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Title: STOPDVTs: development and testing of a clinical assessment tool to guide nursing assessment of postoperative patients for DVT.
Epworth Authors: O'Brien, Alanna
Wood, Beverley
Botti, Mari
Hutchinson, Ana
Other Authors: Redley, Bernice
Keywords: Deep Vein Thrombosis
Clinical Assessment Tool
Venous Thromboembolism
VTE Prophylaxis
Postoperative Orthopaedic Patients
Content Validity
Nursing Assessment
Local Signs of DVT
Systemic Signs of DVT
Orthopaedic Nursing
Surgical Nursing
Epworth Deakin Centre for Clinical Nursing Research, Epworth HealthCare, Victoria, Australia.
Issue Date: Mar-2018
Publisher: Wiley
Citation: J Clin Nurs. 2018 Mar 1
Abstract: AIMS AND OBJECTIVES: The purpose of this research was to develop and test a clinical tool to guide nurses' assessment of postoperative patients for Deep Vein Thrombosis (DVT). BACKGROUND: Preventing venous thromboembolism (VTE) in hospitalised patients is an international patient safety priority. Despite high-level evidence for optimal VTE prophylaxis, implementation is inconsistent and the incidence of Deep Vein Thrombosis (DVT) remains high. METHODS: A two stage sequential multi-method design was used. In stage 1 the STOPDVTs tool was developed using a review of the literature and focus groups with local clinical experts. Stage 2 involved pilot testing the tool with 38 surgical nurses who conducted repeated assessments on a prospective sample of 50 postoperative orthopaedic patients. RESULTS: Stage 1: The focus group members who were members of the nursing leadership team agreed on eight local and systemic signs and symptoms that should be included in a nursing patient assessment tool for early DVT. Local symptoms were pain in the limbs, calf swelling and tightness, changes in the affected limb's skin temperature. Systemic signs included in the tool were: increased shortness of breath, increased respiratory and heart rates, and decreased oxygen saturation. Stage 2: The STOPDVTs tool had acceptable face and content validity, the agreement between the expert nurse and surgical nurses on assessments of individual signs and symptoms varied between 44 and 94%. Surgical nurses were less likely than the expert nurse to identify signs indicative of DVT. CONCLUSION: Despite finding the STOPDVTs clinical assessment tool was a useful guide for nursing assessment, surgical nurses often underestimated the potential importance of clinical signs. The findings reveal a gap in nursing knowledge and skill in assessing for DVT in postoperative orthopaedic patients.
DOI: 10.1111/jocn.14329
PubMed URL:
ISSN: 1365-2702
Journal Title: Journal of Clinical Nursing
Type: Journal Article
Affiliated Organisations: Deakin University, Geelong. School of Nursing and Midwifery, Victoria.
Deakin University, Geelong. Centre for Quality, Patient Safety Research- Monash Health Partnership, Monash Health, Clayton, Melbourne, Australia.
Centre for Quality and Patient Safety Research, Epworth HealthCare Partnership, Deakin University, Geelong, Australia.
Type of Clinical Study or Trial: Validation Study
Appears in Collections:UroRenal, Vascular

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