Compliance status and reason analysis of patients with intermittent pneumatic compression device after lumbar surgery_West China Medical Journal

Authors：

WANG Lili , LI Gaoyang , TONG Bingdu ,  CHEN Yaping

Department of Orthopaedics, Peking Union Medical College Hospital, Beijing 100730, P. R. China;

Corresponding author：

CHEN Yaping, Email: 18612672357@139.com

Keywords：

Lumbar surgery; venous thromboembolism; intermittent pneumatic compression device; adherence

DOI：

10.7507/1002-0179.202309094

Video：

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Objective To investigate the compliance status of intermittent pneumatic compression device (IPCD) in patients after lumbar surgery, and to analyze the reasons and influencing factors affecting compliance. Methods The continuous enrollment method was used to select patients who underwent posterior decompression for lumbar degenerative diseases in the orthopedic department of Peking Union Medical College Hospital between December 2022 and June 2023. The general information of patients and their compliance with IPCD were collected, and the reasons that affected compliance were analyzed. Results A total of 46 patients were included. The overall proportion of patients with good compliance was relatively low, and their compliance was poor. On the first and second day after surgery, the daytime compliance was relatively good (the proportion range of excellent compliance was 39%-52%); the compliance at night was significantly lower than that during the daytime (the proportion range of excellent compliance was 21%-26%); after 3 days of surgery, the patients’ compliance significantly decreased. A total of 460 time periods were observed and 195 reasons for not using IPCD were collected. The main reasons were physical discomfort caused by the device, inconvenience during bedside activities, and little significance to the patient. The compliance of female patients was better than that of males (P<0.05). Patients with education level of primary school and below had the highest compliance, while patients with high school and above had the lowest compliance (P<0.05). There was no statistically significant difference in compliance among patients of different age groups (P>0.05). Conclusions The overall compliance of patients with IPCD after lumbar surgery is poor, which is an urgent clinical problem, and the adaptability and cognitive level of patients to the device are the main factors affecting compliance. In clinical nursing work, men and patients with higher education level should be strengthened.

Citation： WANG Lili, LI Gaoyang, TONG Bingdu, CHEN Yaping. Compliance status and reason analysis of patients with intermittent pneumatic compression device after lumbar surgery. West China Medical Journal, 2023, 38(10): 1480-1484. doi: 10.7507/1002-0179.202309094 Copy

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2.	Shojania KG, Duncan BW, McDonald KM, et al. Making health care safer: a critical analysis of patient safety practices. Summary. AHRQ Publication No. 01-E057. Agency for Healthcare Research and Quality, Rockville, MD: 2001.
3.	卫生部医政司. 三级综合医院评审标准实施细则(2011 年版). 卫办医管发[2011]148 号, 2012, 6.
4.	Jacobs DG, Piotrowski JJ, Hoppensteadt DA, et al. Hemodynamic and fibrinolytic consequences of intermittent pneumatic compression: preliminary results. J Trauma, 1996, 40(5): 710-716.
5.	Cindolo L, Salzano L, Mirone V, et al. Thromboprophylaxis in radical retropubic prostatectomy: efficacy and patient compliance of a dual modality. Urol Int, 2009, 83(1): 12-18.
6.	Froimson MI, Murray TG, Fazekas AF. Venous thromboembolic disease reduction with a portable pneumatic compression device. J Arthroplasty, 2009, 24(2): 310-316.
7.	Ritsema DF, Watson JM, Stiteler AP, et al. Sequential compression devices in postoperative urologic patients: an observational trial and survey study on the influence of patient and hospital factors on compliance. BMC Urol, 2013, 13: 20.
8.	Brady MA, Carroll AW, Cheang KI, et al. Sequential compression device compliance in postoperative obstetrics and gynecology patients. Obstet Gynecol, 2015, 125(1): 19-25.
9.	Caprini JA. Thrombosis risk assessment as a guide to quality patient care. Dis Mon, 2005, 51(2/3): 70-78.
10.	Ho KM. Benefit of intermittent pneumatic compression of lower limbs in reducing venous thromboembolism in hospitalised patients: interactions between risk and effectiveness. Anaesth Intensive Care, 2014, 42(1): 140-141.
11.	苏莉莉, 袁越, 田敏, 等. 静脉血栓栓塞症临床预防的研究进展. 中国护理管理, 2016, 16(8): 1123-1126.
12.	何华英, 尹世玉, 孙丽凯, 等. 老年卧床患者深静脉血栓的即时风险评估和分级干预. 护理学杂志, 2016, 31(11): 39-41.
13.	Obi AT, Alvarez R, Reames BN, et al. A prospective evaluation of standard versus battery-powered sequential compression devices in postsurgical patients. Am J Surg, 2015, 209(4): 675-681.
14.	Cornwell EE 3rd, Chang D, Velmahos G, et al. Compliance with sequential compression device prophylaxis in at-risk trauma patients: a prospective analysis. Am Surg, 2002, 68(5): 470-473.
15.	Bainbridge P. Why don’t patients adhere to compression therapy?. Br J Community Nurs, 2013(Suppl): S35-S36, S38-S40.
16.	Falck-Ytter Y, Francis CW, Johanson NA, et al. Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141(Suppl 2): e278S-e325S.
17.	Bohnenkamp S, Pelton N, Rishel CJ, et al. Implementing evidence-based practice using an interprofessional team approach: part two. Oncol Nurs Forum, 2014, 41(5): 548-550.

