriate SCD use (adjusted odds ratio = 3.44; 95% confidence interval, 0.76-15.49), although this difference was not statistically significant (P = .103).

The resident-led intervention demonstrated a positive trend in SCD compliance, though results did not reach statistical significance due to the small sample size. Addressing knowledge gaps through education and protocol clarification may enhance compliance, but institutional barriers and workflow considerations require further attention. Larger studies are needed to further evaluate the impact of educational interventions and identify additional strategies to improve adherence.