SCD Compliance
Change is a hard concept for most, but change in the hospital setting can be beneficial for both staff and patients. According to Mclean (2011), “Every change begins with an ending” (p.79). How people respond to change can make the process easy or hard depending on how the change is presented.
Sequential Compression Devices (SCD’s) mechanically replace normal muscle motion in the leg via a cuff that inflates and deflates uniformly. This mechanical inflation and deflation keeps blood flowing in the veins and prevents the formation of clots that can result in deep vein thrombosis (DVT) or pulmonary embolism. SCD’s are used as prophylaxis in patient groups with low to moderate risk of DVT (Brady et al., 2007, p. 256). Patient compliance plays a major role in the effective application of SCD’s. The Association of Perioperative Registered Nurses (2007) states:
Deep venous thrombosis (DVT) and pulmonary embolus (PE) are major risk factors for patients undergoing surgical or other invasive procedures, and thromboprophylaxis should be considered for all these patients. Prevention of venous thromboembolism (VTE), a combination of DVT and PE, is more effective than treatment and is an important aspect of patient care before, during, and after surgery. (p. 607)
Patient compliance with SCD’s in the surgical area is a major problem. Patients are less likely to be compliant with thigh-length SCD’s than knee-length SCD’s. The most common reason for noncompliance with thigh-length SCD’s was that the devices were hot and itchy. Thigh-length SCD’s are less likely to be reapplied after ambulation. Thigh-length SCD’s also have a tendency to be fitted improperly around the patient’s upper leg. The size of the SCD is either too large or too small causing discomfort. This is a common reason for noncompliance. Knee-length SCD’s are lighter and more comfortable for the patient and encourage more consistent use. To encourage patient compliance knee-length SCD’s can be
Sequential Compression Devices (SCD’s) mechanically replace normal muscle motion in the leg via a cuff that inflates and deflates uniformly. This mechanical inflation and deflation keeps blood flowing in the veins and prevents the formation of clots that can result in deep vein thrombosis (DVT) or pulmonary embolism. SCD’s are used as prophylaxis in patient groups with low to moderate risk of DVT (Brady et al., 2007, p. 256). Patient compliance plays a major role in the effective application of SCD’s. The Association of Perioperative Registered Nurses (2007) states:
Deep venous thrombosis (DVT) and pulmonary embolus (PE) are major risk factors for patients undergoing surgical or other invasive procedures, and thromboprophylaxis should be considered for all these patients. Prevention of venous thromboembolism (VTE), a combination of DVT and PE, is more effective than treatment and is an important aspect of patient care before, during, and after surgery. (p. 607)
Patient compliance with SCD’s in the surgical area is a major problem. Patients are less likely to be compliant with thigh-length SCD’s than knee-length SCD’s. The most common reason for noncompliance with thigh-length SCD’s was that the devices were hot and itchy. Thigh-length SCD’s are less likely to be reapplied after ambulation. Thigh-length SCD’s also have a tendency to be fitted improperly around the patient’s upper leg. The size of the SCD is either too large or too small causing discomfort. This is a common reason for noncompliance. Knee-length SCD’s are lighter and more comfortable for the patient and encourage more consistent use. To encourage patient compliance knee-length SCD’s can be
References: AORN guideline for prevention of venous stasis. (2007, March). AORN Journal, 85(3), 607-624. Retrieved from http://compressionsolutions.us/files/pdfs/AORN%20Guidelines.pdf Brady, D., Raingruber, B., Peterson, J., Varnau, W., Denman, J., Resuello, R.,...Mahnke, J. (2007, July-September). The use of knee-length versus thigh-length compression stockings and sequential compression devices. Critical Care Nursing Quarterly, 30(3), 255-262. Retrieved from http://downloads.lww.com/wolterskluwer_vitalstream_com/journal_library/cnq_08879303_2007_30_3_255.pdf Kearney-Nunnery, R. (2012). Advancing your career: Concepts of professional nursing (5 ed.). Philadelphia, PA: F.A. Davis. Mclean, C. (2011, March). Change and transition: What is the difference? British Journal of School Nursing, 6(2), 76-81.