1. 中华医学会骨科学分会. 中国骨科大手术静脉血栓栓塞症预防指南. 中华骨科杂志, 2016, 36(2): 65-71.
2. Shojania KG, Duncan BW, McDonald KM, et al. Making health care safer: a critical analysis of patient safety practices. Summary. AHRQ Publication No. 01-E057. Agency for Healthcare Research and Quality, Rockville, MD: 2001.
3. 卫生部医政司. 三级综合医院评审标准实施细则(2011 年版). 卫办医管发[2011]148 号, 2012, 6.
4. Jacobs DG, Piotrowski JJ, Hoppensteadt DA, et al. Hemodynamic and fibrinolytic consequences of intermittent pneumatic compression: preliminary results. J Trauma, 1996, 40(5): 710-716.
5. Cindolo L, Salzano L, Mirone V, et al. Thromboprophylaxis in radical retropubic prostatectomy: efficacy and patient compliance of a dual modality. Urol Int, 2009, 83(1): 12-18.
6. Froimson MI, Murray TG, Fazekas AF. Venous thromboembolic disease reduction with a portable pneumatic compression device. J Arthroplasty, 2009, 24(2): 310-316.
7. Ritsema DF, Watson JM, Stiteler AP, et al. Sequential compression devices in postoperative urologic patients: an observational trial and survey study on the influence of patient and hospital factors on compliance. BMC Urol, 2013, 13: 20.
8. Brady MA, Carroll AW, Cheang KI, et al. Sequential compression device compliance in postoperative obstetrics and gynecology patients. Obstet Gynecol, 2015, 125(1): 19-25.
9. Caprini JA. Thrombosis risk assessment as a guide to quality patient care. Dis Mon, 2005, 51(2/3): 70-78.
10. Ho KM. Benefit of intermittent pneumatic compression of lower limbs in reducing venous thromboembolism in hospitalised patients: interactions between risk and effectiveness. Anaesth Intensive Care, 2014, 42(1): 140-141.
11. 苏莉莉, 袁越, 田敏, 等. 静脉血栓栓塞症临床预防的研究进展. 中国护理管理, 2016, 16(8): 1123-1126.
12. 何华英, 尹世玉, 孙丽凯, 等. 老年卧床患者深静脉血栓的即时风险评估和分级干预. 护理学杂志, 2016, 31(11): 39-41.
13. Obi AT, Alvarez R, Reames BN, et al. A prospective evaluation of standard versus battery-powered sequential compression devices in postsurgical patients. Am J Surg, 2015, 209(4): 675-681.
14. Cornwell EE 3rd, Chang D, Velmahos G, et al. Compliance with sequential compression device prophylaxis in at-risk trauma patients: a prospective analysis. Am Surg, 2002, 68(5): 470-473.
15. Bainbridge P. Why don’t patients adhere to compression therapy?. Br J Community Nurs, 2013(Suppl): S35-S36, S38-S40.
16. Falck-Ytter Y, Francis CW, Johanson NA, et al. Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 2012, 141(Suppl 2): e278S-e325S.
17. Bohnenkamp S, Pelton N, Rishel CJ, et al. Implementing evidence-based practice using an interprofessional team approach: part two. Oncol Nurs Forum, 2014, 41(5): 548-550.

West China Medical Journal

Compliance status and reason analysis of patients with intermittent pneumatic compression device after lumbar surgery

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