The Effect Of Information Platform-based Nursing On Preventing Venous Thromboembolism In Patients With Hip Fracture

Objective:1.Identification of risk factors for VTE by analyzing the clinical characteristics of patients with hip fractures,with a focus on exploring whether patient compliance is an independent risk factor for VTE.2.Based on the factors affecting patient’s medication compliance,an information platform was built involving post-admission thrombosis risk assessment,thrombus risk monitoring during hospitalization,pre-discharge health education,and follow-up after discharge.Nursing intervention was conducted for patients with hip fractures to appraise the preventive effect of VTE.Methods:1.A retrospective cohort study design was conducted,including patients with hip fractures who were consecutively admitted to our hospital from January 2008 to December 2012.Screening was performed by a pre-established inclusion and exclusion criteria.The variables including demographic information,comorbidities,compliance,and fracture-related factors were collected,and VTE functioned as the outcome index.The risk factors for VTE were screened by univariate and multivariate analysis.Multivariate model was applied in order to determine whether compliance is an independent risk factor for VTE.2.Construct an integrated information platform consisted of clinical information module,risk assessment module,risk warning module,health education module,and post-hospital follow-up module.Hip fracture patients who underwent routine thromboprophylaxis care were assigned in the control group(n=1177),and those who underwent information platform-based nursing intervention were determined as the experimental group(n=491).Results:1.VTE prevention compliance in patients with hip fractures appears low,and only 16.3%of patients are in good compliance.Medication compliance is closely associated with VTE,serving as an independent risk factor(OR=3.404,95%CI:1.646～7.043,P<0.05).In addition VTE history(OR=6.261,95%CI:2.448-16.015,P<0.05),hormone replacement therapy(OR=11.925,95%CI:2.026～70.192,P<0.05),malignant tumor(OR=2.094,95%CI:1.008～4.352,P<0.05)are strongly associated with the risk of VTE in patients as well.2.The proportion of patients with good compliance in the experimental group was 59.1%,as compated to 16.3%in the control group.The difference in compliance between the two groups was statistically significant(P<0.05).In terms of thrombosis,VTE occurred in 126(10.7%)patients in the control group,and that occurred in 35 patients(7.1%)in the experimental group.The difference between the two groups was statistically significant(P<0.05).Conclusion:1.Patient compliance is an independent risk factor for postoperative VTE in patients with hip fractures.2.Nursing intervention based on information platform can effectively improve medication compliance in patients with hip fractures and significantly reduce the incidence of thrombosis.