Educating Nurses About Venous Thromboembolism (VTE) Prevention
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Cardiology, Cardiology, Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 10/14/2017 |
| Start Date: | July 2014 |
| End Date: | July 2016 |
Educating Nurses About Venous Thromboembolism Prevention
As part of mandatory on-going nursing education, the investigators have incorporated
identical information into two distinct web-based learning formats - the traditional linear
PowerPoint format (with voice-over) and a new interactive format developed with central
nursing education.
The investigators will cluster randomize nurses by floor to receive either the traditional
education or the new interactive education, and evaluate the impact on administration of VTE
prophylaxis doses administered by nurses before and after education. All nurses on a floor
will receive the same educational format. If one method of education results in statistically
significant improvement in VTE prophylaxis administration, the investigators will cross over
to deliver the superior education format to all nurses who originally were given the less
effective method.
identical information into two distinct web-based learning formats - the traditional linear
PowerPoint format (with voice-over) and a new interactive format developed with central
nursing education.
The investigators will cluster randomize nurses by floor to receive either the traditional
education or the new interactive education, and evaluate the impact on administration of VTE
prophylaxis doses administered by nurses before and after education. All nurses on a floor
will receive the same educational format. If one method of education results in statistically
significant improvement in VTE prophylaxis administration, the investigators will cross over
to deliver the superior education format to all nurses who originally were given the less
effective method.
BACKGROUND
- In an attempt to improve venous thromboembolism (VTE) prophylaxis adherence we carried
out qualitative studies to obtain patients' viewpoints on how nurses should be educated
about VTE prevention and to assess nurses' beliefs and perceptions about pharmacologic
VTE prophylaxis
- We observed deficiencies in nurses' knowledge and misconceptions about VTE prophylaxis
that likely lowers adherence to administration of prescribed VTE prophylaxis doses
- As a part of our original Patient-Centered Outcomes Research Institute (PCORI) proposal,
we planned to educate nurses to address the observed deficiencies and misconceptions and
improve their ability to communicate effectively with patients
- Historically, nurse education has been done via a linear, PowerPoint-based platform
with voice-over but with no interactive component (TRADITIONAL)
- A newer platform for nurse education became available for use and includes
scenario-based teaching, ongoing assessment, and immediate remediation. Most
importantly, it is a highly interactive product (CONTEMPORARY)
STUDY DESIGN AND ANALYTIC PLAN
- Research hypotheses
- Primary: Nurse participants who receive either of these interventions will improve
administration of prescribed VTE prophylaxis evidenced by a decrease in frequency
of non-administered doses of VTE prophylaxis, compared with their frequency at
baseline.
- Secondary: Nurse participants who receive the contemporary education format will
have a larger decrease in frequency of missed doses of VTE prophylaxis compared
with those who participate in the traditional education format.
- Study Design
- Cluster Randomized Trial 21 floors, block randomized by floor type (medicine [n=11]
vs. surgery [n=10]) and (ICU [n=5] vs. non-ICU [n=16]) All nurses on each floor are
assigned the same education type to mitigate issues related to contamination if
nurses discuss the education with their colleagues
- Primary Outcome measure: Proportion of non-administered doses of pharmacological VTE
prophylaxis (dose level)
- Secondary Outcome Measures:
- Proportion of doses documented as missed due to patient refusal (dose level)
- Proportion of patients with any VTE (patient level)
- Proportion of patients with Deep Vein Thrombosis (DVT) (patient level)
- Proportion of patients with Pulmonary Embolism (PE) (patient level)
- Analytic methods
- Primary analyses - Intention-to-treat (includes all nurses assigned, whether or not
they completed the education) Is there a difference between units allocated to
either of the interventions comparing their outcome measure to their baseline
measure? Is there a difference comparing those who received the contemporary
education format vs. the traditional education format?
- Secondary analysis - Per protocol (includes only nurses who completed the
education) Do nurses who receive education perform better (improved administration
of prescribed VTE prophylaxis) than those who did not? Do nurses who received the
education in the contemporary format perform better than those who received it in
the traditional format
- In an attempt to improve venous thromboembolism (VTE) prophylaxis adherence we carried
out qualitative studies to obtain patients' viewpoints on how nurses should be educated
about VTE prevention and to assess nurses' beliefs and perceptions about pharmacologic
VTE prophylaxis
- We observed deficiencies in nurses' knowledge and misconceptions about VTE prophylaxis
that likely lowers adherence to administration of prescribed VTE prophylaxis doses
- As a part of our original Patient-Centered Outcomes Research Institute (PCORI) proposal,
we planned to educate nurses to address the observed deficiencies and misconceptions and
improve their ability to communicate effectively with patients
- Historically, nurse education has been done via a linear, PowerPoint-based platform
with voice-over but with no interactive component (TRADITIONAL)
- A newer platform for nurse education became available for use and includes
scenario-based teaching, ongoing assessment, and immediate remediation. Most
importantly, it is a highly interactive product (CONTEMPORARY)
STUDY DESIGN AND ANALYTIC PLAN
- Research hypotheses
- Primary: Nurse participants who receive either of these interventions will improve
administration of prescribed VTE prophylaxis evidenced by a decrease in frequency
of non-administered doses of VTE prophylaxis, compared with their frequency at
baseline.
- Secondary: Nurse participants who receive the contemporary education format will
have a larger decrease in frequency of missed doses of VTE prophylaxis compared
with those who participate in the traditional education format.
- Study Design
- Cluster Randomized Trial 21 floors, block randomized by floor type (medicine [n=11]
vs. surgery [n=10]) and (ICU [n=5] vs. non-ICU [n=16]) All nurses on each floor are
assigned the same education type to mitigate issues related to contamination if
nurses discuss the education with their colleagues
- Primary Outcome measure: Proportion of non-administered doses of pharmacological VTE
prophylaxis (dose level)
- Secondary Outcome Measures:
- Proportion of doses documented as missed due to patient refusal (dose level)
- Proportion of patients with any VTE (patient level)
- Proportion of patients with Deep Vein Thrombosis (DVT) (patient level)
- Proportion of patients with Pulmonary Embolism (PE) (patient level)
- Analytic methods
- Primary analyses - Intention-to-treat (includes all nurses assigned, whether or not
they completed the education) Is there a difference between units allocated to
either of the interventions comparing their outcome measure to their baseline
measure? Is there a difference comparing those who received the contemporary
education format vs. the traditional education format?
- Secondary analysis - Per protocol (includes only nurses who completed the
education) Do nurses who receive education perform better (improved administration
of prescribed VTE prophylaxis) than those who did not? Do nurses who received the
education in the contemporary format perform better than those who received it in
the traditional format
Inclusion Criteria:
- Nurses on selected surgical and medical floors at Johns Hopkins Hospital
Exclusion Criteria:
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